Leino-Arjas Päivi, Kauppila Leena, Kaila-Kangas Leena, Shiri Rahman, Heistaro Sami, Heliövaara Markku
Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FIN-00250 Helsinki, Finland.
Atherosclerosis. 2008 Mar;197(1):43-9. doi: 10.1016/j.atherosclerosis.2007.07.035. Epub 2007 Sep 7.
Atherosclerosis of arteries supplying the lumbar region has been suggested as a mechanism leading to intervertebral disc degeneration and sciatica. The study described here examined whether serum lipid levels or pharmacologically treated hyperlipidemia were associated with sciatica.
A nationally representative sample (n=8028) of Finns aged 30 years or over was interviewed and examined. Sciatica was assessed by a physician according to preset criteria. Information for the present purpose was available for 74.8% of the sample.
The prevalence of sciatica was 3.3% for men and 2.2% for women. In men without hyperlipidemia treatment, sciatica was associated with total cholesterol (high vs. low tertile: OR 2.28, 95% CI 1.14-4.55), LDL cholesterol (2.12; 1.11-4.05), and triglycerides (1.92; 1.04-3.55), adjusted for age, BMI, exercise, smoking, heavy physical work, and education. HDL was not associated with sciatica. For men in the highest tertile of both total cholesterol and triglycerides, the OR of sciatica was 3.89 (1.68-8.99) in comparison to men with cholesterol in the lowest tertile and triglycerides in the lowest or the middle tertile. In similar analyses among women no associations were seen. Pharmacologically treated hyperlipidemia was associated with sciatica in women (2.02; 1.01-4.04), but not in men (1.71; 0.83-3.55).
Independent of BMI and other possible confounders, clinically assessed sciatica in men was associated with levels of atherogenic serum lipids. Pharmacologically treated hyperlipidemia was associated with sciatica in women. The findings are in accordance with the atherosclerosis-sciatica hypothesis.
有研究提出，供应腰椎区域的动脉发生动脉粥样硬化是导致椎间盘退变和坐骨神经痛的一种机制。本文所述研究探讨了血清脂质水平或药物治疗的高脂血症是否与坐骨神经痛有关。
对芬兰30岁及以上具有全国代表性的样本（n = 8028）进行访谈和检查。由医生根据预设标准评估坐骨神经痛。本研究所需信息可从74.8%的样本中获取。
男性坐骨神经痛患病率为3.3%，女性为2.2%。在未接受高脂血症治疗的男性中，经年龄、体重指数、运动、吸烟、重体力劳动和教育程度校正后，坐骨神经痛与总胆固醇（高三分位数与低三分位数相比：比值比2.28，95%置信区间1.14 - 4.55）、低密度脂蛋白胆固醇（2.12；1.11 - 4.05）和甘油三酯（1.92；1.04 - 3.55）相关。高密度脂蛋白与坐骨神经痛无关。总胆固醇和甘油三酯均处于最高三分位数的男性，与胆固醇处于最低三分位数且甘油三酯处于最低或中间三分位数的男性相比，坐骨神经痛的比值比为3.89（1.68 - 8.99）。在女性的类似分析中未发现相关性。药物治疗的高脂血症与女性坐骨神经痛相关（2.02；1.01 - 4.04），但与男性无关（1.71；0.83 - 3.55）。
独立于体重指数和其他可能的混杂因素，临床评估的男性坐骨神经痛与致动脉粥样硬化血清脂质水平有关。药物治疗的高脂血症与女性坐骨神经痛相关。这些发现符合动脉粥样硬化 - 坐骨神经痛假说。
