Comorbidity of type 2 diabetes mellitus and low back pain

Iskra D.A.

doi:https://doi.org/10.17116/jnevro2018118081126

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Abstract:

Diabetes mellitus (DM) and back pain are widespread and often develop simultaneously. In patients with DM 2 type, the incidence of back pain is increased. The association of DM with the severity of pain and the frequency of its chronization and recurrence has been revealed. The most likely mechanism of such an association is the lesion of intervertebral discs mediated by the accumulation of advanced glycation end-products (EGP). In DM the concentration of EGP increases significantly; they initiate ectopic calcification, a decrease in cell density in the end plates, and changes in vertebras. Cells of the pulpous nuclei begin to produce pro-inflammatory cytokines and chemokines that trigger the processes of angio- and neurogenesis. Dorsopathies develop due to other etiological factors, but the mechanisms of systemic inflammation are similar. Thus, DM and back pain are comorbid pathologies with common elements in pathogenesis. To prevent the development of dorsopathy in DM 2 type it is considered promising to use drugs that reduce the intensity of accumulation of AGP and inhibitors of pro-inflammatory cytokines, for example, symptomatic slow acting drugs.

Keywords:

type 2 diabetes mellitus

low back pain

intervertebral disc

advanced glycation end-products

proinflammatory cytokines

neurogenesis

angiogenesis

symptomatic slow acting drugs

Authors:

Iskra D.A.

Kirov Military Medical Academy, Saint-Petersburg, Russia

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References:

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