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Abstract
Background
Both low back pain (LBP) and obesity are important public issues, but the association between them is controversial. This study was conducted to investigate the association of LBP with obesity and abdominal obesity among Koreans aged 50 years or more.
Methods
This cross-sectional study analyzed data from participants aged 50 years or more (n=11,941) who measured height, weight and waist circumference and answered the questions about low back pain in the Korean National Health and Nutrition Examination Survey 2010–2013. To investigate the association of LBP with obesity and abdominal obesity, weighted univariate and multivariate logistic regression analyses were done after adjusting for socioeconomic variables and lifestyle variables.
Results
The prevalence of LBP in men and women was 13.1% (standard error [SE], 0.6) and 31.0% (SE, 0.8), respectively, higher in women than men (P<0.001). For women only, abdominal obesity was significantly associated with an increased prevalence of LBP (odds ratio [OR] 1.20, 95% confidence interval [CI] 1.01–1.44) after adjustment of confounding variables, and the odds ratio of LBP in the highest quartile of waist circumference was higher compared to the lowest quartile of waist circumference (OR 1.30, 95% CI 1.02–1.66). For men abdominal obesity was not associated with an increased prevalence of LBP. There were no associations between obesity and LBP in both men and women.
References
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Table 1.
Characteristics of participants according to the low back pain by gender
| Variable | Men (5,075) | Women (6,866) | ||||
|---|---|---|---|---|---|---|
| LBP (−) | LBP (+) | P | LBP (−) | LBP (+) | P | |
| Proportion | 86.9 (0.6) | 13.1 (0.6) | 69.0 (0.8) | 31.0 (0.8) | ||
| Age | 61.0±0.2 | 64.1±0.5 | <0.001 | 61.3±0.2 | 66.9±0.3 | <0.001 |
| BMI (kg/m2) | 23.9±0.1 | 23.5±0.1 | <0.001 | 24.2±0.1 | 24.4±0.1 | 0.031 |
| BMI group | 0.006 | 0.092 | ||||
| <18.5 | 2.7 (3.5) | 3.5 (0.7) | 2.2 (0.3) | 2.7 (0.5) | ||
| 18.5–25 | 63.2 (0.9) | 69.0 (2.2) | 61.7 (0.9) | 58.2 (1.3) | ||
| ≥25 | 34.1 (0.9) | 27.5 (2.0) | 36.1 (0.9) | 39.1 (1.3) | ||
| Waist circumference (cm) | 85.1±0.2 | 85.0±0.3 | 0.787 | 81.3±0.2 | 83.3±0.3 | <0.001 |
| Abdominal obesitya | 0.678 | <0.001 | ||||
| No | 72.1 (0.8) | 71.3 (2.0) | 67.0 (0.9) | 58.0 (1.3) | ||
| Yes | 27.9 (0.8) | 28.7 (2.0) | 33.0 (0.9) | 42.0 (1.3) | ||
| Educationb | <0.001 | <0.001 | ||||
| Elementary | 28.0 (0.9) | 43.1 (2.3) | 50.2 (1.0) | 74.8 (1.2) | ||
| Middle | 20.3 (0.8) | 21.4 (1.9) | 19.0 (0.7) | 12.3 (0.9) | ||
| High | 32.8 (1.0) | 23.5 (2.0) | 23.3 (0.8) | 10.4 (0.8) | ||
| University | 18.9 (0.8) | 12.0 (1.6) | 7.5 (0.5) | 2.5 (0.4) | ||
| Physical activityc | 0.646 | <0.001 | ||||
| 1st quartile | 28.7 (0.8) | 29.9 (2.1) | 29.2 (0.9) | 37.0 (1.4) | ||
| 2nd quartile | 23.9 (0.7) | 21.1 (1.9) | 23.3 (0.8) | 19.8 (1.1) | ||
| 3rd quartile | 23.0 (0.8) | 23.7 (2.0) | 24.1 (0.8) | 19.0 (1.0) | ||
| 4th quartile | 24.4 (0.9) | 25.2 (1.1) | 23.4 (0.8) | 24.2 (1.2) | ||
| Smoking | 0.314 | 0.475 | ||||
| No | 65.1 (0.9) | 62.5 (2.3) | 95.7 (0.4) | 95.2 (0.6) | ||
| Yes | 34.9 (0.9) | 37.5 (2.3) | 4.3 (0.4) | 4.8 (0.6) | ||
| Monthly drinking | 0.011 | <0.001 | ||||
| No | 29.8 (0.9) | 35.4 (2.2) | 71.1 (0.8) | 77.3 (1.1) | ||
| Yes | 70.2 (0.9) | 64.6 (2.2) | 28.9 (0.8) | 22.7 (1.1) | ||
| Occupation | <0.001 | <0.001 | ||||
| White collar | 43.2 (1.1) | 33.2 (2.3) | 50.8 (1.1) | 33.6 (1.4) | ||
| Blue collar | 56.8 (1.1) | 66.8 (2.3) | 49.2 (1.1) | 66.4 (1.4) | ||
Table 2.
