Relationship between hyperlipidemia and lumbar disc degeneration in patients with low back pain: an observational retrospective study

Front Physiol. 2026 Jun 3;17:1810691. doi: 10.3389/fphys.2026.1810691. eCollection 2026.

ABSTRACT

OBJECTIVE: To investigate the association between hyperlipidemia lumbar disc degeneration (LDD) in patients hospitalized for low back pain.

METHODS: A total of 165 patients with hyperlipidemia hospitalized for low back pain (mean age 44.06 ± 9.69 years; BMI 25.95 ± 2.55 kg/m²; 59.39% male) were enrolled and compared with 165 age-, sex-, and BMI-matched non-hyperlipidemic controls. The Pfirrmann grading system was utilized to evaluate the severity of LDD in both groups. The primary outcome was the difference in radiographic features of disc degeneration between groups, while secondary outcomes assessed the correlation between specific lipid profiles and the severity of LDD.

RESULTS: The hyperlipidemia group exhibited a significantly higher number of degenerated discs compared to the non-hyperlipidemia group (P<0.05), with significant differences observed particularly at the L1/2, L2/3, and L3/4 levels (P<0.05). The number of severely degenerated discs was also significantly higher in the hyperlipidemia group (P = 0.008), most notably at the L1/2 and L2/3 levels (P = 0.044 and P = 0.026, respectively). Furthermore, the prevalence of multi-level LDD was significantly higher in the hyperlipidemia group (P<0.05). While there was no significant difference in the number of patients with 3-level degeneration between the two groups (P = 0.238), significant differences were found in 4-level and 5-level degeneration (P<0.05). Abnormalities in Total Cholesterol (TC), Triglycerides (TG), and Lipoprotein(a) [Lp(a)] were associated with LDD (P<0.05); however, no significant difference in LDD severity was found among the four subtypes of hyperlipidemia (hypercholesterolemia, hypertriglyceridemia, mixed hyperlipidemia, and low HDL cholesterolemia) (P>0.05).

CONCLUSION: This study demonstrates a significant association between hyperlipidemia and lumbar disc degeneration. Patients with hyperlipidemia hospitalized for low back pain present with a greater number of degenerated discs, a higher propensity for multi-level degeneration, and a significantly higher proportion of severe degeneration. Elevated levels of TC, TG, and Lp(a) are correlated with the severity of lumbar disc degeneration. Future research is needed to conduct a forward-looking study to determine whether lipid regulation has a preventive or therapeutic effect on intervertebral disc-related low back pain.

PMID:42318506 | PMC:PMC13272483 | DOI:10.3389/fphys.2026.1810691