Mapping the association between back pain and type 2 diabetes: A cross-sectional and longitudinal study of adult Spanish twins

被引：36

作者：

Dario, Amabile ^{[1
]}

Ferreiraz, Manuela ^{[2
,3
]}

Refshauge, Kathryn ^{[1
]}

Harmer, Alison ^{[1
]}

Sanchez-Romera, Juan ^{[4
,5
]}

Perez-Riquelme, Francisco ^{[4
,5
]}

Cisneros, Ligia ^{[6
]}

Ordonana, Juan ^{[4
,5
]}

Ferreira, Paulo ^{[1
]}

机构：

[1] Univ Sydney, Fac Hlth Sci, Sydney, NSW, Australia

[2] Univ Sydney, Sydney Med Sch, George Inst Global Hlth, Sydney, NSW, Australia

[3] Univ Sydney, Sydney Med Sch, Inst Bone & Joint Res, Sydney, NSW, Australia

[4] Univ Murcia, Dept Human Anat & Psychobiol, Murcia Twin Registry, Murcia, Spain

[5] Univ Clin Hosp Virgen Arrixaca, IMIB Arrixaca UMU, Biomed Res Inst Murcia, Murcia, Spain

[6] Univ Fed Minas Gerais, Dept Physiotherapy, Belo Horizonte, MG, Brazil

来源：

PLOS ONE | 2017年 / 12卷 / 04期

关键词：

LUMBAR DISC DEGENERATION; MUSCULOSKELETAL PAIN; PHYSICAL-ACTIVITY; MELLITUS; PREVALENCE; MENOPAUSE; SPINE; AGE; OSTEOARTHRITIS; DISCORDANT;

D O I：

10.1371/journal.pone.0174757

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background Back pain and type 2 diabetes often co-occur, resulting in greater impact on people's health and complexity in their care. Plausible causal mechanisms for this association have been proposed, yet the nature of the link remains unclear. We therefore explored the direction of the association between type 2 diabetes and chronic back pain in twins, controlling for genetics and early environmental confounding. Methods 2,096 and 1,098 twins were included in the cross-sectional and longitudinal analyses, respectively. Any or severe (>= 9) low back pain (LBP), neck pain (NP), and spinal pain (concurrent LBP and NP) and type 2 diabetes were investigated. Sequential analyses were performed using logistic regression. Firstly, twins were analysed unpaired (adjusted age and gender): total sample analyses. Then, to control for genetic and shared environmental factors, a co-twin case-control analysis was performed including monozygotic and dizygotic twin pairs discordant for back pain (cross-sectional only). Results In the cross-sectional total sample analyses, type 2 diabetes was associated with chronic spinal pain (OR 1.61; 95% CI 1.12 to 2.31), severe chronic spinal pain (OR 3.33; 95% CI 1.47 to 7.53), chronic NP (OR 1.37; 95% CI 1.01 to 1.85), severe chronic NP (OR 2.28; 95% CI 1.24 to 4.21), and severe chronic LBP (OR 1.63; 95% CI 1.00 to 2.64). After further adjustment for genetic and shared environmental factors, none of the associations remained significant. The longitudinal analyses indicated that the presence of type 2 diabetes did not increase the risk of future back pain, or vice-versa, after two to four years. Conclusions Chronic back pain (spinal pain, NP, or LBP) was associated with the prevalence of type 2 diabetes. Associations are stronger for severe cases of pain. Future research should investigate the temporal relationships between these conditions with longer follow up in twins.

引用

页数：15

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