title: Modic changes in the lumbar spine and their association with body composition, fat distribution and intervertebral disc height - a 3.0 T-MRI study.
abstract: BACKGROUND
  Vertebral endplate (Modic) abnormalities are important structural lesions in the spine, but their association with body composition and fat distribution have not been examined. Moreover, no study has examined whether Modic change are related to other structural features of low back pain, such as reduced intervertebral disc height.
  
  
  METHODS
  Seventy-two community-based individuals not selected for low back pain had lumbar vertebral Modic change and intervertebral disc height assessed from MRI. Dual energy x-ray absorptiometry measured body composition and fat distribution.
  
  
  RESULTS
  The predominance of Modic change was type 2. Modic change was associated with an increased fat mass index (OR 1.20, 95 % CI 1.01 to 1.43), and tended to be associated with a reduced fat-free mass index (OR 0.62, 95 % CI 0.37 to 1.03, p = 0.07). While an increased percentage of gynoid fat was associated with a reduced risk (OR 0.62, 95 % CI 0.43 to 0.89), an increased percentage of android fat was associated with an increased risk of Modic change (OR 2.11, 95 % CI 1.18 to 3.76). Modic change was also associated with reduced intervertebral disc height at L2/3, L4/5 and L5/S1 (OR range 1.4 to 1.8; all p ≤ 0.03).
  
  
  CONCLUSIONS
  Modic type 2 change is associated with reduced intervertebral disc height and an increased fat mass index. Whereas gynoid fat distribution protected against Modic type 2 change, an android pattern increased the risk of this lesion. Modic type 2 change, which histologically represent fat replacement, might have a metabolic component to its aetiology.
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia. andrew.teichtahl@monash.edu.|Baker IDI Heart and Diabetes Institute, Commercial Road, Melbourne, VIC, 3004, Australia. andrew.teichtahl@monash.edu.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Teichtahl
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia. donna.urquhart@monash.edu.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Urquhart
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia. yuanyuan.wang@monash.edu.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia. anita.wluka@monash.edu.
authors.forename: Anita E
authors.initials: AE
authors.lastname: Wluka
authors.affiliation: Healthcare Imaging Services, Epworth Hospital, Richmond, Melbourne, VIC, 3121, Australia. richard.o'sullivan@helthcareimaging.com.au.|Department of Medicine, Central Clinical School, Monash University, Melbourne, VIC, 3004, Australia. richard.o'sullivan@helthcareimaging.com.au.
authors.forename: Richard
authors.initials: R
authors.lastname: O'Sullivan
authors.affiliation: Menzies Research Institute, Private bag 23, Hobart, TAS, 7000, Australia. graeme.jones@utas.edu.au.
authors.forename: Graeme
authors.initials: G
authors.lastname: Jones
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia. flavia.cicuttini@monas.edu.
authors.forename: Flavia M
authors.initials: FM
authors.lastname: Cicuttini
mesh_terms: D000328:Adult; D001823:Body Composition / Q000502:physiology*; D050218:Body Fat Distribution / Q000009:adverse effects* / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D007405:Intervertebral Disc Displacement / Q000175:diagnosis* / Q000209:etiology; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged