Deciphering the Causal Relationships Between Low Back Pain Complications, Metabolic Factors, and Comorbidities

Abstract

Purpose Low back pain (LBP) is one of the major disabling health conditions in aging societies presenting significant cost burdens to health and social care systems. Its complications and associated disability are often accompanied by mental disorders, metabolic comorbidities, changed body composition, and inflammation. However, their mutual relationships in LBP-associated disability remain unclear. Methods In the present case-control study, a self-report validated questionnaire was used to collect LBP disability data in an ethnically homogeneous Israeli Arab sample (489 males and 589 females). Body composition parameters were assessed through bioelectrical impedance analysis and plasma levels of soluble markers by EISA. Comorbidity status was assessed in personal interview and from the individual medical files. Results Our mixed multiple regression analysis identified that GDF-15 (β = 0.160, p = 2.95×10-8), vaspin (β = 0.085, p = 0.003), follistatin (β = 0.076, p = 0.001), extracellular water (β = 0.096, p = 0.001), waist hip ratio (β = 0.072, p = 0.009), mental disorders (β = 0.077, p = 0.001), and metabolic comorbidities (β = 0.059, p = 0.02) were significantly associated with LBP disability scores, when controlling for age and sex effects. Additive Bayesian network modelling further suggests that LBP disability appears to be directly influenced by age, sex, GDF-15, and extracellular water, and indirectly by mental and metabolic disorders, waist-hip ratio, and follistatin. LBP, in turn, seems to affect the vaspin levels directly. Conclusion Our data suggest the existence of a complex, age-associated, and probably hierarchical, relationship between LBP disability and mental and metabolic disorders, inflammation-related soluble markers, and body composition parameters.

The search for systemic biomarkers for monitoring degenerative lumbar spinal disorders

“…Blood samples were used to assay plasma concentrations of biochemical factors relevant to this study. Further details have been reported in our recent studies on this subject [ 3 , 21 ].…”

“…However, the pathogenesis of this multifactorial condition is still not fully understood. We recently reported that complex, age-associated and most probably, hierarchical relationships exist between LBP disability, inflammation-related soluble markers, body composition parameters, and the sideways curve of the spine – scoliosis [ 3 , 4 ]. However, it is unclear whether these factors affect LBP via spine-morphological changes, such as spinal osteoarthritis, specifically, facet joint osteoarthritis (FJOA) and lumbar disc degeneration (LDD), acknowledged as the major contributors to LBP [ 5 ].…”

“…by predicting mortality in hemodialysis patients [ 13 ]. ECW has been found to be associated with LBP severity [ 3 , 14 ]. Chronic, systemic inflammation manifested by the enhanced production of diverse pro-inflammatory cytokines, may be involved in the pathogenesis of spinal degenerative disorders [ 15 ].…”

“…We have recently reported that plasma levels of GDF-15, and adipokine vaspin, are significantly and independently associated with LBP severity [ 3 , 14 , 17 ]. Interestingly, circulating levels of these blood factors were found to be associated with several body composition parameters [ 14 , 18 ], and both factors were found to be associated with the inflammation process [ 18 , 19 ].…”

Dolor Lumbar asociado a la ansiedad y depresión en estudiantes de terapia física y rehabilitación de una universidad privada.

“…La discapacidad tiene un impacto negativo y una influencia importante en la calidad de vida física en individuos con dolor lumbar crónico. Se ha evidenciado en diferentes estudios que la discapacidad lumbar se asocia de manera significativa a factores bioquímicos y parámetros de composición corporal y se agrava por trastornos mentales y comorbilidades metabólicas (4) .…”