Centre of Expertise for Health and Work Ability, and Disability Prevention Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
Semin Arthritis Rheum. 2013 Jun;42(6):640-50. doi: 10.1016/j.semarthrit.2012.09.002. Epub 2012 Dec 25.
To study the effects of obesity, physical activity, and change in physical activity on the incidence of low back pain and explore whether obesity modifies the effects of physical activity.
As part of the ongoing Young Finns Study, 1224 subjects aged 24-39 years free from low back pain during the preceding 12 months at baseline in 2001 were included. Obesity was defined based on the body mass index (BMI) and waist circumference, and physical activity was assessed by the metabolic equivalent of task (MET) index in 2001 and 2007.
Abdominal obesity, defined by an increased waist circumference, was associated with an increased incidence of radiating low back pain (adjusted odds ratio (OR) = 1.7 and 95% confidence interval (CI) 1.1-2.7), while it had no effect on non-specific low back pain. BMI was associated neither with the incidence of radiating low back pain nor with non-specific low back pain. Compared with subjects who stayed active during follow-up, those with a low level of physical activity (adjusted OR = 2.0 and 95% CI 1.1-3.5) and active subjects who further increased their physical activity during follow-up (OR = 3.1 and 95% CI 1.5-6.7) had a higher incidence of radiating low back pain. Low level of physical activity was associated with an increased incidence of radiating low back pain in obese (OR = 3.3 and 95% 1.1-10.4), but not in non-overweight subjects (OR = 1.1 and 95% CI 0.6-1.9). Physical activity was not associated with non-specific low back pain.
Our findings indicate that both obesity and low level of physical activity are independent risk factors of radiating low back pain. The current findings propose a U-shaped relation between physical activity and radiating low back pain. Moderate level of physical activity is recommended for the prevention of low back pain, especially in obese individuals. In all, our findings imply that obese individuals should stay physically active, even if they may not lose weight.
研究肥胖、身体活动以及身体活动变化对腰痛发生率的影响，并探讨肥胖是否会改变身体活动的影响。
作为正在进行的芬兰年轻人研究的一部分，2001 年在基线时，共有 1224 名年龄在 24-39 岁之间、过去 12 个月内无腰痛的参与者纳入研究。肥胖是根据体重指数（BMI）和腰围来定义的，身体活动则通过 2001 年和 2007 年的代谢当量（MET）指数来评估。
腹部肥胖（腰围增加）与放射状腰痛的发生率增加有关（调整后的优势比（OR）=1.7，95%置信区间（CI）为 1.1-2.7），而与非特异性腰痛无关。BMI 与放射状腰痛或非特异性腰痛的发生率均无关。与随访期间保持活跃的参与者相比，身体活动水平较低（调整后的 OR=2.0，95%CI 为 1.1-3.5）和活跃的参与者在随访期间进一步增加身体活动（OR=3.1，95%CI 为 1.5-6.7）的放射状腰痛发生率更高。低水平的身体活动与肥胖者放射状腰痛的发生率增加有关（OR=3.3，95%CI 为 1.1-10.4），但与非超重者无关（OR=1.1，95%CI 为 0.6-1.9）。身体活动与非特异性腰痛无关。
我们的研究结果表明，肥胖和低水平的身体活动都是放射状腰痛的独立危险因素。目前的研究结果表明，身体活动与放射状腰痛之间存在 U 形关系。建议中等水平的身体活动预防腰痛，特别是在肥胖者中。总之，我们的研究结果表明，肥胖者应该保持身体活动，即使他们可能不会减肥。
