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抑郁症状在土耳其人群中与性别及腰痛相关的中介作用:来自一项全国性健康调查的证据。

The mediating role of depressive symptoms among Turkish population related to gender and low back pain: evidence from a national health survey.

作者信息

Yıldız Nadire Gülçin, Aydin Halide Z, Sambo Grace, Aydın Kemal, Yıldız Hatice, Santri Ichtiarini Nurullita, Wardani Yuniar, Mwamulima Bwanalori, Isni Khoiriyah, Phiri Yohane V A

机构信息

Faculty of Education, Department of Guidance and Counseling, Istanbul Medipol University, Istanbul, Turkey.

Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

出版信息

BMC Public Health. 2024 Apr 23;24(1):1136. doi: 10.1186/s12889-024-18612-9.

Abstract

BACKGROUND

Low back pain (LBP), though non-life-threatening, burdens healthcare with treatment expenses and work hours lost. Globally, 70-84% experience it, with risk factors tied to societal structure, income, and living conditions, making it a leading cause of disability.

METHODS

This study utilized data from the 2019 Türkiye Health Survey, which consisted of 17,084 individuals aged 15 and above. Our study focused on investigating the factors related to low back pain through a cross-sectional analysis. To analyze these factors, we employed binary multivariate logistic regression. Additionally, we conducted post-hoc analyses to assess the potential mediating effect of depressive symptoms on the relationship between low back pain and gender.

RESULTS

We found that 31.9% of the population experienced low back pain, with women being 58% more likely [aOR = 1.58; 95% CI (1.45-1.73)] than men to report symptoms. Individuals aged 55 + years old had a 90% [aOR = 1.90; 95% CI (1.61-2.23)] chance of experiencing low back pain, indicating an age-related increase. In the general population, having depressive symptoms was 2.49 [95% CI (2.23-2.78)] times more likely associated with low back pain. Our mediation analysis showed that gender (i.e., women vs. men), indicated by direct effects with β-estimates e = 0.78, predicted the likelihood of low back pain. Additionally, the relationship between gender and low back pain, mediated through a history of depressive symptoms, had a significant total indirect effect (i.e., β-estimate given as e = 0.49). Specifically, a history of depressive symptoms accounted for 17.86% [95% CI (9.67-20.10)] of the association between women having a higher likelihood of low back pain compared to men.

CONCLUSION

We observed that a higher likelihood of low back pain associated with gender and aging. Additionally, BMI served as a significant predictor, particularly in adults. Depression mediated the association between gender and low back pain. Acknowledging these associations may help identify and address contributing factors to LBP, potentially increasing awareness and alleviating the burden. Policymakers and healthcare professionals may consider these findings when developing prevention and treatment programs for low back pain.

摘要

背景

腰痛(LBP)虽不危及生命,但却给医疗保健带来治疗费用和工作时间损失的负担。在全球范围内,70%-84%的人经历过腰痛,其风险因素与社会结构、收入和生活条件相关,使其成为导致残疾的主要原因。

方法

本研究利用了2019年土耳其健康调查的数据,该调查涵盖了17084名15岁及以上的个体。我们的研究通过横断面分析来调查与腰痛相关的因素。为了分析这些因素,我们采用了二元多变量逻辑回归。此外,我们还进行了事后分析,以评估抑郁症状对腰痛与性别之间关系的潜在中介作用。

结果

我们发现31.9%的人群经历过腰痛,女性报告症状的可能性比男性高58%[调整后比值比(aOR)=1.58;95%置信区间(CI)(1.45-1.73)]。55岁及以上的个体经历腰痛的可能性为90%[aOR=1.90;95%CI(1.61-2.23)],表明与年龄相关的增加。在一般人群中,有抑郁症状与腰痛相关的可能性是没有抑郁症状的2.49倍[95%CI(2.23-2.78)]。我们的中介分析表明,性别(即女性与男性),通过β估计值e=0.78的直接效应来表示,预测了腰痛的可能性。此外,通过抑郁症状史介导的性别与腰痛之间的关系具有显著的总间接效应(即β估计值给定为e=0.49)。具体而言,抑郁症状史占女性比男性患腰痛可能性更高这一关联的17.86%[95%CI(9.67-20.10)]。

结论

我们观察到腰痛与性别和年龄增长有关。此外,体重指数是一个重要的预测因素,尤其是在成年人中。抑郁介导了性别与腰痛之间的关联。认识到这些关联可能有助于识别和解决导致腰痛的因素,潜在地提高认识并减轻负担。政策制定者和医疗保健专业人员在制定腰痛的预防和治疗方案时可考虑这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da86/11040760/c0b6cce65369/12889_2024_18612_Fig1_HTML.jpg

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