{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T17:30:31Z","timestamp":1781803831318,"version":"3.54.5"},"reference-count":37,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T00:00:00Z","timestamp":1611532800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>A sex- and age-matched case-control study and a cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>In our previous study, patients with early-onset (&lt;50 years of age) ossification of the posterior longitudinal ligament (OPLL) had distinct features such as morbid obesity, a high prevalence of lifestyle-related diseases, and diffuse ossified lesions mainly affecting the thoracic spine. Our goals were to determine whether early-onset OPLL patients have unbalanced dietary habits and to identify nutritional factors associated with OPLL exacerbation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In Study 1, the simple brief-type self-administered diet history questionnaire (BDHQ) was used to compare nutrient intake levels of early-onset OPLL patients (n = 13) with those of sex- and age-matched non-OPLL controls (n = 39) or with those of common OPLL (onset age \u2265 50 years, n = 62). In Study 2, serological validation was conducted for thoracic OPLL patients (n = 77) and non-OPLL controls (n = 101) in a nationwide multicenter study in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The BDHQ showed that the early-onset OPLL patients had significantly lower intakes of vitamins A and B6 than non-OPLL controls. These results were validated by lower serum vitamins A and B6 levels in the early-onset thoracic OPLL patients. The severity of OPLL negatively correlated with serum vitamin A levels in male early-onset OPLL patients. The multiple regression analysis revealed that the severity of thoracic OPLL had an association with onset age and serum vitamin A level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Vitamin A deficiency resulting from unbalanced dietary habits is associated with exacerbation of male early-onset OPLL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2192568221989300","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T21:29:55Z","timestamp":1611610195000},"page":"1770-1780","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Association Between Vitamin A Intake and Disease Severity in Early-Onset Heterotopic Ossification of the Posterior Longitudinal Ligament of the Spine"],"prefix":"10.1177","volume":"12","author":[{"given":"Tsutomu","family":"Endo","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1721-9626","authenticated-orcid":false,"given":"Shiro","family":"Imagama","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Showa Ward, Nagoya, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kaito","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Sakai","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Japan Organization of Occupational Health and Safety, Spinal Injuries Center, Iizuka, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Ikegawa","sequence":"additional","affiliation":[{"name":"Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Minato-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiharu","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Kanayama","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Hisada","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinao","family":"Koike","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Showa Ward, Nagoya, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1533-3476","authenticated-orcid":false,"given":"Kazuyoshi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Showa Ward, Nagoya, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itaru","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hokkaido Orthopedic Memorial Hospital, Toyohira-ku, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazufumi","family":"Okada","sequence":"additional","affiliation":[{"name":"Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Takagi","sequence":"additional","affiliation":[{"name":"Clinical Research and 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"key":"bibr1-2192568221989300","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0040587"},{"key":"bibr2-2192568221989300","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2011.5.4.267"},{"key":"bibr3-2192568221989300","doi-asserted-by":"publisher","DOI":"10.14336\/AD.2017.0201"},{"key":"bibr4-2192568221989300","doi-asserted-by":"publisher","DOI":"10.1007\/s00774-019-01026-8"},{"key":"bibr5-2192568221989300","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.2009.00228.x"},{"issue":"11","key":"bibr6-2192568221989300","first-page":"1059","volume":"64","author":"Musha Y","year":"1990","journal-title":"Nippon Seikeigeka Gakkai 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