{"title":"Physiotherapy Reduces Pain and Alters Fatty Acid Biomarkers in Women with Chronic Non-Specific Low Back Pain.","authors":"Zhou Zhang, Xin Li, Wen Tang, Hao Xie, Hong-Jiang Wang, Hao-Yu Xie, Chu-Huai Wang","doi":"10.2147/IJWH.S551117","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chronic nonspecific low back pain (cNLBP) represents the most prevalent musculoskeletal disorder encountered in clinical practice, constituting approximately two-thirds of all chronic low back pain cases. Epidemiological studies have identified significant gender differences in the incidence of cNLBP, with women exhibiting a slightly higher prevalence and reporting greater pain severity compared to men. However, the underlying mechanisms contributing to the increased severity of cNLBP in women remain largely unexplored. Our research is the first to explore fatty acid biomarkers in female patients with cNLBP undergoing physiotherapy from the perspectives of metabolomics and lipidomics.</p><p><strong>Methods: </strong>The study comprised 13 healthy female volunteers and 15 women diagnosed with cNLBP. Metabolomic and lipidomic analyses were employed to identify lipid metabolites closely associated with cNLBP in women. Subsequently, the 15 patients with cNLBP underwent manual therapy and exercise therapy, which incorporated both manual therapy and exercise therapy. Each therapy session lasted 50 minutes and was conducted over six sessions, occurring every two days. The Visual Analog Scale (VAS) scores of the patients were evaluated before and after treatment, and serum samples were collected for lipid determination at both pre- and post-treatment intervals.</p><p><strong>Results: </strong>Our metabolomic and lipidomic analyses revealed significantly elevated levels of three fatty acids (FAs): C14:0 FA (<i>P</i>=0.046), C20:0 FA (<i>P</i>=0.000001), and C20:1 FA (<i>P</i>=0.0007)), alongside significantly reduced levels of C20:5 (<i>P</i>=0.021) FA in women with cNLBP compared to healthy female volunteers. Receiver Operating Characteristic (ROC) curve analyses demonstrated that the Area Under the Curve (AUC) for these FAs exceeded 75%, indicating robust diagnostic performance. Notably, C20:0 FA exhibited an AUC greater than 95%, suggesting its potential as the most effective biomarker for diagnosing female patients with cNLBP. Additionally, physiotherapy significantly reduced pain levels in these women and was associated with a substantial decrease in blood FA levels.</p><p><strong>Conclusion: </strong>The study revealed a significant correlation between FA levels and female patients with cNLBP undergoing physiotherapy, thereby providing valuable insights for the development of personalized treatment approaches.</p><p><strong>Trial registration: </strong>(Chinese Clinical Trial Registry (https://www.chictr.org.cn), No.ChiCTR2300076620, 10/13/2023).</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"3055-3065"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448080/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Women's Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/IJWH.S551117","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Chronic nonspecific low back pain (cNLBP) represents the most prevalent musculoskeletal disorder encountered in clinical practice, constituting approximately two-thirds of all chronic low back pain cases. Epidemiological studies have identified significant gender differences in the incidence of cNLBP, with women exhibiting a slightly higher prevalence and reporting greater pain severity compared to men. However, the underlying mechanisms contributing to the increased severity of cNLBP in women remain largely unexplored. Our research is the first to explore fatty acid biomarkers in female patients with cNLBP undergoing physiotherapy from the perspectives of metabolomics and lipidomics.
Methods: The study comprised 13 healthy female volunteers and 15 women diagnosed with cNLBP. Metabolomic and lipidomic analyses were employed to identify lipid metabolites closely associated with cNLBP in women. Subsequently, the 15 patients with cNLBP underwent manual therapy and exercise therapy, which incorporated both manual therapy and exercise therapy. Each therapy session lasted 50 minutes and was conducted over six sessions, occurring every two days. The Visual Analog Scale (VAS) scores of the patients were evaluated before and after treatment, and serum samples were collected for lipid determination at both pre- and post-treatment intervals.
