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肥胖与椎间盘退变、下腰痛和坐骨神经痛的因果关系:两样本孟德尔随机化研究。

Causal Associations of Obesity With the Intervertebral Degeneration, Low Back Pain, and Sciatica: A Two-Sample Mendelian Randomization Study.

机构信息

School of Anesthesiology, Weifang Medical University, Weifang, China.

Master Programme in Biomedicine, Karolinska Institutet, Stockholm, Sweden.

出版信息

Front Endocrinol (Lausanne). 2021 Dec 8;12:740200. doi: 10.3389/fendo.2021.740200. eCollection 2021.


DOI:10.3389/fendo.2021.740200
PMID:34956075
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8692291/
Abstract

The role of obesity in the development of dorsopathies is still unclear. In this study, we assessed the associations between body mass index (BMI) and several dorsopathies including intervertebral disc degeneration (IVDD), low back pain (LBP), and sciatica by using the Mendelian randomization method. We also assessed the effect of several obesity-related traits on the same outcomes. Single-nucleotide polymorphisms associated with the exposures are extracted from summary-level datasets of previously published genome-wide association studies. Summary-level results of IVDD, LBP, and sciatica were from FinnGen. In our univariable Mendelian randomization analysis, BMI is significantly associated with increased risks of all dorsopathies including sciatica (OR = 1.33, 95% CI, 1.21-1.47, p = 5.19 × 10), LBP (OR = 1.28, 95% CI, 1.18-1.39, p = 6.60 × 10), and IVDD (OR = 1.23, 95% CI, 1.14-1.32, p = 2.48 × 10). Waist circumference, hip circumference, whole-body fat mass, fat-free mass, and fat percentage, but not waist-hip ratio, were causally associated with increased risks of IVDD and sciatica. Higher hip circumference, whole-body fat mass, fat-free mass, and fat percentage increased the risk of LBP. However, only whole-body fat-free mass remained to have a significant association with the risk of IVDD after adjusting for BMI with an odds ratio of 1.57 (95% CI, 1.32-1.86, p = 2.47 × 10). Proportions of BMI's effect on IVDD, sciatica, and LBP mediated by leisure sedentary behavior were 41.4% (95% CI, 21.8%, 64.8%), 33.8% (95% CI, 17.5%, 53.4%), and 49.7% (95% CI, 29.4%, 73.5%), respectively. This study provides evidence that high BMI has causal associations with risks of various dorsopathies. Weight control is a good measure to prevent the development of dorsopathies, especially in the obese population.

摘要

肥胖在背病发展中的作用仍不清楚。在这项研究中,我们使用孟德尔随机化方法评估了体重指数(BMI)与几种背病的关联,包括椎间盘退行性变(IVDD)、下腰痛(LBP)和坐骨神经痛。我们还评估了几种肥胖相关特征对相同结果的影响。与暴露相关的单核苷酸多态性从以前发表的全基因组关联研究的汇总数据集提取。IVDD、LBP 和坐骨神经痛的汇总结果来自 FinnGen。在我们的单变量孟德尔随机分析中,BMI 与所有背病的风险增加显著相关,包括坐骨神经痛(OR=1.33,95%CI,1.21-1.47,p=5.19×10)、LBP(OR=1.28,95%CI,1.18-1.39,p=6.60×10)和 IVDD(OR=1.23,95%CI,1.14-1.32,p=2.48×10)。腰围、臀围、全身脂肪量、去脂体重和脂肪百分比,但不是腰臀比,与 IVDD 和坐骨神经痛的风险增加有因果关系。较高的臀围、全身脂肪量、去脂体重和脂肪百分比增加了 LBP 的风险。然而,在用 BMI 调整后,只有全身去脂体重与 IVDD 的风险仍有显著相关性,其比值比为 1.57(95%CI,1.32-1.86,p=2.47×10)。BMI 对 IVDD、坐骨神经痛和 LBP 的影响中,休闲性久坐行为的比例分别为 41.4%(95%CI,21.8%,64.8%)、33.8%(95%CI,17.5%,53.4%)和 49.7%(95%CI,29.4%,73.5%)。这项研究提供了证据表明,高 BMI 与各种背病的风险有因果关系。控制体重是预防背病发展的好措施,特别是在肥胖人群中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d5c/8692291/350521b9bb22/fendo-12-740200-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d5c/8692291/e3c8793e1819/fendo-12-740200-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d5c/8692291/5ecf1dd9a0f9/fendo-12-740200-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d5c/8692291/45f2ee38246f/fendo-12-740200-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d5c/8692291/7606648b64ac/fendo-12-740200-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d5c/8692291/350521b9bb22/fendo-12-740200-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d5c/8692291/e3c8793e1819/fendo-12-740200-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d5c/8692291/5ecf1dd9a0f9/fendo-12-740200-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d5c/8692291/45f2ee38246f/fendo-12-740200-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d5c/8692291/7606648b64ac/fendo-12-740200-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d5c/8692291/350521b9bb22/fendo-12-740200-g005.jpg

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本文引用的文献

[1]
Obesity could be associated with poor paraspinal muscle quality at upper lumbar levels and degenerated spine at lower lumbar levels: Is this a domino effect?

J Clin Neurosci. 2021-12

[2]
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J Biomech. 2021-5-24

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Diabetes Metab Res Rev. 2019-11-16

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Int J Epidemiol. 2019-6-1

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Nat Genet. 2018-4-23

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