Metabolic Syndrome and Low Back Pain: Evidence from Cross-Sectional and Mendelian Randomization Analysis
Xingkun Wang1,2, Dingnan Sun3, Heng Duan1,2
1Department of Orthopedics, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China.
Journal of Pain Research
|March 20, 2026
Summary
Metabolic syndrome (MetS) is linked to low back pain (LBP). Genetic analysis suggests hypertension and abdominal obesity causally contribute to LBP, highlighting metabolic health
Area of Science:
- Cardiovascular Health
- Metabolic Disorders
- Musculoskeletal Health
Background:
- Metabolic syndrome (MetS) and low back pain (LBP) are prevalent health issues with an unclear relationship.
- Components of MetS, including abdominal obesity and hypertension, may influence musculoskeletal degeneration.
Purpose of the Study:
- To investigate the association between MetS and LBP.
- To explore the potential causal links between MetS components and LBP.
Main Methods:
- Analysis of 5,523 adults from NHANES 1999-2004 data.
- MetS defined by ATPIII, IDF, and mWHO criteria.
- Weighted logistic regression, mediation analysis (CRP), and Mendelian randomization (MR) using GWAS data.
Main Results:
- Higher MetS prevalence observed in participants with LBP across all definitions.
- Significant associations found between MetS and LBP (IDF OR=1.27, ATPIII OR=1.26, mWHO OR=1.21).
- MR analysis indicated causal effects of hypertension and waist circumference on LBP; CRP did not mediate the association.
Conclusions:
- MetS is associated with LBP, supported by genetic evidence implicating hypertension and abdominal obesity.
- Improving metabolic health may be a viable strategy for reducing the burden of LBP.
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