title: Progression, incidence, and risk factors for intervertebral disc degeneration in a longitudinal population-based cohort: the Wakayama Spine Study.
abstract: The present study examined the progression, incidence, and risk factors for intervertebral disc degeneration (DD) throughout the lumbar spine using magnetic resonance imaging (MRI) in a large population-based cohort.
  
  
  
  We followed up 617 subjects for more than 4 years as part of the Wakayama Spine Study. 1) "Progression of DD" in each of the entire, upper (L1/2 to L3/4) and lower (L4/5 and L5/S1) lumbar spine was defined as Pfirrmann grade progression at follow-up in at least one disc in the affected region. 2) "Incidence of DD" in each of these regions was defined if all discs were grade 3 or lower (white disc) at baseline, and at least one disc had progressed to grade 4 or higher (black disc) at follow-up. Logistic regression analyses were used to determine the risk factors for progression and incidence of DD.
  
  
  
  DD progression and incidence in the entire lumbar spine were 52.0% and 31.6% in men, and 60.4% and 44.7% in women, respectively. Women was associated with DD progression in the upper lumbar spine (odds ratio [OR] = 1.68, 95% confidence interval [CI] = 1.18-2.42). Aging was associated with the incidence of DD in each region (entire: OR = 1.14, CI = 1.06-1.14; upper: OR = 1.10, CI = 1.05-1.15; lower: OR = 1.11, CI = 1.05-1.19). Diabetes mellitus (DM) was associated with the incidence of DD in the upper lumbar spine (OR = 6.83, CI = 1.07-133.7).
  
  
  
  This 4-year longitudinal study is the first to demonstrate DD progression and incidence in the lumbar spine and their risk factors in a large population-based cohort.
authors.affiliation: Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Teraguchi
authors.affiliation: Department of Joint Disease Research, 22nd Century Medical & Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Yoshimura
authors.affiliation: Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan. Electronic address: hashizum@wakayama-med.ac.jp.
authors.forename: H
authors.initials: H
authors.lastname: Hashizume
authors.affiliation: Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yamada
authors.affiliation: Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Oka
authors.affiliation: Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Minamide
authors.affiliation: Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nagata
authors.affiliation: Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ishimoto
authors.affiliation: Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Kagotani
authors.affiliation: Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kawaguchi
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Rehabilitation Services Bureau, National Rehabilitation Center for Persons with Disabilities, Tokorozawa City, Saitama, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Akune
authors.affiliation: Rehabilitation Services Bureau, National Rehabilitation Center for Persons with Disabilities, Tokorozawa City, Saitama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Joint Disease Research, 22nd Century Medical & Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Muraki
authors.affiliation: Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yoshida
mesh_terms: D000368:Aged; D048909:Diabetes Complications / Q000150:complications / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D015994:Incidence; D055959:Intervertebral Disc Degeneration / Q000453:epidemiology / Q000209:etiology*; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000453:epidemiology / Q000209:etiology; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D006442:Glycated Hemoglobin
keywords: Aging; Diabetes mellitus; Epidemiology; Incidence; Intervertebral disc degeneration; Longitudinal large population cohort; Progression; ROAD study