School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA.
Mol Pain. 2023 Jan-Dec;19:17448069231210648. doi: 10.1177/17448069231210648.
Chronic low back pain (cLBP) is associated with insomnia and advanced age. Emerging evidence suggests that the severity of both sleep disorders (like insomnia) and chronic pain are associated with a faster pace of biological aging. We aimed to determine whether the pace of biological age mediates the relationship between insomnia and the impact of cLBP in a sample of community-dwelling adults ages 19 to 85 years. Participants (49 with no pain, 32 with low-impact pain, and 37 with high-impact pain) completed sociodemographic, pain, insomnia, and short physical performance battery assessments. We calculated the pace of biological aging using DunedinPACE from blood leukocyte DNA. On average, individuals with high-impact cLBP had significantly faster biological aging than those with low-impact and no chronic pain ( < .001). Bivariate associations of DunedinPACE scores with insomnia severity and functional performance were significant at < .01 (r = 0.324 and -0.502, respectively). After adjusting for race and sex, the association of insomnia severity and the impact of cLBP was partially mediated by the pace of biological aging (β = 0.070, < .001). Also, the association of insomnia severity with functional performance was partially mediated by the pace of biological aging (β = -0.105, < .001). Thus, insomnia remains strongly predictive of cLBP outcomes, and the pace of biological aging helps explain this association. Future prospective studies with repeated assessments are needed to uncover the directionality of these complex relationships and ultimately develop interventions to manage cLBP.
慢性下背痛（cLBP）与失眠和年龄增长有关。新出现的证据表明，睡眠障碍（如失眠）和慢性疼痛的严重程度都与生物衰老的速度有关。我们的目的是确定在一个年龄在 19 至 85 岁的社区居住的成年人样本中，生物年龄的速度是否会调解失眠与 cLBP 影响之间的关系。参与者（49 名无疼痛，32 名低影响疼痛，37 名高影响疼痛）完成了社会人口统计学，疼痛，失眠和短期身体表现电池评估。我们使用 DunedinPACE 从血液白细胞 DNA 中计算生物年龄的速度。平均而言，患有高影响 cLBP 的个体的生物衰老速度明显快于患有低影响和无慢性疼痛的个体（<.001）。DunedinPACE 评分与失眠严重程度和功能表现的双变量关联在 <.01 时具有显著性（r = 0.324 和-0.502，分别）。在调整种族和性别后，失眠严重程度和 cLBP 影响之间的关联部分由生物年龄的速度介导（β=0.070，<.001）。此外，失眠严重程度与功能表现之间的关联部分由生物年龄的速度介导（β=-0.105，<.001）。因此，失眠仍然强烈预测 cLBP 结局，而生物年龄的速度有助于解释这种关联。需要进行重复评估的未来前瞻性研究来揭示这些复杂关系的方向性，并最终开发管理 cLBP 的干预措施。
