The association between dyslipidemia and intervertebral disc degeneration: a prospective cohort study based on the UK...

Intervertebral disc degeneration (IDD) is a progressive and debilitating condition associated with aging, inflammation, and metabolic disorders. Although dyslipidemia has been implicated in IDD pathogenesis, large-scale prospective evidence remains limited. This study aimed to investigate the observational association between serum lipid traits and IDD risk using data from the UK Biobank.

A prospective cohort study was conducted among 298,226 participants (aged 37-73 years; 54.2% female, n = 161,770) without IDD at baseline. Serum lipid levels, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A (Apo A) and apolipoprotein B (Apo B), were measured at enrollment. IDD cases were identified via ICD-10 codes. Cox proportional hazards models, adjusted for demographic, lifestyle, and comorbid factors, were used to assess associations between lipid levels and IDD risk. Restricted cubic spline analyses explored potential nonlinear relationships, and subgroup analyses examined effect modifications.

Over a median follow-up of 12 years, 8,745 participants developed IDD. Higher levels of TC (> 5.64 mmol/L) and TG (> 1.51 mmol/L) were significantly associated with increased IDD risk. Compared with the lowest quintile, the highest TC quintile was associated with a 10.2% increased risk (HR = 1.102; 95% CI: 1.029-1.181; P = 0.006), and the highest TG quintile with an 11.3% increased risk (HR = 1.113; 95% CI: 1.036-1.195; P = 0.003), after full adjustment. No significant associations were found for LDL-C, HDL-C, Apo A, or Apo B after multivariable adjustment (all P > 0.05). Subgroup analyses revealed significant interactions between age and TG (P for interaction < 0.05), with younger participants (≤ 60 years) showing a stronger association. Additionally, age modified the effects of HDL-C and Apo A. These findings provide observational evidence that lipid traits may be differentially associated with IDD risk across age groups.

Higher TC and TG levels were associated with increased IDD risk. These findings provide observational evidence for the role of lipid levels in stratifying IDD risk. Routine lipid screening may help identify high-risk individuals and guide early prevention strategies.