Starkweather Angela, Julian Thomas, Ramesh Divya, Heineman Amy, Sturgill Jamie, Dorsey Susan G, Lyon Debra E, Wijesinghe Dayanjan Shanaka
Angela Starkweather, PhD, RN, FAAN, is Professor; Thomas Julian, BSN, RN, is Research Assistant; and Divya Ramesh, PhD, is Project Director, University of Connecticut School of Nursing, Storrs. Amy Heineman, BSN, RN, is Research Coordinator, Virginia Commonwealth University School of Nursing, Richmond. Jamie Sturgill, PhD, is Assistant Professor, University of Kentucky School of Medicine, Lexington. Susan G. Dorsey, PhD, RN, FAAN, is Professor and Chair, University of Maryland, Baltimore, School of Nursing. Debra E. Lyon, PhD, RN, FAAN, is Professor and Executive Associate Dean, University of Florida College of Nursing, Gainesville. Dayanjan Shanaka Wijesinghe, PhD, is Assistant Professor, Virginia Commonwealth University School of Pharmacy, Richmond.
Nurs Res. 2017 Nov/Dec;66(6):454-461. doi: 10.1097/NNR.0000000000000248.
In individuals with low back pain, higher lipid levels have been documented and were associated with increased risk for chronic low back pain.
The purpose of this research was to identify plasma lipids that discriminate participants with acute low back pain with or without pain sensitization as measured by quantitative sensory testing.
This exploratory study was conducted as part of a larger parent randomized controlled trial. A cluster analysis of 30 participants with acute low back pain revealed two clusters: one with signs of peripheral and central sensitivity to mechanical and thermal stimuli and the other with an absence of peripheral and central sensitivity. Lipid levels were extracted from plasma and measured using mass spectroscopy.
Triacylglycerol 50:2 was significantly higher in participants with peripheral and central sensitization compared to the nonsensitized cluster. The nonsensitized cluster had significantly higher levels of phosphoglyceride 34:2, plasmenyl phosphocholine 38:1, and phosphatidic acid 28:1 compared to participants with peripheral and central sensitization. Linear discriminant function analysis was conducted using the four statistically significant lipids to test their predictive power to classify those in the sensitization and no-sensitization clusters; the four lipids accurately predicted cluster classification 58% of the time (R = .58, -2 log likelihood = 14.59).
The results of this exploratory study suggest a unique lipidomic signature in plasma of patients with acute low back pain based on the presence or absence of pain sensitization. Future work to replicate these preliminary findings is underway.
在腰痛患者中,已记录到较高的血脂水平,且其与慢性腰痛风险增加相关。
本研究的目的是确定血浆脂质,这些脂质可区分通过定量感觉测试测量的有无疼痛敏化的急性腰痛参与者。
本探索性研究作为一项更大的母体随机对照试验的一部分进行。对30名急性腰痛参与者进行聚类分析,发现两个聚类:一个具有对机械和热刺激的外周和中枢敏感性迹象,另一个没有外周和中枢敏感性。从血浆中提取脂质水平并使用质谱法进行测量。
与非敏化聚类相比,具有外周和中枢敏化的参与者中三酰甘油50:2显著更高。与具有外周和中枢敏化的参与者相比,非敏化聚类中磷脂酰甘油34:2、缩醛磷脂酰胆碱38:1和磷脂酸28:1的水平显著更高。使用四种具有统计学意义的脂质进行线性判别函数分析,以测试它们对敏化和非敏化聚类中的参与者进行分类的预测能力;这四种脂质在58%的时间内准确预测了聚类分类(R = 0.58,-2对数似然 = 14.59)。
本探索性研究的结果表明,基于疼痛敏化的存在与否,急性腰痛患者血浆中存在独特的脂质组特征。正在进行未来工作以重复这些初步发现。