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管理和护理方法对腰痛:调查与生活方式相关的风险因素的因果关系。

Management and Nursing Approaches to Low Back Pain: Investigating the Causal Association with Lifestyle-Related Risk Factors.

机构信息

School of Rehabilitation Medicine, Jiangsu Vocational College of Medicine, Jiangsu, China.

School of Rehabilitation Medicine, Jiangsu Vocational College of Medicine, Jiangsu, China.

出版信息

Pain Manag Nurs. 2024 Jun;25(3):300-307. doi: 10.1016/j.pmn.2024.01.001. Epub 2024 Feb 9.


DOI:10.1016/j.pmn.2024.01.001
PMID:38341339
Abstract

BACKGROUND: Notwithstanding a plethora of observational studies, the causal implications of obesity, encompassing both body mass index (BMI) and waist circumference (WC), as well as type 2 diabetes (T2D), and lifestyle factors, in relation to the vulnerability to low back pain (LBP), remain enigmatic. AIMS: This study was designed to investigate the related causal associations DESIGN: A two-sample Mendelian randomization (MR) analysis. SETTINGS: By utilizing genetic variants associated with pertinent factors gleaned from genome-wide association studies (GWASs), We extracted independent genetic variants about exposures such as BMI, WC, T2D, smoking, alcohol consumption, and coffee intake from published GWASs, ensuring their genome-wide significance. PARTICIPANTS/SUBJECTS: The GWASs were selected from the most up-to-date and largest publicly accessible databases. METHODS: The summary data concerning LBP emanated from a GWAS of European cases and controls, which was based on the esteemed MRC-IEU (Medical Research Council Integrative Epidemiology Unit) consortium. RESULTS: Heightened body mass index and waist circumference exhibited odds ratios of 1.003 (95% confidence interval [CI] = 1.002-1.004, p < 0.001) and 1.003 (95% CI = 1.002-1.004, p < 0.001) for LBP, respectively, per each standard deviation (SD) increase. As for smoking initiation and every SD increase in the frequency of alcohol intake, the odds ratios were 1.002 (95% CI = 1.001-1.003, p = 0.003) and 1.002 (95% CI = 1.000-1.003, p = 0.011), respectively, for LBP. Conversely, an increased log odds ratio for T2D, and prevalence of coffee intake, divulged no discernible causal effects on the risk of LBP. CONCLUSION: This study provides suggestive evidence to support the causal involvement of obesity, smoking, and the frequency of alcohol intake in the development of LBP, which suggests that implementing measures to mitigate these risk factors may aid in preventing LBP.

摘要

背景:尽管有大量的观察性研究,但肥胖(包括体重指数 BMI 和腰围 WC)、2 型糖尿病 T2D 以及生活方式因素与腰痛 LBP 易感性之间的因果关系仍然令人费解。

目的:本研究旨在探讨相关的因果关联。

设计:两样本孟德尔随机化(MR)分析。

设置: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,我们从已发表的 GWAS 中提取了与 BMI、WC、T2D、吸烟、饮酒和咖啡摄入等暴露因素相关的独立遗传变异,并确保其具有全基因组意义。

参与者/受试者:GWAS 从最新和最大的公开可访问数据库中选择。

方法:与腰痛相关的汇总数据来自欧洲病例对照的 GWAS,该研究基于享有盛誉的 MRC-IEU(医学研究委员会综合流行病学单位)联盟。

结果:体重指数和腰围每增加一个标准差,腰痛的优势比分别为 1.003(95%置信区间 [CI] = 1.002-1.004,p < 0.001)和 1.003(95% CI = 1.002-1.004,p < 0.001)。对于吸烟开始和饮酒频率每增加一个标准差,优势比分别为 1.002(95% CI = 1.001-1.003,p = 0.003)和 1.002(95% CI = 1.000-1.003,p = 0.011),腰痛的风险增加。相反,T2D 的对数优势比增加和咖啡摄入的流行率并未显示出对 LBP 风险有明显的因果影响。

结论:本研究提供了有说服力的证据,支持肥胖、吸烟和饮酒频率在腰痛发展中的因果作用,这表明采取措施减轻这些危险因素可能有助于预防腰痛。

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