BACKGROUND: Various vascular risk factors such as smoking, obesity, and diabetes mellitus are associated with hyperviscosity and lumbar disc herniation (LDH). However, the changes of viscosity in LDH have not been examined.
AIMS: The present study was to elucidate 1) the rheological parameter levels in patients with LDH, 2) the risk factors that were related to rheological parameters.
METHODS: Our study evaluated the rheological parameters in 307 cases with LDH and in 307 control subjects. Multiple linear regression analysis was conducted to assess the significant factors for whole blood viscosity (WBV) at low shear rate.
RESULTS: LDH patients had markedly lower physical activity and significantly higher WBV 3 s–1 compared with non-LDH subjects (p < 0.001). Moreover, WBV (3 s–1) tended to increase as physical activity decreased. Multiple linear regression analysis revealed that reduced physical activity was a significant factor contributing to elevated WBV (3 s–1).
CONCLUSIONS: WBV (3 s–1) is elevated in patients with LDH. In addition, reduced physical activity is a significant factor for WBV (3 s–1). Further studies are warranted to determine the role of WBV (3 s–1) in LDH.
AhmedH.M., BlahaM.J., NasirK., RiveraJ.J. and BlumenthalR.S., Effects of physical activity on cardiovascular disease, Am J Cardiol109 (2012), 288–295.
2.
BaskurtO.K. and MeiselmanH.J., RBC aggregation: More important than RBC adhesion to endothelial cells as a determinant of in vivo blood flow in health and disease, Microcirculation15 (2008), 585–590.
3.
BrunJ.F., Varlet-MarieE., RomainA.J. and
Mauvergerde R.E., Interrelationships among body composition, blood rheology and exercise performance, Clin Hemorheol Microcirc49 (2011), 183–197.
4.
CaralloC., IraceC., De FranceschiM.S.,
CoppolettaF.,
TirioloR.,
ScicchitanoC.,
ScavelliF. and
GnassoA., The effect of aging on blood and plasma viscosity. An 11.6 years follow-up study, Clin Hemorheol Microcirc47 (2011), 67–74.
5.
ChilibeckP.D., VatanparastH., CornishS.M., AbeysekaraS. and CharlesworthS., Evidence-based risk assessment and recommendations for physical activity: Arthritis, osteoporosis, and low back pain, Appl Physiol Nutr Metab36(Suppl 1) (2011), S49–S79.
6.
CowanA.Q., ChoD.J. and RosensonR.S., Importance of blood rheology in the pathophysiology of atherothrombosis, Cardiovasc Drugs Ther26 (2012), 339–348.
7.
de SimoneG.,
DevereuxR.B.,
ChienS.,
AldermanM.H.,
AtlasS.A. and
LaraghJ.H., Relation of blood viscosity to demographic and physiologic variables and to cardiovascular risk factors in apparently normal adults, Circulation81 (1990), 107–117.
8.
FardonD.F. and MiletteP.C., Nomenclature and classification of lumbar disc pathology. Recommendations of the Combined task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology, Spine (Phila Pa 1976)26 (2001), E93–93E113.
9.
GillJ.M., Celis-MoralesC.A. and GhouriN., Physical activity, ethnicity and cardio-metabolic health: Does one size fit all, Atherosclerosis232 (2014), 319–333.
10.
GrunhagenT., Shirazi-AdlA., FairbankJ.C. and UrbanJ.P., Intervertebral disk nutrition: A review of factors influencing concentrations of nutrients and metabolites, Orthop Clin North Am42 (2011), 465–477, vii.
11.
JhawarB.S., FuchsC.S., ColditzG.A. and StampferM.J., Cardiovascular risk factors for physician-diagnosed lumbar disc herniation, Spine J6 (2006), 684–691.
12.
Joint Health Surveys Unit. Health Survey for England Physical Activity Validation Study: Substantive Report. Leeds: Health Social Care Information Centre, 2007.
KauppilaL.I., MikkonenR., MankinenP., Pelto-VaseniusK. and MaenpaaI., MR aortography and serum cholesterol levels in patients with long-term nonspecific lower back pain, Spine (Phila Pa 1976)29 (2004), 2147–2152.
15.
