血脂水平升高与颈椎间盘突出的关系:病例对照研究

Relationship between serum lipid level and the risk of cervical disc herniation:A case-control study

目的探讨血脂水平与颈椎间盘退行性病变之间的相关性。方法收集2012年1月-2013年5月入住北京天坛医院脊柱外科的颈椎间盘突出患者101例作为病例组,另收集同一时期因四肢外伤入院的102例患者作为对照组,记录每位研究对象的人口统计学资料、身高、体重、高血压史、糖尿病史、吸烟饮酒情况,检测其空腹血脂水平（总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白）,进行两组间的成组匹配病例对照研究,探讨血脂水平与颈椎间盘退行性病变之间的相关性。结果病例组与对照组匹配良好,两组基线特征差异无统计学意义（P〉0.05）。与对照组相比,病例组中吸烟者及饮酒者比例均明显升高（40.59%vs 19.61%,P=0.004;31.68%vs 5.88%,P〈0.001）。单因素分析显示,病例组总胆固醇水平与甘油三酯水平显著高于对照组,而两组低密度脂蛋白及高密度脂蛋白水平差异无统计学意义。多因素调整后显示甘油三酯水平升高可显著增加颈椎间盘突出的风险（OR=1.90,95%CI 1.25～2.90）。同时调整总胆固醇水平与甘油三酯水平后,甘油三酯水平仍是颈椎间盘突出的独立预测因子。结论甘油三酯升高可能增加颈椎间盘突出的风险,但因果关系的确证需进一步的研究证据支持。

Objective To assess the relationship between the lipid level and the risk of cervical disc degeneration. Methods A standardized case-control study of cervical disc herniation was formulated. One hundred and one patients with cervical disc herniation, and 102 patients with wounded limbs as control were admitted to B eijing Jishuitan Hospital from January 2012 to May 2013. The data of demographics, history of hypertension and type 2 diabetes, smoking and drinking habit were collected from all the patients. At the time of hospitalization, levels of total cholesterol, triglyceride, low-density lipoprotein （LDL） cholesterol and high- density lipoprotein （HDL） cholesterol in fasting blood were measured by automatic biochemical analyzer in all patients, and the group matched case-control study was performed to assess the relationship between the lipid level and cervical disc degeneration. Results No differences were found in gender and age between cases and controls. Compared with controls, the levels of total cholesterol and triglyceride were significantly higher in the patients, with the values of 4.88mmol/L vs 4.47mmol/L （P=0.002） and 1.89 mmol/L vs 1.28mmol/L （P=0.003）, respectively. Triglyceride level was significantly correlated with cervical disc degeneration after adjustment for multiple covariates through logistic regression. The summary odds ratio （95% confidence interval） per lmmol/ L increase of triglyceride was 1.90（1.25, 2.90）, and that of triglyceride was an independent predictive factor for cervical disc herniation after adjustment of total cholesterol and triglyceride levels. Conclusion Elevated triglyceride level may increase the risk of cervical disc herniation. However, more evidences are needed to validate the cause and effect.