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腰椎管狭窄症患者内脏脂肪与慢性下腰痛和中枢敏化的相关性。

Associations between visceral fat chronic low back pain and central sensitization in patients with lumbar spinal stenosis.

机构信息

Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.

Department of Orthopaedic Surgery, Sapporo Maruyama Orthopaedic Hospital, Sapporo, Japan.

出版信息

J Back Musculoskelet Rehabil. 2022;35(5):1035-1041. doi: 10.3233/BMR-210124.

Abstract

BACKGROUND

Pain sensitization may be one of the mechanisms contributing to chronic low back pain (CLBP).

OBJECTIVE

To evaluate the association between visceral fat, CLBP, and central sensitization (CS); describe the relationship between low back pain (LBP) intensity and CS; and identify possible correlation between visceral fat and LBP intensity.

METHODS

Patients with CLBP were divided using their CS inventory (CSI) scores into low- (CSI < 40) and high-CSI (CSI ⩾ 40) subgroups. We compared computed tomography (CT) measurements and scores for association with pain according to the visual analogue scale (VAS) between the two groups.

RESULTS

The low-CSI and the high-CSI groups had 47 patients (67.1%; 21 men, 26 women) and 23 patients (32.9%; 11 men and 12 women), respectively. The high-CSI group had a significantly higher mean VAS score (p< 0.01) and estimated mean visceral fat area (p< 0.05) than the low-CSI group. There was a moderate positive correlation between VAS score and visceral fat (standardised partial regression coefficient: 0.659, p< 0.01) in the high-CSI group according to multiple linear regression analysis adjusted for age and sex.

CONCLUSIONS

Visceral fat is associated with CLBP, regardless of sex or age, and may be a potential therapeutic target for CLBP with CS.

摘要

背景

疼痛敏化可能是导致慢性下背痛(CLBP)的机制之一。

目的

评估内脏脂肪、CLBP 和中枢敏化(CS)之间的关联;描述下背痛(LBP)强度与 CS 之间的关系;并确定内脏脂肪与 LBP 强度之间的可能相关性。

方法

根据 CS 量表(CSI)评分,将 CLBP 患者分为低 CSI(CSI<40)和高 CSI(CSI ⩾40)亚组。我们比较了两组之间 CT 测量值和根据视觉模拟量表(VAS)评分与疼痛的关联。

结果

低 CSI 组和高 CSI 组分别有 47 名患者(67.1%;21 名男性,26 名女性)和 23 名患者(32.9%;11 名男性和 12 名女性)。高 CSI 组的平均 VAS 评分(p<0.01)和估计的平均内脏脂肪面积(p<0.05)明显高于低 CSI 组。多元线性回归分析调整年龄和性别后,高 CSI 组 VAS 评分与内脏脂肪之间存在中度正相关(标准化偏回归系数:0.659,p<0.01)。

结论

无论性别或年龄如何,内脏脂肪与 CLBP 相关,它可能是 CS 型 CLBP 的潜在治疗靶点。

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