Karolinska Institutet, Institute of Environmental Medicine, Box 210, 171 77, Stockholm, Sweden.
Karolinska Institutet, Department of Neurobiology, Caring Sciences, and Society, Division of Physiotherapy, 144 83, Huddinge, Sweden.
Eur Spine J. 2019 Nov;28(11):2502-2509. doi: 10.1007/s00586-019-06071-5. Epub 2019 Jul 19.
A multi-morbidity perspective of troublesome low back pain (LBP) has been highlighted for example in relation to respiratory disorders. Our purpose was to investigate whether respiratory disorders are risk factors for reporting troublesome LBP in people with no or occasional LBP at baseline.
This prospective cohort study was based on the Stockholm Public Health Cohort 2006/2010. We included adults reporting no or occasional LBP the last 6 months at baseline (n = 17,177). Exposures were self-reported asthma and/or Chronic Obstructive Pulmonary Disease (COPD). Outcome was troublesome LBP defined as reporting LBP a couple of days per week or more often that restricted work capacity or hindered daily activities to some or to a high degree, the last 6 months. Binomial regression models were used to calculate risk ratios (RR) with 95% confidence intervals (95% CI).
Adjusted results indicate that those suffering from asthma had a risk of troublesome LBP at follow-up (RR 1.29, 95% CI 0.92-1.81) as do those suffering from COPD (RR 2.0, 95% CI 1.13-3.56). If suffering from asthma and concurrent COPD the RR was 3.55 (95% CI 1.58-7.98).
Our findings indicate that suffering from asthma and/or COPD increases the risk of developing troublesome LBP, which highlights the importance to consider the overall health of people at risk of troublesome LBP and to take the multi-morbidity perspective into consideration. Future longitudinal studies are needed to confirm our findings. These slides can be retrieved under Electronic Supplementary Material.
多疾病视角下的腰痛（LBP）问题已受到关注，例如与呼吸障碍相关。本研究旨在探讨基线时无或偶发性 LBP 的人群中，呼吸障碍是否为报告 LBP 问题的危险因素。
本前瞻性队列研究基于 2006/2010 年斯德哥尔摩公共卫生队列。我们纳入了基线时报告过去 6 个月无或偶发性 LBP 的成年人（n=17177）。暴露因素为自我报告的哮喘和/或慢性阻塞性肺疾病（COPD）。结局为报告 LBP 困扰，即每周有几天或更多时间出现 LBP，以致工作能力受限或日常活动受到一定程度或高度限制，在过去 6 个月内。采用二项式回归模型计算风险比（RR）和 95%置信区间（95%CI）。
调整后的结果表明，患有哮喘的人在随访时出现 LBP 问题的风险较高（RR 1.29，95%CI 0.92-1.81），患有 COPD 的人风险更高（RR 2.0，95%CI 1.13-3.56）。如果同时患有哮喘和 COPD，RR 为 3.55（95%CI 1.58-7.98）。
本研究结果表明，患有哮喘和/或 COPD 会增加出现 LBP 问题的风险，这突出了考虑有 LBP 问题风险人群的整体健康状况并考虑多疾病视角的重要性。需要进一步开展纵向研究来验证我们的发现。这些幻灯片可在电子补充材料中获取。
