Dionne Clermont E, Laurin Danielle, Desrosiers Thérèse, Abdous Belkacem, Le Sage Natalie, Frenette Jérôme, Mondor Myrto, Pelletier Sylvie
Centre de recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada.
Quebec Centre of Excellence on Aging (CEVQ), Centre de recherche du CHU de Québec-Université Laval, Quebec City, QC, Canada.
Pain. 2016 Nov;157(11):2527-2535. doi: 10.1097/j.pain.0000000000000671.
Back pain brings about one of the heaviest burden of disease. Despite much research, this condition remains poorly understood, and effective treatments are frustratingly elusive. Thus, researchers in the field need to consider new hypotheses. Vitamin C (ascorbic acid) is an essential cofactor for collagen crosslinks, a key determinant of ligament, tendon, and bone quality. Recent studies have reported high frequency of hypovitaminosis C in the general population. We hypothesized that lack of vitamin C contributes to poor collagen properties and back pain. We conducted this study to examine the associations between serum concentration of vitamin C and the prevalence of spinal pain and related functional limitations in the adult general population. This study used nationwide cross-sectional data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2003-2004. Data were available for 4742 individuals aged ≥20 years. Suboptimal serum vitamin C concentrations were associated with the prevalence of neck pain (adjusted odds ratio [aOR]: 1.5; 95% confidence interval [CI]: 1.2-2.0), low back pain (aOR: 1.3; 95% CI: 1.0-1.6), and low back pain with pain below knee (aOR: 1.3; 95% CI: 1.0-1.9) in the past 3 months, self-reported diagnosis of arthritis/rheumatism (aOR: 1.4; 95% CI: 1.2-1.7), and related functional limitations' score (adjusted difference of means [aB]: 0.03; 95% CI: 0.00-0.05). The prevalence of hypovitaminosis C in the general population is high. Our study shows associations between vitamin C and spinal pain that warrant further investigation to determine the possible importance of vitamin C in the treatment of back pain patients.
背痛是疾病负担最重的情况之一。尽管进行了大量研究，但这种病症仍未被充分了解，有效的治疗方法也极难找到。因此，该领域的研究人员需要考虑新的假设。维生素C（抗坏血酸）是胶原蛋白交联的必需辅助因子，而胶原蛋白交联是韧带、肌腱和骨骼质量的关键决定因素。最近的研究报告称，普通人群中维生素C缺乏症的发生率很高。我们假设维生素C缺乏会导致胶原蛋白特性不佳和背痛。我们开展这项研究，以检验成年普通人群中维生素C血清浓度与脊柱疼痛患病率及相关功能受限之间的关联。本研究使用了来自美国国家健康和营养检查调查（NHANES）2003 - 2004年的全国横断面数据。有4742名年龄≥20岁的个体的数据可供使用。血清维生素C浓度未达最佳水平与过去3个月内颈部疼痛的患病率（调整后的优势比[aOR]：1.5；95%置信区间[CI]：1.2 - 2.0）、下背痛（aOR：1.3；95% CI：1.0 - 1.6）、伴有膝关节以下疼痛的下背痛（aOR：1.3；95% CI：1.0 - 1.9）、自我报告诊断为关节炎/风湿病（aOR：1.4；95% CI：1.2 - 1.7）以及相关功能受限评分（调整后的均值差异[aB]：0.03；95% CI：0.00 - 0.05）相关。普通人群中维生素C缺乏症的患病率很高。我们的研究表明维生素C与脊柱疼痛之间存在关联，这值得进一步研究，以确定维生素C在治疗背痛患者方面可能的重要性。
