Tsutomu Endo1, Shiro Imagama2, Satoshi Kato3, Takashi Kaito4, Hiroaki Sakai5, Shiro Ikegawa6, Yoshiharu Kawaguchi7, Masahiro Kanayama8, Yuichiro Hisada1, Yoshinao Koike1, Kei Ando2, Kazuyoshi Kobayashi2, Itaru Oda9, Kazufumi Okada10, Ryo Takagi10, Norimasa Iwasaki1, Masahiko Takahata1. 1. Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo, Hokkaido, Japan. 2. Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Showa Ward, Nagoya, Aichi, Japan. 3. Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan. 4. Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. 5. Department of Orthopedic Surgery, Japan Organization of Occupational Health and Safety, Spinal Injuries Center, Iizuka, Fukuoka, Japan. 6. Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Minato-ku, Tokyo, Japan. 7. Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan. 8. Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan. 9. Department of Spine Surgery, Hokkaido Orthopedic Memorial Hospital, Toyohira-ku, Sapporo, Hokkaido, Japan. 10. Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan.
Abstract
STUDY DESIGN: A sex- and age-matched case-control study and a cross-sectional study. OBJECTIVE: In our previous study, patients with early-onset (<50 years of age) ossification of the posterior longitudinal ligament (OPLL) had distinct features such as morbid obesity, a high prevalence of lifestyle-related diseases, and diffuse ossified lesions mainly affecting the thoracic spine. Our goals were to determine whether early-onset OPLL patients have unbalanced dietary habits and to identify nutritional factors associated with OPLL exacerbation. METHODS: In Study 1, the simple brief-type self-administered diet history questionnaire (BDHQ) was used to compare nutrient intake levels of early-onset OPLL patients (n = 13) with those of sex- and age-matched non-OPLL controls (n = 39) or with those of common OPLL (onset age ≥ 50 years, n = 62). In Study 2, serological validation was conducted for thoracic OPLL patients (n = 77) and non-OPLL controls (n = 101) in a nationwide multicenter study in Japan. RESULTS: The BDHQ showed that the early-onset OPLL patients had significantly lower intakes of vitamins A and B6 than non-OPLL controls. These results were validated by lower serum vitamins A and B6 levels in the early-onset thoracic OPLL patients. The severity of OPLL negatively correlated with serum vitamin A levels in male early-onset OPLL patients. The multiple regression analysis revealed that the severity of thoracic OPLL had an association with onset age and serum vitamin A level. CONCLUSIONS: Vitamin A deficiency resulting from unbalanced dietary habits is associated with exacerbation of male early-onset OPLL.
STUDY DESIGN: A sex- and age-matched case-control study and a cross-sectional study. OBJECTIVE: In our previous study, patients with early-onset (<50 years of age) ossification of the posterior longitudinal ligament (OPLL) had distinct features such as morbid obesity, a high prevalence of lifestyle-related diseases, and diffuse ossified lesions mainly affecting the thoracic spine. Our goals were to determine whether early-onset OPLL patients have unbalanced dietary habits and to identify nutritional factors associated with OPLL exacerbation. METHODS: In Study 1, the simple brief-type self-administered diet history questionnaire (BDHQ) was used to compare nutrient intake levels of early-onset OPLL patients (n = 13) with those of sex- and age-matched non-OPLL controls (n = 39) or with those of common OPLL (onset age ≥ 50 years, n = 62). In Study 2, serological validation was conducted for thoracic OPLL patients (n = 77) and non-OPLL controls (n = 101) in a nationwide multicenter study in Japan. RESULTS: The BDHQ showed that the early-onset OPLL patients had significantly lower intakes of vitamins A and B6 than non-OPLL controls. These results were validated by lower serum vitamins A and B6 levels in the early-onset thoracic OPLL patients. The severity of OPLL negatively correlated with serum vitamin A levels in male early-onset OPLL patients. The multiple regression analysis revealed that the severity of thoracic OPLL had an association with onset age and serum vitamin A level. CONCLUSIONS: Vitamin A deficiency resulting from unbalanced dietary habits is associated with exacerbation of male early-onset OPLL.