Department of Anesthesiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China.
Eur Spine J. 2024 Feb;33(2):525-532. doi: 10.1007/s00586-023-08069-6. Epub 2023 Dec 20.
BACKGROUND: Despite numerous observational studies, the causal relationship between obesity-measured by body mass index (BMI) and waist circumference (WC)-as well as type 2 diabetes (T2D), lifestyle habits, and susceptibility to low back pain (LBP) remains obscure. METHODS: This investigation employed two-sample Mendelian randomization (MR) analysis to explore causality, using genetic variants linked to relevant factors from genome-wide association studies (GWASs). Specifically, we selected independent genetic variants related to BMI, WC, T2D, smoking, alcohol consumption, and coffee intake from established GWASs, all of which demonstrated genome-wide significance. The comparative data for LBP were derived from a GWAS involving European subjects, under the auspices of the renowned MRC-IEU (Medical Research Council Integrative Epidemiology Unit) consortium. RESULTS: Elevated BMI and WC were associated with odds ratios of 1.002 (95% confidence interval [CI] = 1.001-1.004, p < 0.001) and 1.003 (95% CI = 1.002-1.004, p < 0.001) for LBP per standard deviation (SD) increase, respectively. Regarding smoking initiation and coffee consumption, the odds ratios stood at 1.002 (95% CI = 1.001-1.004, p = 0.001) and 1.004 (95% CI = 1.001-1.008, p = 0.034) for LBP, respectively. However, an augmented log odds ratio for T2D and each SD rise in alcohol consumption frequency revealed no significant causal impact on LBP risk. CONCLUSION: Our findings indicate a potential causal link between obesity, smoking, and coffee intake in the genesis of LBP, suggesting that mitigating these factors could contribute to LBP prevention.
背景:尽管有大量的观察性研究,但肥胖(通过身体质量指数 BMI 和腰围 WC 衡量)与 2 型糖尿病(T2D)、生活方式习惯以及对腰痛(LBP)的易感性之间的因果关系仍然不清楚。
方法:本研究采用双样本 Mendelian 随机化(MR)分析,利用来自全基因组关联研究(GWAS)的与相关因素相关的遗传变异来探索因果关系。具体来说,我们从已建立的 GWAS 中选择了与 BMI、WC、T2D、吸烟、饮酒和咖啡摄入相关的独立遗传变异,这些变异均显示出全基因组显著意义。LBP 的比较数据来自一个涉及欧洲人群的 GWAS,该研究由著名的 MRC-IEU(医学研究委员会综合流行病学单位)联盟发起。
结果:BMI 和 WC 的升高与 LBP 的比值比分别为 1.002(95%置信区间 [CI] = 1.001-1.004,p < 0.001)和 1.003(95% CI = 1.002-1.004,p < 0.001),每增加一个标准差(SD)。关于吸烟开始和咖啡摄入,LBP 的比值比分别为 1.002(95% CI = 1.001-1.004,p = 0.001)和 1.004(95% CI = 1.001-1.008,p = 0.034)。然而,T2D 和酒精摄入频率每增加一个 SD 的对数比值增加并没有显示出对 LBP 风险的因果影响。
结论:我们的研究结果表明肥胖、吸烟和咖啡摄入与 LBP 的发生之间存在潜在的因果关系,表明减轻这些因素可能有助于预防 LBP。
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