Level of serum beta carotene and its association with lumbar osteophyte formation

Introduction: Cause of chronic low back pain in persons over the age of 50 years include degenerative diseases like osteoarthritis of spine and spinal canal stenosis. Osteoarthritis of spine is a degenerative process19-30 identified radiologically by joint space reduction, marginal osteophytes and sub-chondral sclerosis. Nathan et al3 classified significantly osteophyte positive if more than SIX osteophytes are found from L1 / L2 to L5 /S1 vertebrae in the lumbar spine X-rays. Serum beta carotene is a carotenoid, which has anti-oxidant effect35-37 by increasing Glutathione levels in cells. Normal serum beta carotene level ranges from 0.74 nmol/ml to 3.72 nmols/ml. Based on literature, higher serum beta carotene levels are shown to halt the progression of many diseases including cardiac diseases 38,39 and degenerative changes in knee joint. But so far only a single study is available to co-relate the levels of serum beta carotene and lumbar spine osteophytes. Hence this study was done. Materials and Methods: This study was conducted at JIPMER, Pondicherry, from August 2015 to March 2017. It was conducted as OP procedure. 153 patients of over 50 years of year who complained of low back pain of more than 3 months duration were selected. Their personal history regarding alcohol drinking and smoking noted. Radiographs of lumbar spine A.P. and lateral views were taken. They were divided into osteophyte positive or negative as defined by Nathan.3 These patients' serum beta carotene levels were assessed. The level of serum beta carotene and its relationship with lumbar spine osteophyte formation was analysed. Results: Females predominated study 67% of patients were osteophyte negative and 33% were positive. 74% of osteophyte positive patients had serum beta carotene less than 0.7 nmol/ml and 26% had more than that. But, nearly all 98% of osteophyte negative had more than 0.7 nmol/ml of serum beta carotene, showing that the lumbar osteophyte formation is inversely proportional to the level of serum beta carotene levels. Our statistics also showed that there is a strong association between alcohol consumptions and smoking with lumbar osteophyte formation. Conclusion: Our study showed that low serum beta carotene levels predisposed and increased lumbar osteophyte formation. It also showed strong association between Alcohol consumption and Tobacco use with lumbar osteophyte formation.