Leino-Arjas Päivi, Solovieva Svetlana, Kirjonen Juhani, Reunanen Antti, Riihimäki Hilkka
Finnish Institute of Occupational Health, Department of Epidemiology and Biostatistics, Topeliuksenkatu 41 a A, FIN-00250 Helsinki, Finland.
Scand J Work Environ Health. 2006 Feb;32(1):12-9. doi: 10.5271/sjweh.971.
Atherosclerosis of the lumbar vessels has been suggested as a mechanism leading to low-back pain (LBP). We studied whether seven cardiovascular disease (CVD) risk factors predict LBP.
A sample (N=902) stratified by gender, age, and occupational class was drawn from employees in an engineering company in 1973 and examined for body mass index (BMI), smoking, exercise, serum total cholesterol and triglyceride concentrations, systolic blood pressure (SBP), diastolic blood pressure (DBP), and LBP. By November 2000, 232 persons had died, 108 from cardiovascular causes. In 2000, 546 (81% of the survivors) responded to a follow-up questionnaire on, for example, LBP.
Among the men, frequent local LBP at follow-up was predicted by high triglyceride and DBP levels and being a past smoker at baseline, adjusted for age, occupational class and frequent local LBP at baseline. In analogous models, high triglyceride and SBP levels and smoking (past and current) predicted frequent radiating LBP. An increased LBP score was predicted by a high BMI, serum total cholesterol, triglyceride, SBP and DBP levels, and smoking status at baseline. When BMI was allowed for, the associations between triglyceride level and all LBP outcomes persisted, as well as the association between SBP and frequent radiating LBP and an increased LBP score. An overall score of CVD risk factors showed a graded association with increased LBP. Among the women, a high BMI predicted frequent local and radiating LBP, and smoking at baseline predicted frequent radiating LBP and an increased LBP score.
The study adds to the evidence supporting the atherosclerosis-LBP hypothesis particularly for men.
腰椎血管动脉粥样硬化被认为是导致腰痛（LBP）的一种机制。我们研究了七种心血管疾病（CVD）危险因素是否可预测腰痛。
1973年从一家工程公司的员工中抽取了一个按性别、年龄和职业类别分层的样本（N = 902），并对其进行体重指数（BMI）、吸烟、运动、血清总胆固醇和甘油三酯浓度、收缩压（SBP）、舒张压（DBP）以及腰痛的检查。到2000年11月，232人已死亡，其中108人死于心血管疾病。2000年，546人（占幸存者的81%）回复了一份关于腰痛等情况的随访问卷。
在男性中，经年龄、职业类别和基线时的频繁局部腰痛校正后，随访时频繁的局部腰痛可由高甘油三酯和DBP水平以及基线时曾吸烟预测。在类似模型中，高甘油三酯和SBP水平以及吸烟（过去和现在）可预测频繁的放射性腰痛。基线时高BMI、血清总胆固醇、甘油三酯、SBP和DBP水平以及吸烟状况可预测腰痛评分增加。当考虑BMI时，甘油三酯水平与所有腰痛结局之间的关联仍然存在，SBP与频繁放射性腰痛以及腰痛评分增加之间的关联也仍然存在。CVD危险因素的总体评分与腰痛增加呈分级关联。在女性中，高BMI可预测频繁的局部和放射性腰痛，基线时吸烟可预测频繁的放射性腰痛和腰痛评分增加。
该研究进一步证明了支持动脉粥样硬化 - 腰痛假说的证据，尤其是对男性而言。
