Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
Department of Mathematics, University of Bergen, Bergen, Norway.
BMJ Open. 2022 Feb 24;12(2):e055118. doi: 10.1136/bmjopen-2021-055118.
In most population-based studies of low back pain (LBP), women have a higher risk than men, possibly reflecting hormonal influences. The aim of this study was to explore associations between age at menarche and menopause and risk of chronic LBP.
Population-based cross-sectional and cohort study designs.
The HUNT2 and HUNT3 medical surveys of the entire population of Nord-Trøndelag County in Norway.
Prevalence or risk of chronic LBP, defined as LBP persisting at least 3 months continuously during last year.
Associations between age at menarche and prevalence of chronic LBP were examined in cross-sectional data from HUNT2, comprising 27 697 women aged 20-69 years, with 7300 women reporting LBP. The corresponding cohort data included 11 659 women without LBP at baseline in HUNT2, with 2353 women reporting LBP at follow-up 11 years later in HUNT3. Cross-sectional data on age at menopause or premenopausal status included 11 332 women aged 40-69 years, with 3439 women reporting chronic LBP. Corresponding cohort data included 7893 women without LBP at baseline, of whom 1100 developed LBP.
Associations between age at menarche or menopause and risk of chronic LBP were examined by generalised linear modelling.
A U-shaped association was indicated between age at menarche and risk of chronic LBP, both in the cross-sectional and cohort studies. Age at menarche ≤11 years was associated with an increased risk of chronic LBP, with a relative risk of 1.32 (95% CI 1.15 to 1.52), compared with age 14 years at menarche, after relevant adjustments. Corresponding cross-sectional crude absolute risks were 32% and 25%, respectively. No association was established between age at menopause and risk of LBP. Being premenopausal had no influence on risk.
In contrast to results for age at menopause, the association with age at menarche suggests that hormonal factors affect the risk of LBP.
在大多数基于人群的腰痛（LBP）研究中，女性的风险高于男性，这可能反映了激素的影响。本研究旨在探讨初潮和绝经年龄与慢性 LBP 风险之间的关系。
基于人群的横断面和队列研究设计。
挪威特隆赫姆郡全部人口的 HUNT2 和 HUNT3 医疗调查。
慢性 LBP 的患病率或风险，定义为过去一年中持续至少 3 个月的 LBP。
在 HUNT2 的横断面数据中，研究了初潮年龄与慢性 LBP 患病率之间的关系，该数据包括 27697 名 20-69 岁的女性，其中 7300 名女性报告有 LBP。相应的队列数据包括 11659 名在 HUNT2 基线时无 LBP 的女性，其中 2353 名女性在 11 年后的 HUNT3 随访中报告有 LBP。包括 40-69 岁的 11332 名女性的绝经年龄或绝经前状态的横断面数据，其中 3439 名女性报告慢性 LBP。相应的队列数据包括 7893 名在基线时无 LBP 的女性，其中 1100 名女性出现 LBP。
通过广义线性模型检查初潮或绝经年龄与慢性 LBP 风险之间的关系。
初潮年龄与慢性 LBP 风险之间呈 U 形关系，横断面和队列研究均如此。与 14 岁初潮相比，初潮年龄≤11 岁的女性慢性 LBP 的风险增加，相对风险为 1.32（95%CI 1.15 至 1.52），相应的横断面粗绝对风险分别为 32%和 25%。与绝经年龄与 LBP 风险之间无关联。绝经前状态对风险没有影响。
与绝经年龄的结果相反，与初潮年龄的关系表明激素因素会影响 LBP 的风险。
