Prevalence and Risk Factors of Diabetes in People with Low Back Pain: a Systematic Review and Meta-Analysis.

The relationship between low back pain (LBP) and diabetes mellitus (DM) remains inconclusive, with no prior meta-analysis specifically evaluating risk factors for DM in patients with LBP. A comprehensive search of PubMed, Web of Science, Embase, and Cochrane Library databases was conducted. Eligible studies explicitly reported risk factors for LBP and DM. Demographic data were extracted, and meta-analyses were performed using random- or fixed-effects models, with statistical analyses conducted in Review Manager (RevMan) 5.4 software. A total of 21 studies involving 346,380 patients were included. The prevalence of DM in patients with LBP was 27%. Sixteen risk factors were identified, with six quantitatively investigated. Substantial evidence supported the association of LBP with age (mean difference [MD] = 4.27; 95% confidence interval [CI]: 2.98 - 5.56; p < 0.00001), male gender (OR = 1.18; 95% CI: 1.08 - 1.29; p < 0.0002), body mass index (BMI) (MD = 1.02; 95% CI: 0.15 - 1.89; p = 0.02), hypertension (OR = 2.63; 95% CI: 2.29 - 3.01; p < 0.00001), and educational level (OR = 0.76; 95% CI: 0.46 - 0.91; p = 0.003). No significant association was found between smoking and DM in those with LBP. This meta-analysis highlights a significant correlation between LBP and DM, identifying age, male gender, BMI, hypertension, and lower educational level as key risk factors for DM in patients with LBP.