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肥胖、糖尿病、生活方式因素与腰痛风险之间的因果关系。

Causations between obesity, diabetes, lifestyle factors and the risk of low back pain.

机构信息

Department of Anesthesiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China.

出版信息

Eur Spine J. 2024 Feb;33(2):525-532. doi: 10.1007/s00586-023-08069-6. Epub 2023 Dec 20.


DOI:10.1007/s00586-023-08069-6
PMID:38123704
Abstract

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.

摘要

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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Ann Med. 2025-12

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Risk factors for low back pain in the Chinese population: a systematic review and meta-analysis.

BMC Public Health. 2024-4-26

本文引用的文献

[1]
Genetic Predisposition of Both Waist Circumference and Hip Circumference Increased the Risk of Venous Thromboembolism.

Thromb Haemost. 2023-3

[2]
Alcohol and marijuana co-use among adults with chronic low back pain: Associations with substance misuse, mental health, and pain experience.

Am J Addict. 2022-11

[3]
Nicotine and Nicotine Replacement Therapy Use During Myocardial Perfusion Imaging.

Fed Pract. 2022-1

[4]
Association between type 2 diabetes and chronic low back pain in general practices in Germany.

BMJ Open Diabetes Res Care. 2021-7

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Low back pain.

Lancet. 2021-7-3

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J Clin Med. 2020-9-4

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Wellcome Open Res. 2023-8-4

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Rheumatol Int. 2019-3-8

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Is there an association between diabetes and neck and back pain? A systematic review with meta-analyses.

PLoS One. 2019-2-21

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Association studies of up to 1.2 million individuals yield new insights into the genetic etiology of tobacco and alcohol use.

Nat Genet. 2019-1-14

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