The relationship between obesity, low back pain, and lumbar disc degeneration when genetics and the environment are considered: a systematic review of twin studies

Dario, Amabile Borges; Ferreira, Manuela L; Refshauge, Kathryn M.; Lima, Thais S.; Ordoñana, Juan R.; Ferreira, Paulo H.

doi:10.1016/j.spinee.2015.02.001

Cited by 167 publications

(130 citation statements)

References 36 publications

Supporting

Mentioning

119

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, the magnitude of the ORs for the significant predictors in the total sample (BMI and percent body fat) is still similar to the all within-pair twin case-control analyses, which points to the fact that the association between obesity-related measures and chronic LBP in fact was weak and non-reliable when twins were considered as individuals. Secondly, according to a systematic review recently published, the reduced association between LBP and obesity seems to be consistent across studies when genetics and the environment factors are considered [30]. Pooled results of two MZ case-control studies with greater sample sizes than ours, 442 [10] and 413 [21] pairs, has shown no association between obesity and LBP (OR 1.4; 95 % CI 0.8-2.3) [30].…”

Section: Limitationsmentioning

confidence: 52%

“…Secondly, according to a systematic review recently published, the reduced association between LBP and obesity seems to be consistent across studies when genetics and the environment factors are considered [30]. Pooled results of two MZ case-control studies with greater sample sizes than ours, 442 [10] and 413 [21] pairs, has shown no association between obesity and LBP (OR 1.4; 95 % CI 0.8-2.3) [30]. Notwithstanding, this study represents a step forward in the investigation of the relationship between obesity and chronic LBP relationship because we used a comprehensive assessment of obesity that accounts for body fat distribution and employed a within-pair casecontrol design to allow for more direct and precise estimates of obesity-LBP relationship.…”

Section: Limitationsmentioning

confidence: 85%

See 1 more Smart Citation

Are obesity and body fat distribution associated with low back pain in women? A population-based study of 1128 Spanish twins

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Limitationsmentioning

confidence: 52%

Section: Limitationsmentioning

confidence: 85%

Are obesity and body fat distribution associated with low back pain in women? A population-based study of 1128 Spanish twins

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…We would expect the BMI of a sample population from today to be approximately 25% greater than that of our specimens [24]. Previous research indicates that increasing BMI is not only a risk factor for degenerative disc disease and low back pain [13], but also spondylolysis [47]. Although we cannot make clinical correlations based on our cadaveric specimens, based on previous data we might reasonably infer that a sample population from today would have, if anything, increased prevalence of degenerative disc disease, spondylolysis, and low back pain based on the changes in body habitus that have developed during the last century or more.…”

Section: Discussionmentioning

confidence: 77%

Bilateral Pars Defects at the L4 Vertebra Result in Increased Degeneration When Compared With Those at L5: An Anatomic Study

McCunniff

Yoo

Dugarte

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Cadaveric studies have examined disc degeneration at the L4-L5 and L5-S1 motion segments; however, we are not aware of another study that has examined the relationship between bilateral spondylolysis and its effect on degenerative disc disease at those levels. This may have been overlooked by researchers owing to the majority of spondylolysis occurring at the L5 vertebra. Questions/purposes Using osteologic specimens from a collection that included individuals who died in one city in the USA between 1893 and 1938, we asked: (1) do specimens with bilateral spondylolysis (bilateral pars defects) have increased levels of disc degeneration, at their respective motion segments, when compared with matched controls without spondylolysis, and (2) is the finding of a bilateral pars defect associated with more severe arthritis at L4-L5 than at L5-S1? Methods An observational study was performed on 665 skeletal lumbar spines from the Hamann-Todd Osteologic Collection at the Cleveland Museum of Natural History (Cleveland, OH, USA). The specimens included 534 males and 131 females ranging from 17 to 87 years old, with a nearly bell-shaped distribution of ages for males and a larger proportion of younger ages in the female specimens. Of those with spondylolysis, 81 had a defect at L5 and 14 had a defect at L4. The gross specimens were examined subjectively for evidence of arthrosis. At the time of examination, specific attention was not paid to the coexisting presence or absence of spondylolysis nor was the examiner blinded to the age of the specimens. Disc degeneration was measured by the classification of Eubanks et al., a modified version of the Kettler and Wilke classification. Linear regression was performed to derive a formula that would predict the amount of disc degeneration at L4-L5 and L5-S1 for the normal control population given a specimen's age, sex, and race. We then used this formula to evaluate the difference in disc degeneration at the corresponding level of the pars defect that is greater Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. This work was performed at the University Hospitals Case Medical Center and the Cleveland Museum of Natural History, Cleveland, OH, USA. P. T. McCunniff (&), Clinical Orthopaedics and Related Research ®A Publication of The Association of Bone and Joint Surgeons® than the pr...

