Wáng Yì Xiáng J, Wáng Jùn-Qīng, Káplár Zoltán
Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.
Quant Imaging Med Surg. 2016 Apr;6(2):199-206. doi: 10.21037/qims.2016.04.06.
Female sex hormones play an important role in the etiology and pathophysiology of a variety of musculoskeletal degenerative diseases. Postmenopausal women show accelerated disc degeneration due to relative estrogen deficiency. This literature review aims to validate or falsify this hypothesis, i.e., while overall females have higher prevalence of low back pain (LBP) across all age groups, this male vs. female difference in LBP prevalence further increases after female menopause age. The literature search was performed on PubMed on January 2, 2016. The search word combination was (low back pain) AND prevalence AND [(males OR men) AND (females OR women)]. The following criteria were taken to include the papers for synthetic analysis: (I) only English primary literatures on nonspecific pain; (II) only prospective studies on general population, but not population with occupational LBP causes, of both males and female subjects studied using the same LBP criterion, ages-specific information available, and males and female subjects were age-matched; (III) studies without major quality flaws. In total 98 studies with 772,927 subjects were analyzed. According to the information in the literature, participant subjects were divided into four age groups: (I) school age children group: 6-19 years; (II) young and middle aged group: 20-50 years; (III) mixed age group: data from studies did not differentiate age groups; (IV) elderly group: ≥50 years old. When individual studies were not weighted by participant number and each individual study is represented as one entry regardless of their sample size, the median LBP prevalence ratio of female vs. males was 1.310, 1.140, 1.220, and 1.270 respectively for the four age groups. When individual studies were weighted by participant number, the LBP prevalence ratio of female vs. males was 1.360, 1.127, 1.185, and 1.280 respectively for the four groups. The higher LBP prevalence in school age girls than in school age boys is likely due to psychological factors, female hormone fluctuation, and menstruation. Compared with young and middle aged subjects, a further increased LBP prevalence in females than in males was noted after menopause age.
女性性激素在多种肌肉骨骼退行性疾病的病因学和病理生理学中发挥着重要作用。绝经后女性由于相对雌激素缺乏,椎间盘退变加速。这篇文献综述旨在验证或证伪这一假设,即虽然总体上所有年龄组的女性腰痛(LBP)患病率较高,但绝经后女性与男性在LBP患病率上的差异会进一步增大。2016年1月2日在PubMed上进行了文献检索。检索词组合为(腰痛)AND患病率AND[(男性)AND(女性)]。纳入论文进行综合分析的标准如下:(I)仅关于非特异性疼痛的英文原始文献;(II)仅针对普通人群的前瞻性研究,而非有职业性腰痛病因的人群,对男性和女性受试者使用相同的腰痛标准进行研究,有年龄特异性信息,且男性和女性受试者年龄匹配;(III)无重大质量缺陷的研究。总共分析了98项研究,涉及772,927名受试者。根据文献中的信息,参与研究的受试者被分为四个年龄组:(I)学龄儿童组:6 - 19岁;(II)中青年组:20 - 50岁;(III)混合年龄组:研究数据未区分年龄组;(IV)老年组:≥50岁。当不按参与人数对个体研究进行加权,且每个个体研究无论样本大小都作为一个条目时,四个年龄组女性与男性的腰痛患病率中位数比值分别为1.310、1.140、1.220和1.270。当按参与人数对个体研究进行加权时,四组女性与男性的腰痛患病率比值分别为1.360、1.127、1.185和1.280。学龄女童腰痛患病率高于学龄男童可能是由于心理因素、女性激素波动和月经。与中青年受试者相比,绝经后女性腰痛患病率比男性进一步升高。