Sex differences in the association of metabolic syndrome with low back pain among middle-aged Japanese adults: a large-scale cross-sectional study

Abstract

Background Although some recent studies have indicated an association between metabolic syndrome (MetS) and musculoskeletal disease, little is known about the association of MetS with low back pain (LBP). The present study aimed to investigate sex differences in the association of MetS and the clustering of MetS components with LBP among middle-aged Japanese individuals. Methods Study subjects were 45,192 adults (30,695 men, 14,497 women) aged 40–64 years who underwent annual health checkups conducted from April 2013 to March 2014. MetS was defined according to the criteria of the Examination Committee of Criteria for MetS in Japan as abdominal obesity plus at least two of dyslipidemia, high blood pressure, or high blood glucose. Information on LBP and health-related lifestyles were collected using a self-administered questionnaire. Logistic regression modeling was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for LBP. Results After adjusting for age and lifestyle factors, the OR of MetS for LBP was 1.15 (95% CI 0.95–1.40) in men and 2.16 (95% CI 1.32–3.53) in women. Compared to subjects without abdominal obesity, the presence of abdominal obesity significantly increased the OR for LBP among men (abdominal obesity only: OR 1.34, 95% CI 1.02–1.76; abdominal obesity plus one component: OR 1.24, 95% CI 1.01–1.52; abdominal obesity plus two or more components: OR 1.26, 95% CI 1.02–1.55). Among women, adding other components of MetS to abdominal obesity significantly increased ORs for LBP (abdominal obesity only: OR 1.70, 95% CI 0.94–3.08; abdominal obesity plus one component: OR 1.66, 95% CI 1.06–2.60; abdominal obesity plus two or more components: OR 2.30, 95% CI 1.41–3.78). Conclusions This large-scale cross-sectional study indicated that MetS was significantly associated with LBP among women only and that a sex-difference existed in the association between the clustering of MetS components and LBP. Clustering of MetS components by sex may need to be considered for the prevention of LBP, although further prospective studies are needed to clarify the causality.

Leptin signaling and the intervertebral disc: Sex dependent effects of leptin receptor deficiency and Western diet on the spine in a type 2 diabetes mouse model

“…The association of metabolic syndrome with low back pain has greater prevalence in women than in men [61] and in our study, female Db/Db mice on WD had the most substantial effects on vertebral bone structure and IVDs. A limitation of this study is that we did not assess the underlying mechanisms that might be responsible for these observed sex-effects.…”

<p>Clustering of Lifestyle Factors and Its Association with Low Back Pain: A Cross-Sectional Study of Over 400,000 Japanese Adults</p>

“…We previously revealed the relationship of metabolic syndrome with LBP among middle-aged Japanese adults. 30 However, individual components of metabolic syndrome are significantly affected by various lifestyles. In the present study, we investigated the association between the clustering of multiple unhealthy lifestyle behaviors and LBP among all adults using a large-scale health checkup data in Japan.…”

Leptin signaling and the intervertebral disc: Sex dependent effects of leptin receptor deficiency and Western diet on the spine in a type 2 diabetes mouse model

“…Female Db/Db mice on WD had the most substantial effects on vertebral bone structure and IVDs. The association of metabolic syndrome with low back pain has greater prevalence in women than in men [46]. Sex dependent effects of leptin receptor deficiency were also suggested in a recent study by McCabe et al [47] who demonstrated that alterations of specific leptin receptor sites contributed to sex-dependent bone responses to leptin, which could be particularly relevant during juvenile obesity, where loss of leptin signaling could diminish bone development and growth [47].…”