Is spinal osteophytosis associated with fatty liver?

Lipopolysaccharide (LPS) is a bacterial endotoxin. LPS-induced cartilage damage is widely used as a model to investigate the effectiveness of cartilage protective agents in vitro. Overwhelming liver LPS of intestinal origin break impaired liver barriers, achieve blood stream in low but sustained accounts and spread to joints. That results in LPS-binding protein (LBP) - CD14 activation of inflammatory response and development of degenerative joints changes (osteophyte formation and cartilage loss). Easy penetration of LPS into circulation may be a result from liver dysfunction associated with fatty liver. We proposed an analogical in vivo model of bone degenerative changes related to fatty liver. Ultrasound (US) images of patients admitted to the emergency department for abdominal pain were revised. Fifty two patients were divided to two groups. The first included 26 patients (M/F =13/13, age of 56.2±8.5 years) with US features of fatty liver. The second comprised of 26 patients (M/F=13/13, age of 57.5±8.0 years, P=0.56) without US features of fatty liver. Retrospective analysis of images of the whole spine (X-ray, computed tomography) in both populations obtained from the hospital imaging data base, was performed. Four maximal size spinal osteophytes were measured. In order to reduce an influence of individual body size factors the spine osteophyte radial length/vertebral width (O/V) ratio was calculated. Hence, the osteophyte size was measured as a part of a vertebral width. Correlation between osteophytes' size, patient age, and body mass index (BMI) in both groups was assessed. Spine osteophytes of patients with fatty liver had a bigger size (O/V=0.21±0.06) compared with patients with normal liver (O/V=0.14±0.03, P<0.001). Fatty liver patients had a higher BMI (32.7±5.4 kg/m2) compared to normal liver patients (28.0±6.7kg/m2, P=0.031). Spine with normal liver had marginal vertebral bulging less 0.17 or 17% of the vertebral width. Maximal osteophyte size was 0.3 of the vertebral width or 30% in fatty liver group. In order to distinguish an influence of BMI and fatty liver on O/V, patients of normal liver group were divided according to increased BMI (>25 kg/m2) and normal one (<25 kg/m2). O/V of both subgroups showed similar values: 0.14±0.03 (high BMI) and 0.13±0.02 (normal BMI) (P=0.52). BMI of the subgroups was significantly different: 31.8±5.4 (high BMI) and 21.3±1.7 (normal BMI) (P<0.001). No direct correlation was found between O/V and BMI in fatty liver and normal liver groups (P=0.81, P=0.51 respectively). In opposite, significant O/V and age correlation was found in normal liver group (P=0.014) and weak correlation in fatty liver group (P=0.063). Spine osteophytes of patients with fatty liver have a bigger size compared with patients with normal liver. Fatty liver may be considered as a predisposing factor in the pathogenesis of spine osteophytosis.