Study Finds Connection Between Biomarkers and Disc Degeneration

Dino Samartzis, Ph.D., a research assistant professor in the Department of Orthopaedics & Traumatology at the University of Hong Kong and Queen Mary Hospital in China, presented a study at the recent International Society for the Study of the Lumbar Spine meeting held in Scottsdale, Ariz. Researchers from Finland and China found that elevated serum biomarker ratios of tyrosine-lactate and valine to histidine were associated with lumbar disc degeneration.

“This is the first study, to my knowledge, that addresses serum metabolomics with regards to the relationship of lumbar disc degeneration, and this gives us a much greater depth of knowledge looking at the molecular descent of disc degeneration,” Samartzis said during his presentation. “We have identified some interesting serum biomarkers related to early as well as moderate to severe disc degeneration.”

Samartzis and his colleagues assembled a database of 3,500 Chinese volunteers who offered their magnetic resonance imaging scans, genetic profiles, environmental factors and lifestyle factors related to disc degeneration and low back pain. Out of that list, the researchers assessed the serum metabolomic profiles of the first 810 individuals. The researchers used Schneiderman radiographic criteria to assess disc degeneration from L1 to S1 (the lower third of the spinal column) and obtained a summated score to determine patients’ global severity of disc degeneration. The participants had a mean age of 51 years and 61 percent were women.

Seventy-seven percent of the participants had disc degeneration and 20 percent had moderate to severe degeneration.

“We saw something interesting: With an increase in lumbar disc degeneration, we saw an increased trend in these levels of tyrosine-lactate on a systemic level utilizing a metabolomic approach,” Samartzis said. “Utilizing other types of statistical analysis looking at sensitivity and specificity of various markers related to the different types of lactate ratio, we found this marker of greater than 0.029 was significantly associated with moderate to severe forms of disc degeneration.”

The study also concluded that the valine to histidine ratio was significantly associated with moderate to severe forms of lumbar disc degeneration.

“This large-scale study and initiative provides the foundation for new and exciting research into assessing how our body’s metabolic state can affect the spine,” Samartzis added. “Although further studies are needed, ‘spino-metabolomics’ has the potential to one day build on the concept of personalized spine care, and in that how it can be used for diagnostic, prognostic and novel therapeutic considerations to treat the disc and other spinal disorders.”