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Type 2 diabetes can affect intervertebral disc collagen

by Corrie Pelc
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How type 2 diabetes affects the spine may explain why people experience lower back pain. Designed by MNT.Photography: Philadendron/Getty Images, Paul Harrisan/Getty Images
  • People with type 2 diabetes are at increased risk for several diseases and complications, including back pain.
  • Researchers at the University of California, San Diego and the University of Utah have reported in animal models that type 2 diabetes negatively affects the intervertebral discs that make up the spine.
  • This finding may explain why people with type 2 diabetes often experience chronic body pain, including back pain.

The researchers found that approx. 508 million people People all over the world have type 2 diabetes. Type 2 diabetes is a condition in which the body does not use insulin properly.

People with type 2 diabetes are at increased risk of: Heart disease, stroke, high blood pressure, kidney diseaseand dementia.

Type 2 diabetes can cause several health complications, including: nerve damage, eye disease, skin problems, sleep problemsand chronic body paininclude back pain.

Now, researchers from the University of California, San Diego and the University of Utah report that type 2 diabetes has negative health consequences. intervertebral disc It forms the spine.

Through animal models, scientists have discovered that type 2 diabetes causes symptoms such as: collagen fibrils The interior of the intervertebral disc loses its flexibility and constitutes its ability to withstand pressure.

New research recently published in the journal PNAS Nexus.

Past research has shown that type 2 diabetes can negatively impact your spine and back.

For example, people with type 2 diabetes have a higher risk of developing type 2 diabetes. Diffuse idiopathic skeletal hyperostosis (DISH). DISH is a type of arthritis that hardens the tendons and ligaments around the spine, causing stiffness, reduced movement, and pain.

A study published in March 2022 found that people with type 2 diabetes are at serious risk. high risk For lumbar disc degeneration.

Other studies have linked type 2 diabetes to an increased risk of other spinal diseases. spinal canal stenosis and vertebral osteomyelitis.

Previous studies have also shown an association with the progression of type 2 diabetes. chronic lower back pain.

Previous studies have shown that people with diabetes have the following symptoms: 35% increased risk They are more likely to experience lower back pain and 24% more likely to experience neck pain than people without the disease.

“We wanted to know whether the effects of diabetes seen on bones were also present in the discs. This could explain disc degeneration and low back pain in these people.” Dr. Claire Acevedoassistant professor in the Department of Mechanical and Aerospace Engineering at the University of California, San Diego, and adjunct assistant professor in the Department of Biomedical Engineering and Mechanical Engineering at the University of Utah, and co-lead author of the study. Today’s medical news When asked why he decided to focus his research on the spinal column,

In this study, the researchers used a rat model of type 2 diabetes. The intervertebral discs of type 2 diabetic rats were compared with those of healthy rats, and the deformation of collagen fibrils within the discs was investigated. The outer part of the disc is made of layers of collagen and protein.

Researchers found that in rats with type 2 diabetes, the compressive ability of intervertebral disc collagen fibrils is impaired, making the collagen stiff and brittle, making it difficult to withstand compression as well as when it is healthy. .

“Type 2 diabetes and the associated hyperglycemia (cross-linking) causes more collagen fibrils than normal, just as it accelerates aging.”
— Dr. Claire Acevedo

“This increased cross-linking, first, limits deformation of the collagen fibrils, making the collagen stiffer and more brittle, (and) second, limits laminar rotation, which is the normal compression mechanism within the disc. , which limits the energy dissipation mechanism,” he said. . Acevedo explained.

“Future treatments could target bridging to restore the disc’s ability to deform normally,” she added.

Scientists used an experimental technique called . Synchrotron small-angle X-ray scattering (SAXS) Check for changes in the behavior of collagen on the disc. nanoscale.

“Small-angle X-ray scattering is an X-ray diffraction technique that can measure the periodicity (67 nm) of collagen fibrils. Tensile testing in front of an X-ray beam increases the periodicity of collagen,” says Dr. Acevedo. said.

“Because we can capture changes in the periodicity of collagen, we can calculate the deformation and strain of the collagen and at the same time measure the deformation and strain of the entire disc,” she continued. “We can therefore see how much disc strain is transferred to the collagen level at the nanoscale.”

As a next step for this study, Dr. Acevedo said they will look at ways to find surrogates. Advanced glycation end products (AGEs) Crosslinking evaluation. AGE is biomarker related to aging and both development and deterioration It can cause degenerative diseases such as diabetes.

“Assessing AGEs content in discs and bones is complex and tedious, and although absolute content values ​​vary from tissue to tissue, assessing the increase in AGEs cross-linking in the skin can be difficult to assess for the same increase in discs and bone. That could be a good way to go,” she said. she said.

MNT I talked about this research with Dr. Neil Anandan orthopedic surgeon and director of the Cedars-Sinai Spine Center in Los Angeles, California.

Dr. Anand said he was not surprised by the study’s results.

“Type 2 diabetes affects collagen. It’s a collagen disease, and intervertebral discs are collagen,” he explained. “The outer ring of the disc is made of collagen fibers, so it’s not surprising that it affects the disc in some way, shape, or fashion.”

“Type 2 diabetes affects collagen throughout the body. Just as it affects blood vessels in the body, collagen is also affected. That’s the symptom of type 2 diabetes. That’s what causes problems, kidney problems. It affects a lot of things because type 2 diabetes causes a million problems, including eye problems.”
— Dr. Neil Anand

However, Dr. Anand pointed out that this study was conducted through a rat model.

“Humans are not rats,” he continued. “Does[this]apply to humans?” (It) probably does — there’s probably some element to it. Someday, someone will have to prove that this is true for humans as well. Ultimately you have to translate it to humans. ”

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