Comparative Analysis of Biological Aging and Inflammatory Profiles in Adult Spinal Deformity Patients Between Japan and the United States: A Correlative Study.
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2025-04
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Abstract
Study design
Retrospective matched cohort study.Objective
Understanding biological aging in adult spinal deformity (ASD) across different populations offers insights into its impact on aging and potential interventions.Summary of background data
ASD significantly impacts physiological health and may accelerate biological aging. Understanding biological aging in ASDs across different populations offers insights into ASD's impact on aging and potential interventions.Materials and methods
ASDs and norms from Japan (JP) and the U.S. (US) were included. The US norm consisted of 8,751 adults from NHNES 2017-20; the JP norm comprised 10,205 adults from health check-ups between 2020-23. Age- and gender-matched norm cohorts of 6,584 pairs (JP vs. US) were established (age: 55±13 vs. 55±14 y; female: 49 vs. 50%). ASD were age-, race- and gender-matched to norm individuals in JP (159 pairs) and the US (132 pairs). Additionally, 81 pairs of ASDs from JP and US were selected for cross-country comparisons.Results
The JP was biologically younger than the US (PhenoAge: mean difference [MD] -6.5±0.3 y; P<0.01). When comparing JP and US Asians, the JP remained biologically younger (MD: -3.1±0.7 y; P<0.01), suggesting lifestyle differences. JP ASDs were biologically older than their norms (MD: 4.2±1.7 y; P=0.02), indicating accelerated aging. However, no significant difference was observed between ASDs and the norms in the US. No significant difference in PhenoAge was found between JP and US ASDs (57.9±18.4 vs. 59.6±17.6 y; P=0.56). ASDs in both countries exhibited higher systemic inflammation, with US ASDs showing particularly elevated CRP levels (US ASD vs. norm: 2.8±8.5 vs. 0.4±0.8 mg/dL; P<0.01; JP: 0.5±1.3 vs. 0.2±0.4 mg/dL; P<0.01).Conclusions
JP are biologically younger than their US counterparts, potentially due to lifestyle factors. JP ASDs exhibit accelerated biological aging compared to the norm cohort, highlighting the impact of ASD on aging. Elevated systemic inflammation in ASDs underscores the importance of managing inflammatory processes.Type
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Yagi, Mitsuru, Naobumi Hosogane, Christopher P Ames, Michael P Kelly, Justin S Smith, Christopher I Shaffrey, Frank J Schwab, Virginie Lafage, et al. (2025). Comparative Analysis of Biological Aging and Inflammatory Profiles in Adult Spinal Deformity Patients Between Japan and the United States: A Correlative Study. Spine. 10.1097/brs.0000000000005370 Retrieved from https://hdl.handle.net/10161/32394.
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Christopher Ignatius Shaffrey
I have more than 25 years of experience treating patients of all ages with spinal disorders. I have had an interest in the management of spinal disorders since starting my medical education. I performed residencies in both orthopaedic surgery and neurosurgery to gain a comprehensive understanding of the entire range of spinal disorders. My goal has been to find innovative ways to manage the range of spinal conditions, straightforward to complex. I have a focus on managing patients with complex spinal disorders. My patient evaluation and management philosophy is to provide engaged, compassionate care that focuses on providing the simplest and least aggressive treatment option for a particular condition. In many cases, non-operative treatment options exist to improve a patient’s symptoms. I have been actively engaged in clinical research to find the best ways to manage spinal disorders in order to achieve better results with fewer complications.
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