Journal
ARTHRITIS RESEARCH & THERAPY
Volume 19, Issue -, Pages -Publisher
BMC
DOI: 10.1186/s13075-017-1242-z
Keywords
Obesity; Body composition; Fat mass; Fat-free mass; Low back pain
Categories
Funding
- National Health and Medical Research Council (NHMRC) [233200]
- Australian Government Department of Health and Ageing
- Abbott Australasia Pty Ltd
- Alphapharm Pty Ltd
- AstraZeneca
- Bristol-Myers Squibb
- City Health Centre-Diabetes Service-Canberra
- Department of Health and Community Services - Northern Territory
- Department of Health and Human Services - Tasmania
- Department of Health - New South Wales
- Department of Health - Western Australia
- Department of Health - South Australia
- Department of Human Services - Victoria
- Diabetes Australia
- Diabetes Australia Northern Territory
- Eli Lilly Australia
- Estate of the Late Edward Wilson
- GlaxoSmithKline
- Jack Brockhoff Foundation
- Janssen-Cilag
- Kidney Health Australia
- Marian and FH Flack Trust
- Menzies Research Institute
- Merck Sharp Dohme
- Novartis Pharmaceuticals
- Novo Nordisk Pharmaceuticals
- Pfizer Pty Ltd
- Pratt Foundation
- Queensland Health
- Roche Diagnostics Australia
- Royal Prince Alfred Hospital, Sydney
- Sanofi Aventis
- sanofi-synthelabo
- Victorian Government's Operational Infrastructure Support (OIS) Program
- AFA-ARA Heald Fellowship - Australian Rheumatology Association
- NHMRC Career Development Fellowship [1011975, 1065464, 1063574]
- NHMRC Research Fellowship
- NHMRC Senior Research Fellowship
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Background: Determining the association between body composition and low back pain (LBP) will improve our understanding of the mechanisms by which obesity affects LBP, and inform novel approaches to managing LBP. The aim of this study was to examine the relationship between body composition and LBP intensity and disability. Methods: A total of 5058 participants (44% men) of the Australian Diabetes, Obesity and Lifestyle Study were assessed for LBP intensity and disability using the Chronic Pain Grade Questionnaire (2013-2014). Body mass index (BMI) and waist circumference were directly obtained. Fat mass and percentage fat were estimated from bioelectrical impedance analysis at study inception (1999-2000). Results: Eighty-two percent of participants reported LBP, of whom 27% also reported LBP disability. BMI, waist circumference, percent fat, and fat mass were each positively associated with LBP intensity and disability at 12 years after adjustment for potential confounders. LBP intensity and disability showed significant dose-responses to sex-specific quartiles of BMI, waist circumference, percent fat and fat mass. For example, the adjusted OR for LBP intensity in women increased with increasing fat mass quartiles [Q1: 1, Q2: 1.05 (95% CI 0.84-1.32); Q3: 1. 25 (1.00-1.57); and Q4: 1.78 (1.42-2.24); p < 0.001]. Conclusions: Fat mass and distribution are associated with LBP intensity and disability, suggesting systemic metabolic factors associated with adiposity play a major role in the pathogenesis of LBP. Clarifying the mechanisms will facilitate developing novel preventive and therapeutic approaches for LBP.
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