The Influence Of Diabetes On Modic Changes And Its Clinical Significance

Objective:To explore the influence of diabetes and related indicators(Hb A1c,diabetes course)on Modic changes(MC),to evaluate whether it is a risk factor for the occurrence of MC,and to provide new ideas for the prevention of MC.Methods:A total of 1331 internal medicine disease patients who were hospitalized in the Department of Endocrinology and Comprehensive Internal Medicine of the First Affiliated Hospital of Fujian Medical University during the period 2013.012020.10 without lumbar spine surgery were collected retrospectively,and 325 patients were finally determined according to the inclusion and exclusion criteria.The demographic and laboratory data were collected,and MRI reading was performed to evaluate the degeneration of the endplate and the bone marrow under the endplate of each lumbar intervertebral space and the degeneration of the lumbar intervertebral disc.According to the presence or absence of MC,it is divided into MC group and nonMC group.In order to eliminate the interference of factors such as age and BMI,we innovatively apply 1:1casecompared matching method to match by age(±3 years),same gender,and BMI (±0.5kg/m~2),and thus obtained Matched MC group and nonMC group.For the data before and after the matching,the t test,u test,Pearson chisquare test or Monte Carlo test were used to analyze the correlation between the presence or absence of diabetes,HbA1c,the course of diabetes,the history of smoking and alcohol and the MC.The data was subjected to conditional logistic regression analysis to further explore the risk factors of MC.Results:(1)BMI,age and HbA1c in the MC group was higher than that in the nonMC group(P<0.05).The proportion of Pfirrmann grade IV and V degeneration,ypertensive patients,diabetic patients in the MC group was also higher than that of the nonMC group(P<0.05),and there was no significant difference between the two roups in gender,history of smoking and alcohol,history of hyperlipidemia,and course of diabetes(P>0.05).(2)Most of the MC occurred in the lower two lumbar ntervertebral spaces(64%),and the MC occurred most often in the L5/S1 space(36%).In the classification of MC,the occurrence rate of MC II changes was the highest,followed by type I,and type III the least.(3)For postmatching data analysis,Hb A1c in the MC group was higher than that of the nonMC group(P<0.05).The proportion of Pfirrmann IV and V degeneration and diabetic patients was higher than that of the nonMC group(P<0.05),and there were no significant differences in gender,age,BMI,history of smoking and alcohol,history of hypertension,history of hyperlipidemia,and ourse of diabetes(P>0.05).(4)For the data analysis after matching,the MC group had a higher proportion of severe intervertebral disc degeneration(Pfirrmann grade IV,V)in each lumbar intervertebral space than the nonMC group(P<0.001).(5)Conditional logistic regression analysis was performed on the matched data.After multifactor correction,the results showed that Hb A1c(OR:1.267,95%CI:1.0211.572,P=0.031)was statistically significant,that is,for every 1 unit increase in Hb1Ac,The risk of MC increased by 1.267 times.Conclusion:Diabetes is related to Modic changes.Higher blood glucose levels are considered to be a risk factor for Modic changes.Clinically optimizing the blood glucose control of diabetic patients can reduce the incidence of Modic changes,and reduce the risk of low back pain caused by this,and improve the quality of life of diabetic patients.