Centre de recherche du CHU de Québec-Université Laval, Quebec City, Quebec, Canada.
Quebec Centre of Excellence on Aging (CEVQ) of the Centre de recherche du CHU de Québec-Université Laval, Quebec City, Quebec, Canada.
Spine (Phila Pa 1976). 2018 Jun 15;43(12):E712-E721. doi: 10.1097/BRS.0000000000002466.
A nationwide cross-sectional study.
To measure the associations between cigarette smoking (defined as serum cotinine concentration >15 ng/mL) and the 3-month prevalence of spinal pain (neck pain, low back pain, low back pain with pain below knee, and self-reported diagnosis of arthritis/rheumatism) and related limitations, and to verify whether these associations are mediated by serum concentrations of vitamin C.
Cigarette smoking has been consistently associated with back pain, but this association has never been explained. Because vitamin C has recently been reported to be associated with spinal pain and related functional limitations, and the metabolism of vitamin C differs between smokers and nonsmokers, we hypothesized that the prevalence of spinal pain and related limitations might be greater among smokers because they are more susceptible to be in a state of hypovitaminosis C.
We conducted secondary analyses of National Health and Nutrition Examination Survey (NHANES) 2003 to 2004 data on 4438 individuals aged ≥20 years.
Serum concentrations of vitamin C and cotinine were strongly and inversely correlated (r = -0.35, P < 0.0001). Smoking was statistically associated with the prevalence of neck pain [adjusted odds ratio: aOR: 1.25; 95% confidence interval (95% CI): 1.06-1.47], low back pain (aOR: 1.20; 95% CI: 1.04-1.39), and low back pain with pain below knee (aOR: 1.58; 95% CI: 1.13-2.22) and related limitations, with a dose-response relationship (P < 0.05). However, the associations between smoking and spinal pain were not mediated by concentrations of vitamin C.
These results confirm the relationship between smoking and spinal pain, but they do not support a mediating effect of vitamin C on this relationship.
一项全国性的横断面研究。
测量血清可替宁浓度>15ng/ml 的吸烟（定义为血清可替宁浓度>15ng/ml）与 3 个月脊柱疼痛（颈痛、腰痛、膝下疼痛伴腰痛、自述关节炎/风湿病诊断）和相关限制的相关性，并验证这些相关性是否由血清维生素 C 浓度介导。
吸烟一直与背痛有关，但这种关联从未得到解释。由于最近有报道称维生素 C 与脊柱疼痛和相关功能受限有关，而且吸烟者和非吸烟者的维生素 C 代谢方式不同，我们假设吸烟者脊柱疼痛和相关限制的患病率可能更高，因为他们更容易处于维生素 C 缺乏状态。
我们对 2003 年至 2004 年全国健康和营养调查（NHANES）中 4438 名年龄≥20 岁的个体进行了二次分析。
血清维生素 C 和可替宁浓度呈强烈负相关（r=-0.35，P<0.0001）。吸烟与颈痛（调整后优势比：aOR：1.25；95%置信区间（95%CI）：1.06-1.47）、腰痛（aOR：1.20；95%CI：1.04-1.39）、膝下腰痛（aOR：1.58；95%CI：1.13-2.22）及相关限制的患病率呈统计学相关（P<0.05），呈剂量反应关系（P<0.05）。然而，吸烟与脊柱疼痛之间的关联不受维生素 C 浓度的介导。
这些结果证实了吸烟与脊柱疼痛之间的关系，但不支持维生素 C 对这种关系的中介作用。
2 级。
