经由孟德尔随机化确定的慢性腰部疼痛因果风险因素:一个横截面队列分析
Patricia Zheng1, Aaron Scheffler2, Susan Ewing2
1Department of Orthopaedic Surgery, University of California, San Francisco, CA, USA.
概括
这项研究确定了慢性腰部疼痛 (cLBP) 的关键可修改的风险因素. 睡眠障碍和肥胖严重影响疼痛和日常功能,突出了有效管理cLBP的目标.
科学领域:
- 流行病学 流行病学
- 疼痛研究 疼痛研究
- 遗传学 遗传学 是一个
背景情况:
- 慢性腰部疼痛 (cLBP) 具有跨生物,心理和社会领域的多因素风险因素.
- 治疗通常假定风险因素是因果关系的,但混变量可能导致无效的干预.
- 严格识别因果风险因素对于改善cLBP治疗结果至关重要.
研究的目的:
- 严格控制混变量,并比较可修改的因果风险因素和cLBP之间的关联.
- 估计特定风险因素与cLBP结果的特定关联.
主要方法:
- 纵向的,在线的,观察性的BACKHOME电子队列研究的横截面分析.
- 美国有1376名患有cLBP的成年人参与了研究.
- 门德尔随机化 (MR) 确定了潜在的因果风险因素:睡眠障碍,抑郁症,BMI,酒精使用和吸烟状况.
- 用定向环形图 (DAG) 和ESC-DAG方法进行了严格的混控制.
主要成果:
- 经过调整后的分析显示,饮酒,睡眠障碍,抑郁症和肥胖与疼痛和功能 (PEG尺度) 之间存在显著的关联.
- 睡眠障碍和肥胖显示出最大的效果大小,睡眠障碍增加和更高的BMI与更差的PEG分数相关.
- 睡眠障碍的每一个标准偏差增加都与PEG评分的0.77点增加有关.
结论:
- 可修改的风险因素包括酒精使用,睡眠障碍,抑郁症和肥胖症与cLBP结果有显著的关联.
- 睡眠障碍,抑郁症和肥胖症的发现与MR研究一致,加强了它们在cLBP中的因果作用的证据.
- 睡眠障碍和肥胖是未来旨在改善cLBP管理的干预措施的关键目标.
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