Department of Physical Therapy, Newark, Delaware, USA.
Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA.
Pain Med. 2021 Jun 4;22(6):1353-1359. doi: 10.1093/pm/pnaa426.
There is considerable overlap in risk profiles between chronic low back pain with radiculopathy (CLBPR) and cardiovascular health among older adults; obesity and smoking are related to both conditions and may largely drive the potential relationship. We sought to explore the impact of CLBPR on cardiovascular health outcomes, independent of body mass index (BMI) and current smoking status.
Age- and sex-matched older adults (60-85 years of age) with (n = 21) and without (n = 21) CLBPR were recruited. Current smokers were excluded. Blood samples were collected to measure cholesterol levels and pro-inflammatory markers (i.e., C-reactive protein and interleukin-6). Vascular endothelial function, a marker of cardiovascular health, was evaluated by measuring brachial artery flow-mediated dilation (FMD). General linear models with multifactorial designs were evaluated; group membership, BMI, education, and their respective two-way interaction terms were included as independent variables.
Older adults with CLBPR had significantly higher BMIs (P = 0.004) and lower educational levels (P = 0.013) than did those without pain. There was a significant group-by-education interaction effect (P = 0.049) for endothelial function. Older adults without pain who were highly educated had higher FMD values, indicating better endothelial function (9.2%), whereas the following combinations all had lower FMD values: no pain plus low education, CLBPR plus high education, and CLBPR plus low education (5.9%, 6.1%, and 6.6%, respectively).
Among older adults, CLBPR is linked with worse endothelial function, regardless of educational level and independent of BMI and smoking. These findings suggest that older adults with CLBPR may be at a higher risk of cardiovascular disease.
慢性下腰痛伴根性病变（CLBPR）与老年人心血管健康之间存在相当大的风险重叠；肥胖和吸烟与这两种情况都有关联，并且可能在很大程度上推动了这种潜在的关系。我们试图探讨 CLBPR 对心血管健康结果的影响，而不考虑体重指数（BMI）和当前的吸烟状况。
招募了年龄和性别匹配的（60-85 岁）患有（n=21）和不患有（n=21）CLBPR 的老年人。排除当前吸烟者。采集血样以测量胆固醇水平和促炎标志物（即 C 反应蛋白和白细胞介素 6）。通过测量肱动脉血流介导的扩张（FMD）来评估血管内皮功能，这是心血管健康的一个标志物。采用多因素设计的一般线性模型进行评估；将组归属、BMI、教育程度及其各自的双向交互项作为自变量。
患有 CLBPR 的老年人的 BMI 显著更高（P=0.004），教育程度显著更低（P=0.013）。内皮功能存在显著的组-教育交互效应（P=0.049）。没有疼痛且教育程度高的老年人具有更高的 FMD 值，表明内皮功能更好（9.2%），而以下几种组合的 FMD 值均较低：无疼痛加低教育、CLBPR 加高教育和 CLBPR 加低教育（分别为 5.9%、6.1%和 6.6%）。
在老年人中，无论教育程度如何，CLBPR 与较差的内皮功能相关，并且独立于 BMI 和吸烟。这些发现表明，患有 CLBPR 的老年人可能患心血管疾病的风险更高。
