身体质量指数（BMI）与脊柱疾病患者背部或腿部疼痛之间的关联：Genodisc研究结果
The Association Between Body Mass Index (BMI) and Back or Leg Pain in Patients With Spinal Conditions: Results from the Genodisc Study.
作者信息
Segar Anand Hari, Urban Jill P G, Fairbank Jeremy C T, Judge Andrew
机构信息
Botnar Institute of Musculoskeletal Sciences, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK.
Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK.
出版信息
Spine (Phila Pa 1976). 2016 Oct 15;41(20):E1237-E1243. doi: 10.1097/BRS.0000000000001606.
STUDY DESIGN
A prospective observational study.
OBJECTIVE
The aim of this study was to identify the relationship between obesity, quantified by body mass index (BMI), and both back and leg pain in spinal patients.
SUMMARY OF BACKGROUND DATA
Obesity and back pain are massive public health problems. Given the poor correlation between pain and a pathological change in the spine, further investigation is required into other, nonpathological predictors such as obesity.
METHODS
The Genodisc Study was one of the largest cross-sectional studies of patients presenting to tertiary spinal units and recruited from six centers in four European countries. In total, 2636 patients were recruited over a 5-year period between 2008 and 2013. Both back and leg pain were scored by patients in the range of 0 to 10. Linear regression was used to model the relationship between BMI and pain. Potential confounders included in the model were age, Zung Depression score, episodes of sport, gender, disability benefit, family history, previous surgery, smoking status, work type, clinical diagnosis, and relevant comorbidities. Back and leg pain outcomes were modeled separately.
RESULTS
The study included 1160 men and 1349 women with a mean age of 50.9 years and mean BMI of 27.2 kg/m. In our fully adjusted model, a 5-point increase in BMI was associated with greater leg [0.19 units (95% confidence interval 0.08-0.31)] but not back [0.10 units (95% CI -0.02 to 0.22)] pain scores. Although this relationship was statically significant, given the small magnitude of the relationship, the clinical significance is limited. Similarly, female gender, heavy workload, rheumatoid arthritis, previous spine surgery, and depression were associated with higher back and leg pain.
CONCLUSION
In this large observational study of spine patients presenting to tertiary European centers, obesity, as measured by increased BMI, was associated with greater leg pain.
LEVEL OF EVIDENCE
研究设计
前瞻性观察性研究。
目的
本研究旨在确定通过体重指数（BMI）量化的肥胖与脊柱疾病患者的背痛和腿痛之间的关系。
背景数据总结
肥胖和背痛是重大的公共卫生问题。鉴于疼痛与脊柱病理变化之间的相关性较差，需要进一步研究其他非病理预测因素，如肥胖。
方法
Genodisc研究是对前往三级脊柱治疗单位的患者进行的最大规模横断面研究之一，从四个欧洲国家的六个中心招募患者。在2008年至2013年的5年期间，共招募了2636名患者。患者对背痛和腿痛的评分范围为0至10分。采用线性回归模型分析BMI与疼痛之间的关系。模型中纳入的潜在混杂因素包括年龄、zung抑郁评分、运动次数、性别、残疾津贴、家族史、既往手术史、吸烟状况、工作类型、临床诊断和相关合并症。背痛和腿痛结局分别建模。
结果
该研究纳入了1160名男性和1349名女性，平均年龄为50.9岁，平均BMI为27.2kg/m²。在我们的完全调整模型中，BMI每增加5个单位，与腿痛评分增加相关[0.19单位（95%置信区间0.08 - 0.31）]，但与背痛评分增加无关[0.10单位（95%置信区间 - 0.02至0.22）]。尽管这种关系具有统计学意义，但鉴于关系的程度较小，临床意义有限。同样，女性、高工作量、类风湿性关节炎、既往脊柱手术和抑郁症与更高的背痛和腿痛相关。
结论
在这项对前往欧洲三级中心的脊柱疾病患者进行的大型观察性研究中，以BMI升高衡量的肥胖与更严重的腿痛相关。
证据水平
2级。
Zotero 插件