Ryu Ji-Hyun, Han Kyungdo, Kim Ju-Yeong
Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Republic of Korea.
J Clin Med. 2024 Dec 4;13(23):7397. doi: 10.3390/jcm13237397.
Despite the increasing prevalence of both spinal stenosis and obesity, their association remains controversial. This study aimed to investigate the relationship between body mass index (BMI) and the risk of lumbar spinal stenosis in the Korean population using nationwide data. We analyzed data from 2,161,684 adults aged ≥40 years who underwent health examinations in 2009 using the Korean National Health Insurance System database. Participants were categorized by BMI into five groups: underweight (<18.5), normal weight (18.5-22.9), overweight (23.0-24.9), obesity class I (25.0-29.9), and obesity class II and above (≥30). Cox proportional hazards models were used to evaluate the association between BMI and lumbar spinal stenosis risk, adjusting for demographic characteristics, lifestyle factors, and comorbidities. During the 10-year follow-up period, the incidence rate of lumbar spinal stenosis increased progressively with higher BMI categories, from 32.77 per 1000 person-years in the underweight group to 51.51 in the obesity class II and above group. In the fully adjusted model, compared to the normal weight group, the hazard ratios (95% confidence intervals) were 0.801 (0.787-0.815) for underweight, 1.132 (1.126-1.139) for overweight, 1.245 (1.238-1.252) for obesity class I, and 1.348 (1.331-1.366) for obesity class II and above. The association was stronger in females and participants aged <65 years. : A higher BMI was independently associated with an increased risk of lumbar spinal stenosis in the Korean population. This association remained robust after adjusting for various confounding factors, suggesting BMI as a significant risk factor for spinal stenosis.
尽管腰椎管狭窄症和肥胖症的患病率都在上升，但它们之间的关联仍存在争议。本研究旨在利用全国性数据调查韩国人群中体重指数（BMI）与腰椎管狭窄症风险之间的关系。我们分析了2009年使用韩国国民健康保险系统数据库进行健康检查的2161684名40岁及以上成年人的数据。参与者按BMI分为五组：体重过轻（<18.5）、正常体重（18.5 - 22.9）、超重（23.0 - 24.9）、I级肥胖（25.0 - 29.9）以及II级及以上肥胖（≥30）。采用Cox比例风险模型评估BMI与腰椎管狭窄症风险之间的关联，并对人口统计学特征、生活方式因素和合并症进行了调整。在10年的随访期内，腰椎管狭窄症的发病率随着BMI类别升高而逐渐增加，从体重过轻组的每1000人年32.77例增加到II级及以上肥胖组的51.51例。在完全调整模型中，与正常体重组相比，体重过轻组的风险比（95%置信区间）为0.801（0.787 - 0.815），超重组为1.132（1.126 - 1.139），I级肥胖组为1.245（1.238 - 1.252），II级及以上肥胖组为1.348（1.331 - 1.366）。这种关联在女性和65岁以下参与者中更强。：较高的BMI与韩国人群中腰椎管狭窄症风险增加独立相关。在调整各种混杂因素后，这种关联仍然很强，表明BMI是椎管狭窄的一个重要风险因素。
