Fernandez Matt, Colodro-Conde Lucia, Hartvigsen Jan, Ferreira Manuela L, Refshauge Kathryn M, Pinheiro Marina B, Ordoñana Juan R, Ferreira Paulo H
Faculty of Health Sciences, The University of Sydney, 75 East St, Lidcombe, Sydney, NSW 2141, Australia.
Murcia Twin Registry, Department of Human Anatomy and Psychobiology, University of Murcia and IMIB-Arrixaca, 30100 Murcia, Spain; Quantitative Genetics Laboratory, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Brisbane, QLD 4006, Australia.
Spine J. 2017 Jul;17(7):905-912. doi: 10.1016/j.spinee.2017.02.009. Epub 2017 Mar 4.
Pain is commonly associated with symptoms of depression or anxiety, although this relationship is considered bidirectional. There is limited knowledge regarding causal relationships.
This study aims to investigate whether chronic low back pain (LBP) increases the risk of depression or anxiety symptoms, after adjusting for shared familial factors.
This is a longitudinal, genetically informative study design from the Murcia Twin Registry in Spain.
The patient sample included 1,269 adult twins with a mean age of 53 years.
The outcome of depression or anxiety symptoms was evaluated with EuroQol questionnaire.
Using logistic regression analyses, twins were initially assessed as individuals in the total sample analysis, followed by a co-twin case-control, which was partially (dizygotic [DZ] twins) and fully (monozygotic [MZ] twins) adjusted for shared familial factors. There was no external funding for this study and no conflict of interest was declared.
There was a significant association between chronic LBP and the risk of depression or anxiety symptoms in the unadjusted total sample analysis (odds ratio [OR]: 1.81, 95% confidence interval [CI]: 1.34-2.44). After adjusting for confounders, the association remained significant (OR: 1.43, 95% CI: 1.05-1.95), although the adjusted co-twin case-control was non-significant in DZ (OR: 1.03, 95% CI: 0.50-2.13) and MZ twins (OR: 1.86, 95% CI: 0.63-5.51).
The relationship between chronic LBP and the future development of depression or anxiety symptoms is not causal. The relationship is likely to be explained by confounding from shared familial factors, given the non-statistically significant associations in the co-twin case-control analyses.
疼痛通常与抑郁或焦虑症状相关，尽管这种关系被认为是双向的。关于因果关系的知识有限。
本研究旨在调查在调整共同的家族因素后，慢性下腰痛（LBP）是否会增加抑郁或焦虑症状的风险。
这是一项来自西班牙穆尔西亚双胞胎登记处的纵向、具有遗传信息的研究设计。
患者样本包括1269对成年双胞胎，平均年龄为53岁。
使用欧洲生活质量调查问卷评估抑郁或焦虑症状的结局。
采用逻辑回归分析，双胞胎最初在总样本分析中作为个体进行评估，随后进行双胞胎病例对照分析，该分析对共同的家族因素进行了部分（异卵双胞胎[DZ]）和完全（同卵双胞胎[MZ]）调整。本研究没有外部资金支持，也未声明存在利益冲突。
在未调整的总样本分析中，慢性LBP与抑郁或焦虑症状的风险之间存在显著关联（优势比[OR]：1.81，95%置信区间[CI]：1.34 - 2.44）。在调整混杂因素后，该关联仍然显著（OR：1.43，95%CI：1.05 - 1.95），尽管在DZ双胞胎（OR：1.03，95%CI：0.50 - 2.13）和MZ双胞胎（OR：1.86，95%CI：0.63 - 5.51）中调整后的双胞胎病例对照分析无统计学意义。
慢性LBP与抑郁或焦虑症状未来发展之间的关系不是因果关系。鉴于双胞胎病例对照分析中无统计学意义的关联，这种关系可能是由共同家族因素的混杂所解释的。