Kilic-ToprakE., ArdicF., ErkenG., Unver-KocakF., KucukatayV. and Bor-KucukatayM., Hemorheological responses to progressive resistance exercise training in healthy young males, Med Sci Monit18 (2012), CR351–CR360.
16.
LoefM. and WalachH., The combined effects of healthy lifestyle behaviors on all cause mortality: A systematic review and meta-analysis, Prev Med55 (2012), 163–170.
17.
LongoU.G., DenaroL., SpieziaF., ForriolF., MaffulliN. and DenaroV., Symptomatic disc herniation and serum lipid levels, Eur Spine J20 (2011), 1658–1662.
18.
MatraiA., WhittingtonR.B. and ErnstE., A simple method of estimating whole blood viscosity at standardized hematocrit, Clin Hemorheol7 (1987), 261–265.
19.
MeredithD.S., HuangR.C., NguyenJ. and LymanS., Obesity increases the risk of recurrent herniated nucleus pulposus after lumbar microdiscectomy, Spine J10 (2010), 575–580.
20.
NimmoM.A., LeggateM., VianaJ.L. and KingJ.A., The effect of physical activity on mediators of inflammation, Diabetes Obes Metab15(Suppl 3) (2013), 51–60.
21.
OlaussonE.A. and KilanderA., Glycaemic index of modified cornstarch in solutions with different viscosity. A study in subjects with diabetes mellitus type 2, Clin Nutr27 (2008), 254–257.
22.
PopG.A., DunckerD.J., GardienM., VranckxP., VersluisS., HasanD. and SlagerC.J., The clinical significance of whole blood viscosity in (cardio)vascular medicine, Neth Heart J10 (2002), 512–516.
23.
RoffeyD.M., WaiE.K., BishopP., KwonB.K., DagenaisS., Causal assessment of workplace manual handling or assisting patients and low back pain: Results of a systematic review, Spine J10 (2010), 639–651 .
24.
SakellaridisN., The influence of diabetes mellitus on lumbar intervertebral disk herniation, Surg Neurol66 (2006), 152–154.
25.
SloopG., HolsworthR.E.Jr,
WeidmanJ.J. and StC.J.A., The role of chronic hyperviscosity in vascular disease, Ther Adv Cardiovasc Dis9 (2015), 19–25.
26.
SoaresF.H. and de SousaM.B., Different types of physical activity on inflammatory biomarkers in women with or without metabolic disorders: A systematic review, Women Health53 (2013), 298–316.
27.
StrasserB., Physical activity in obesity and metabolic syndrome, Ann N Y Acad Sci1281 (2013), 141–159.
28.
ThomasK.C., FisherC.G., BoydM., BishopP., WingP. and DvorakM.F., Outcome evaluation of surgical and nonsurgical management of lumbar disc protrusion causing radiculopathy, Spine (Phila Pa 1976)32 (2007), 1414–1422.
29.
TsaiA.G., AceroC., NanceP.R., CabralesP., FrangosJ.A., BuerkD.G. and IntagliettaM., Elevated plasma viscosity in extreme hemodilution increases perivascular nitric oxide concentration and microvascular perfusion, Am J Physiol Heart Circ Physiol288 (2005), H1730–H1739.
30.
Varlet-MarieE.,
Mauvergerde R.E. and
BrunJ.F., Are overall adiposity and abdominal adiposity separate or redundant determinants of blood viscosity, Clin Hemorheol Microcirc (2014). DOI: 10.3233/CH-141861 [In press].
31.
WaiE.K., RoffeyD.M., BishopP., KwonB.K., DagenaisS., Causal assessment of occupational lifting and low back pain: Results of a systematic review, Spine J10 (2010), 554–566.
32.
WeinsteinJ.N., TostesonT.D., LurieJ.D., TostesonA.N., HanscomB., SkinnerJ.S., AbduW.A., HilibrandA.S., BodenS.D. and DeyoR.A., Surgical vs nonoperative treatment for lumbar disk herniation: The Spine Patient Outcomes Research Trial (SPORT): A randomized trial, JAMA296 (2006), 2441–2450.
33.
WiewioraM., SosadaK., SlowinskaL., PiecuchJ., GluckM., ZurawinskiW. and TurczynskiB., Sex-dependent differences in rheological properties and the relation of blood viscosity to erythrocyte aggregation indices among morbidly obese patients, Clin Hemorheol Microcirc44 (2010), 259–267.