show abstract

“…Knutsson et al [20] found a linear positive relationship between BMI and lumbar spinal stenosis. Several studies suggest that high BMI and obesity may be linked to lumbar disc degeneration [17,21,22,23,24,25,26]. Takatalo et al [25] note that BMI is commonly used as a standardized measure to assess overweight and obesity, although BMI does not indicate specifically the distribution of body fat and muscle mass.…”

Section: Introductionmentioning

confidence: 99%

Associations between Obesity and Spinal Diseases: A Medical Expenditure Panel Study Analysis

Sheng

Feng

Zhang

et al. 2017

IJERPH

View full text Add to dashboard Cite

Background: The link between body weight status and spinal diseases has been suggested by a number of cross-sectional and cohort studies with a limited range of patient populations. No population-representative samples have been used to examine the link between obesity and spinal diseases. The present study is based on a nationally representative sample drawn from the Medical Expenditure Panel Survey. Methods: Using the cross-sectional sample of the 2014 Medical Expenditure Panel Study, we built four weighted logistic regression analyses of the associations between body weight status and the following four spinal diseases: low back pain, spondylosis, other cervical disorders and intervertebral disc disorder (IDD). Each respondent’s body weight status was used as the key independent variable with three categories: normal/underweight, overweight, and obese. We controlled for marital status, gender, age, smoking status, household income, health insurance coverage, educational attainment and the use of health services for other major categories of diseases. Results: A total sample of 23,048 respondents was used in our analysis. Overweight and obese respondents, as compared to normal/underweight respondents, were more likely to develop lower back problems (Overweight: logged odds = 0.218, p < 0.01; Obese: logged odds = 0.395, p < 0.001) and IDD (Overweight: logged odds = 0.441, p < 0.05; Obese: logged odds = 0.528, p < 0.001). The associations between bodyweight status and spondylitis were statistically insignificant (Overweight: logged odds = 0.281, p = 0.442; Obese: logged odds = 0.680, p = 0.104). The associations between body weight status and other cervical disorders (Overweight: logged odds = −0.116, p = 0.304; Obese: logged odds = −0.160, p = 0.865) were statistically insignificant. Conclusions: As the first study using a national sample to study bodyweight and spinal diseases, our paper supports the hypothesis that obesity adds to the burden of low back pain and IDD. Longitudinal and interventional studies are needed to understand the specific mechanisms behind these positive associations.

show abstract

The relationship between obesity, low back pain, and lumbar disc degeneration when genetics and the environment are considered: a systematic review of twin studies

Cited by 167 publications

References 36 publications

Are obesity and body fat distribution associated with low back pain in women? A population-based study of 1128 Spanish twins

Are obesity and body fat distribution associated with low back pain in women? A population-based study of 1128 Spanish twins

Bilateral Pars Defects at the L4 Vertebra Result in Increased Degeneration When Compared With Those at L5: An Anatomic Study

Associations between Obesity and Spinal Diseases: A Medical Expenditure Panel Study Analysis

Contact Info

Product

Resources

About