Yoshimoto Takahiko, Ochiai Hirotaka, Shirasawa Takako, Nagahama Satsue, Uehara Akihito, Muramatsu Jun, Kokaze Akatsuki
Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Shinagawa-Ku, Tokyo, Japan.
All Japan Labor Welfare Foundation, Shinagawa-Ku, Tokyo, Japan.
J Pain Res. 2020 Jun 12;13:1411-1419. doi: 10.2147/JPR.S247529. eCollection 2020.
Although many studies have indicated the association between low back pain (LBP) and lifestyle factors, the combined effect of lifestyle factors on LBP has not been adequately investigated. We aimed to investigate the association between a cluster of unhealthy lifestyle behaviors and LBP using a large cohort of Japanese adults.
We included 419,003 adults aged over 20 years who underwent an annual health checkup between April 2013 and March 2014 in Japan. Information on the following lifestyle factors was collected using the standardized questionnaire: smoking, alcohol intake, exercise, physical activity, walking speed, weight control, eating habits, and sleep. Each factor was evaluated as a dichotomous variable (1: health risk, 0: no health risk). A lifestyle risk score was calculated by summing the score of each lifestyle factor (range: 0-12) and was categorized into three groups (low, moderate, high). LBP was defined as self-reported LBP under treatment. Logistic regression analysis was conducted to calculate the odds ratio (OR) and 95% confidence interval (CI) for LBP.
In multivariable logistic regression analysis, the OR for LBP was significantly higher in the moderate-risk score group (adjusted OR: 1.33 [95% CI: 1.23-1.44] in men; 1.40 [95% CI: 1.27-1.54] in women) and the high-risk score group (adjusted OR: 1.54 [95% CI: 1.43-1.67] in men; 1.83 [95% CI: 1.64-2.03] in women) than in the low-risk score group. A trend of higher risk of LBP associated with higher lifestyle risk score was observed in both sexes ( for trend < 0.001). These results were similar even in subgroup analysis by age and body mass index (BMI).
Clustering of unhealthy lifestyles was associated with increased risk of LBP regardless of age and BMI. These results may provide implications for better prevention and management of LBP, considering modifiable lifestyle factors.
尽管许多研究表明腰痛（LBP）与生活方式因素之间存在关联，但生活方式因素对LBP的综合影响尚未得到充分研究。我们旨在通过一大群日本成年人来调查一系列不健康生活方式行为与LBP之间的关联。
我们纳入了2013年4月至2014年3月期间在日本接受年度健康检查的419,003名20岁以上的成年人。使用标准化问卷收集以下生活方式因素的信息：吸烟、饮酒、运动、体力活动、步行速度、体重控制、饮食习惯和睡眠。每个因素都被评估为二分变量（1：健康风险，0：无健康风险）。通过将每个生活方式因素的得分相加来计算生活方式风险评分（范围：0 - 12），并将其分为三组（低、中、高）。LBP被定义为正在接受治疗的自我报告的LBP。进行逻辑回归分析以计算LBP的优势比（OR）和95%置信区间（CI）。
在多变量逻辑回归分析中，中风险评分组（男性调整后的OR：1.33 [95% CI：1.23 - 1.44]；女性为1.40 [95% CI：1.27 - 1.54]）和高风险评分组（男性调整后的OR：1.54 [95% CI：1.43 - 1.67]；女性为1.83 [95% CI：1.64 - 2.03]）中LBP的OR显著高于低风险评分组。在男女两性中均观察到LBP风险随着生活方式风险评分升高而增加的趋势（趋势P < 0.001）。即使在按年龄和体重指数（BMI）进行的亚组分析中，这些结果也是相似的。
无论年龄和BMI如何，不健康生活方式的聚集都与LBP风险增加有关。考虑到可改变的生活方式因素，这些结果可能为更好地预防和管理LBP提供启示。
