Association between metabolism and low back pain: a cross-sectional study.

IF 2.8 3区医学 Q1 ORTHOPEDICS

Journal of Orthopaedic Surgery and Research Pub Date : 2025-08-21 DOI:10.1186/s13018-025-06218-9

XingKun Wang, Long Tian, Qian Xu, Xin Pan, Lingjun Kong, Hua Zhao

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引用次数: 0

Abstract

Background: While pervious studies have identified metabolic imbalance as a key driver of intervertebral disc degeneration, few studies explored the relationship between metabolic and low back pain directly. We aimed to explore the relationships between two critical metabolic factors-insulin resistance and obesity-and low back pain (LBP), thereby providing novel insights for the integrated management of patients with LBP.

Methods: We enrolled 41663 participants from four NHANES survey cycles (1999-2004 and 2009-2010). The Metabolic Score for Insulin Resistance (METS-IR) and Body Roundness Index (BRI) were utilized to investigate the associations of insulin resistance and visceral obesity with LBP.Weighted logistic regression models were constructed to evaluate associations between MetS-IR/BRI and LBP, reported as odds ratios (ORs) with 95% confidence intervals (CIs). Using Restricted Cubic Splines (RCS) to assess potential nonlinear relationships. ROC curve analysis quantified diagnostic performance through area under the curve (AUC) estimation. Subgroup analyses and interaction tests were conducted to ensure the robustness of the findings.

Results: Multivariable regression analysis revealed significant positive associations between MetS-IR/BRI and LBP after adjusting for all potential confounders (MetS-IR: OR = 1.013, 95% CI: 1.008-1.018; BRI: OR = 1.072, 95% CI: 1.047-1.098) and these associations remained consistent across all subgroups. RCS analysis revealed no significant nonlinear associations between the METS-IR, BRI and LBP. In the ROC analysis, METS-IR showed the highest area under the ROC curve in females, followed by BRI and BMI.

Conclusions: In conclusion, within a nationally representative sample of U.S. adults with low back pain, we identified significant positive correlations between METS-IR/BRI and LBP. These findings underscore the importance of maintaining healthy metabolic status, providing valuable insights for further research.

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代谢与腰痛之间的关系：一项横断面研究。

背景：虽然先前的研究已经确定代谢失衡是椎间盘退变的关键驱动因素，但很少有研究直接探讨代谢与腰痛之间的关系。我们旨在探讨两个关键代谢因素-胰岛素抵抗和肥胖-与腰痛（LBP）之间的关系，从而为腰痛患者的综合管理提供新的见解。方法：我们从四个NHANES调查周期（1999-2004年和2009-2010年）中招募了41663名参与者。使用胰岛素抵抗代谢评分（METS-IR）和身体圆度指数（BRI）来研究胰岛素抵抗和内脏肥胖与LBP的关系。构建加权逻辑回归模型来评估MetS-IR/BRI与LBP之间的关联，报告为95%置信区间（ci）的优势比（ORs）。使用限制三次样条（RCS）来评估潜在的非线性关系。ROC曲线分析通过曲线下面积（AUC）估计来量化诊断效果。进行亚组分析和相互作用检验以确保研究结果的稳健性。结果：多变量回归分析显示，在调整所有潜在混杂因素后，met - ir /BRI与LBP之间存在显著的正相关（met - ir: OR = 1.013, 95% CI: 1.008-1.018; BRI: OR = 1.072, 95% CI: 1.047-1.098），这些关联在所有亚组中保持一致。RCS分析显示met - ir、BRI和LBP之间没有显著的非线性关联。在ROC分析中，met - ir显示女性的ROC曲线下面积最高，其次是BRI和BMI。结论：总之，在具有全国代表性的美国腰痛成年人样本中，我们发现METS-IR/BRI与LBP之间存在显著的正相关。这些发现强调了保持健康代谢状态的重要性，为进一步的研究提供了有价值的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

CiteScore

4.10

自引率

7.70%

发文量

494

审稿时长

>12 weeks

期刊介绍： Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.