Results: Our metabolomic and lipidomic analyses revealed significantly elevated levels of three fatty acids (FAs): C14:0 FA (P=0.046), C20:0 FA (P=0.000001), and C20:1 FA (P=0.0007)), alongside significantly reduced levels of C20:5 (P=0.021) FA in women with cNLBP compared to healthy female volunteers. Receiver Operating Characteristic (ROC) curve analyses demonstrated that the Area Under the Curve (AUC) for these FAs exceeded 75%, indicating robust diagnostic performance. Notably, C20:0 FA exhibited an AUC greater than 95%, suggesting its potential as the most effective biomarker for diagnosing female patients with cNLBP. Additionally, physiotherapy significantly reduced pain levels in these women and was associated with a substantial decrease in blood FA levels.
Conclusion: The study revealed a significant correlation between FA levels and female patients with cNLBP undergoing physiotherapy, thereby providing valuable insights for the development of personalized treatment approaches.
背景：慢性非特异性腰痛（cNLBP）是临床实践中最常见的肌肉骨骼疾病，约占所有慢性腰痛病例的三分之二。流行病学研究发现，cNLBP的发病率存在显著的性别差异，与男性相比，女性的患病率略高，疼痛程度也更严重。然而，导致女性cNLBP严重程度增加的潜在机制在很大程度上仍未被探索。我们的研究首次从代谢组学和脂质组学的角度探讨了接受物理治疗的女性cNLBP患者的脂肪酸生物标志物。方法：研究包括13名健康女性志愿者和15名诊断为cNLBP的女性。代谢组学和脂质组学分析用于鉴定与女性cNLBP密切相关的脂质代谢物。随后，15例cNLBP患者分别进行了手法治疗和运动治疗，手法治疗和运动治疗相结合。每次治疗持续50分钟，分6次进行，每两天进行一次。在治疗前后对患者进行视觉模拟评分（VAS）评分，并在治疗前后分别采集血清样本进行血脂测定。结果：我们的代谢组学和脂质组学分析显示，与健康女性志愿者相比，cNLBP女性的三种脂肪酸（FAs）水平显著升高：C14:0 FA （P=0.046）、C20:0 FA （P=0.000001）和C20:1 FA (P=0.0007)，同时C20:5 FA水平显著降低（P=0.021）。受试者工作特征（ROC）曲线分析表明，这些FAs的曲线下面积（AUC）超过75%，表明诊断性能可靠。值得注意的是，C20:0 FA的AUC大于95%，表明其可能是诊断女性cNLBP患者最有效的生物标志物。此外，物理治疗显著降低了这些妇女的疼痛水平，并与血液中FA水平的显著降低有关。结论：本研究揭示了FA水平与接受物理治疗的女性cNLBP患者之间的显著相关性，从而为个性化治疗方法的发展提供了有价值的见解。试验注册：(中国临床试验注册中心（https://www.chictr.org.cn）；ChiCTR2300076620 10/13/2023)。
期刊介绍：
International Journal of Women''s Health is an international, peer-reviewed, open access, online journal. Publishing original research, reports, editorials, reviews and commentaries on all aspects of women''s healthcare including gynecology, obstetrics, and breast cancer. Subject areas include: Chronic conditions including cancers of various organs specific and not specific to women Migraine, headaches, arthritis, osteoporosis Endocrine and autoimmune syndromes - asthma, multiple sclerosis, lupus, diabetes Sexual and reproductive health including fertility patterns and emerging technologies to address infertility Infectious disease with chronic sequelae including HIV/AIDS, HPV, PID, and other STDs Psychological and psychosocial conditions - depression across the life span, substance abuse, domestic violence Health maintenance among aging females - factors affecting the quality of life including physical, social and mental issues Avenues for health promotion and disease prevention across the life span Male vs female incidence comparisons for conditions that affect both genders.
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