Abstract
BackgroundAbnormal lipid levels have been suggested as a mechanism leading to atherosclerosis of the lumbar vessels, resulting in low back pain (LBP). This study examined whether abnormal lipid levels were associated with LBP among middle-aged adults in Japan.MethodsThe present study included adults between 40 and 64 years old who underwent an annual health checkup. A total of 258,367 eligible participants were analyzed to investigate associations of LBP with low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and LDL-C/HDL-C ratio. Participants were categorized into two groups according to each of LDL-C, HDL-C, and LDL-C/HDL-C ratio (LDL-C: ≥ 140 vs. < 140 mg/dL; HDL-C: ≥ 40 vs. < 40 mg/dL; LDL-C/HDL-C ratio: ≥ 2.5 vs. < 2.5). Information on LBP was obtained using a self-administered questionnaire. Logistic regression modeling was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for LBP.ResultsThe prevalence of LBP was 2.2% in men and 2.1% in women. Multivariable analysis adjusting for age, body mass index, and lifestyle factors found significant associations for HDL-C < 40 mg/dL (OR, 1.34; 95%CI, 1.20–1.48 in men; OR, 1.32; 95%CI, 1.02–1.72 in women) and LDL-C/HDL-C ratio ≥ 2.5 (OR, 1.17; 95%CI, 1.09–1.26 in men; OR, 1.15; 95%CI, 1.03–1.29 in women) with LBP.ConclusionsLow HDL-C and high LDL-C/HDL-C ratio were significantly associated with LBP in a middle-aged Japanese population. These findings might support the atherosclerosis-LBP hypothesis.
Highlights
Abnormal lipid levels have been suggested as a mechanism leading to atherosclerosis of the lumbar vessels, resulting in low back pain (LBP)
Univariate analysis showed that low high-density lipoprotein cholesterol (HDL-C) level and high low-density lipoprotein cholesterol (LDL-C)/HDL-C ratio were significantly associated with LBP in both sexes
This study investigated the association between serum lipids and LBP using large-scale data from annual health
Summary
Abnormal lipid levels have been suggested as a mechanism leading to atherosclerosis of the lumbar vessels, resulting in low back pain (LBP). This study examined whether abnormal lipid levels were associated with LBP among middle-aged adults in Japan. As one of the mechanisms underlying LBP, it has been suggested that atherosclerosis of the lumbar arteries could reduce the blood supply to the lumbar region, leading to disc degeneration and LBP [5, 6]. Considering that LBP could be influenced by arterial degeneration, risk factors for atherosclerosis may be associated with LBP. Several studies have investigated associations of LBP with high levels of blood cholesterol, which are involved in the development of Yoshimoto et al Lipids in Health and Disease (2018) 17:266 atherosclerosis [10,11,12,13]. Given the ethnic differences in lifestyles and the development of metabolic disorders [14], research targeted at the Japanese population is essential to clarify the risk factors for LBP and to explore effective interventions for preventing LBP in this population
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