Factors associated with low back pain
| Variable | Men | Women | ||
|---|---|---|---|---|
| OR (95% CI) | aORa (95% CI) | OR (95% CI) | aORa (95% CI) | |
| Age (per year) | 1.04 (1.03–1.05)b | 1.03 (1.02–1.04)b | 1.06 (1.06–1.07)b | 1.05 (1.04–1.05)b |
| BMI group | ||||
| <18.5 kg/m2 | 1 | 1 | 1 | 1 |
| 18.5–25 kg/m2 | 0.83 (0.53–1.30) | 1.04 (0.67–1.61) | 0.79 (0.50–1.23) | 1.09 (0.68–1.76) |
| ≥25 kg/m2 | 0.61 (0.39–0.95)b | 0.74 (0.45–1.21) | 0.90 (0.58–1.41) | 1.07 (0.65–1.76) |
| Abdominal obesityc | ||||
| Yes | 1.04 (0.86–1.27) | 1.30 (0.99–1.70) | 1.47 (1.31–1.66)b | 1.20 (1.01–1.44)b |
| Education | ||||
| Elementary | 1 | 1 | 1 | 1 |
| Middle | 0.68 (0.52–0.88)b | 0.82 (0.62–1.08) | 0.43 (0.36–0.52)b | 0.64 (0.52–0.79)b |
| High | 0.46 (0.37–0.59)b | 0.58 (0.44–0.76)b | 0.30 (0.25–0.37)b | 0.53 (0.42–0.68)b |
| University | 0.41 (0.30–0.57)b | 0.56 (0.39–0.82)b | 0.22 (0.15–0.31)b | 0.46 (0.31–0.68)b |
| Physical activityd | ||||
| 1st quartile | 1 | 1 | 1 | 1 |
| 2nd quartile | 0.85 (0.64–1.11) | 0.86 (0.66–1.11) | 0.67 (0.60–0.80)b | 0.83 (0.69–1.00)b |
| 3rd quartile | 0.99 (0.76–1.29) | 0.79 (0.58–1.07) | 0.62 (0.52–0.74)b | 0.68 (0.56–0.84)b |
| 4th quartile | 0.99 (0.75–1.32) | 0.86 (0.66–1.13) | 0.81 (0.69–0.96)b | 0.69 (0.56–0.85)b |
| Smoking | ||||
| Yes | 1.10 (0.89–1.37) | 1.20 (0.96–1.51) | 1.12 (0.82–1.53) | 1.28 (0.92–1.78) |
| Monthly drinking | ||||
| Yes | 0.77 (0.63–0.94) | 0.89 (0.72–1.10) | 0.72 (0.62–0.84) | 0.93 (0.79–1.10) |
| Occupation | ||||
| White collar | 1 | 1 | 1 | 1 |
| Blue collar | 1.54 (1.25–1.89)b | 1.16 (0.90–1.48) | 2.04 (1.78–2.34)b | 1.30 (1.12–1.52)b |
Table 3.
Prevalence and adjusted odds ratio of low back pain according to the quartiles of waist circumference by gender
| Prevalence (%) | ORa (95% CI) | |
|---|---|---|
| Quartile of waist circumference in male (cm) | ||
| <79.8 | 13.5 (1.1) | 1 (ref.) |
| 79.8–85.3 | 13.8 (1.1) | 1.22 (0.92–1.60) |
| 85.4–90.7 | 11.8 (1.1) | 1.14 (0.85–1.53) |
| >90.7 | 13.5 (1.1) | 1.49 (1.05–2.12) |
| P | 0.541 | 0.135 |
| Ptrend | 0.533 | 0.061 |
| Quartile of waist circumference in female (cm) | ||
| <75.7 | 27.4 (1.3) | 1 (ref.) |
| 75.7–81.7 | 27.2 (1.3) | 0.93 (0.76–1.14) |
| 81.8–87.9 | 31.9 (1.4) | 1.15 (0.93–1.42) |
| >87.9 | 37.7 (1.4) | 1.30 (1.02–1.66) |
| P | <0.001 | 0.043 |
| Ptrend | <0.001 | 0.019 |
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