Que Zhiqiang, Chen Dingqiang, Cai Huirong, Lan Weibin, Huang Yuxuan, Rui Gang
Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
Front Med (Lausanne). 2025 Apr 28;12:1538754. doi: 10.3389/fmed.2025.1538754. eCollection 2025.
Insulin resistance is one of the major pathophysiological features of type 2 diabetes mellitus. Studies have revealed the association between type 2 diabetes mellitus and low back pain. However, few studies explored the relationship between insulin resistance and low back pain directly. Therefore, this study selected HOMA-IR, TyG, TyG-BMI, TyG-WC, and TyG-WtHR as indicators of insulin resistance to comprehensively investigate the association between insulin resistance and low back pain.
The data for this cross-sectional study were from NHANES. Multivariate logistic regression was used to assess the association of insulin resistance with low back pain, and the stability of the results was evaluated by stratified analysis.
A total of 6,126 adult participants were included in the study, including 3,657 non-LBP participants and 2,469 LBP patients. All of these five indices showed significant association with low back pain after full adjustment for all covariates (Model 3), HOMA-IR [OR = 1.052, 95% CI (1.018, 1.087), = 0.003], TyG [OR = 1.431, 95% CI (1.013, 2.021), = 0.042], TyG-BMI [OR = 1.003, 95% CI (1.002, 1.005), < 0.0001], TyG-WC [OR = 1.001, 95% CI (1.001, 1.002), < 0.0001], TyG-WtHR [OR = 1.268, 95% CI (1.155, 1.393), < 0.0001]. The relationship between insulin resistance and low back pain is stable in most stratified populations (-interaction >0.05).
Insulin resistance is associated with an increased risk of low back pain. The HOMA-IR, TyG, TyG-WC, TyG-BMI, and TyG-WtHR all showed a stable correlation with low back pain. TyG-BMI, TyG-WC, and TyG-WtHR are more stable in their associations with low back pain than TyG alone.
胰岛素抵抗是2型糖尿病的主要病理生理特征之一。研究揭示了2型糖尿病与腰痛之间的关联。然而，很少有研究直接探讨胰岛素抵抗与腰痛之间的关系。因此，本研究选择稳态模型评估胰岛素抵抗指数（HOMA-IR）、甘油三酯-葡萄糖（TyG）指数、基于体重指数的TyG指数（TyG-BMI）、基于腰围的TyG指数（TyG-WC）和基于腰臀比的TyG指数（TyG-WtHR）作为胰岛素抵抗指标，以全面研究胰岛素抵抗与腰痛之间的关联。
本横断面研究的数据来自美国国家健康与营养检查调查（NHANES）。采用多因素logistic回归评估胰岛素抵抗与腰痛的关联，并通过分层分析评估结果的稳定性。
本研究共纳入6126名成年参与者，其中无腰痛参与者3657名，腰痛患者2469名。在对所有协变量进行完全调整后（模型3），所有这五个指标均显示与腰痛存在显著关联，HOMA-IR [比值比（OR）=1.052，95%置信区间（CI）（1.018，1.087），P = 0.003]，TyG [OR = 1.431，95% CI（1.013，2.021），P = 0.042]，TyG-BMI [OR = 1.003，95% CI（1.002，1.005），P < 0.0001]，TyG-WC [OR = 1.001，95% CI（1.001，1.002），P < 0.0001]，TyG-WtHR [OR = 1.268，95% CI（1.155，1.393），P < 0.0001]。在大多数分层人群中，胰岛素抵抗与腰痛之间的关系是稳定的（交互作用P>0.05）。
胰岛素抵抗与腰痛风险增加相关。HOMA-IR、TyG、TyG-WC、TyG-BMI和TyG-WtHR均显示与腰痛存在稳定的相关性。与单独的TyG相比，TyG-BMI、TyG-WC和TyG-WtHR与腰痛的关联更稳定。
