Asthma and early herniated intervertebral disc disease

Abstract

Background: The etiology of herniated intervertebral disc (HIVD) disease in children and adolescents is multifactorial and not merely related to disc degeneration. Therefore, in the present study, we investigated the relationship between young asthma patients and the risk of early HIVD disease in a population under 30 years of age.

Methods: Data from the National Health Insurance Research Database (NHIRD) of Taiwan were used to conduct a retrospective longitudinal cohort study. The study cohort comprised 23,470 patients with asthma (asthma group) and 23,470 patients without asthma (non-asthma group), who were selected through frequency matching on the basis of sex, age, and the index year. The study patients were followed until HIVD disease occurrence, withdrawal from the National Health Insurance program, or 31 December 2013. Cox proportional hazards regression analysis was conducted to assess the risk of HIVD disease in the asthma group after adjustment for sex, age, and comorbidities.

Results: After adjustment for sex, age, and comorbidities, the asthma group had a 1.69-fold (95% confidence interval [CI] = 1.29–2.23) higher risk of HIVD disease than did the non-asthma group. In addition, the asthma group had a higher risk of cervical and lumbar HIVD diseases than did the non-asthma group (adjusted hazard ratio [HR] = 2.38; 95% CI = 1.25–4.57 and adjusted HR = 1.56; 95% CI = 1.15–2.12, respectively).

Conclusions: Young patients with asthma are at a significantly higher risk of early cervical or lumbar HIVD disease.

Keywords:

• Age
• adolescent
• asthma
• cohort
• HIVD

Transparency

Declaration of funding

This study was supported by the Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW106-TDU-B-212-113004); China Medical University Hospital; the Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10501010037); the NRPB Stroke Clinical Trial Consortium (MOST 105-2325-B-039-003); the Tseng-Lien Lin Foundation, Taichung, Taiwan; the Taiwan Brain Disease Foundation, Taipei, Taiwan; and the Katsuzo and Kiyo Aoshima Memorial Funds, Japan.

Author contributions: conception/design: C.-D.C. and C.-H.K.; provision of study materials: C.-H.K.; data collection and assembly: all authors; data analysis and interpretation: all authors; manuscript preparation: all authors; final approval of manuscript: all authors.

Declaration of financial/other relationships

C.-D.C., H.-J.C., H.-P.S., N.-W.Y., H.-R.Y. and C.-H.K. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

We acknowledge the participation of Cheng-Yi Kuo in data interpretation.