Korean journal of health promotion

Korean Society for Health Promotion and Disease Prevention (대한임상건강증진학회)
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Associations Between Body Composition and Chronic Low Back Pain in Adults: Data from the 2009 Korea National Health and Nutrition Examination Survey

성인의 신체조성과 만성 요통과의 관련성: 2009년 국민건강영양조사 자료를 토대로

  • Lee, Moseon (Department of Alternative Medicine, Graduate School Kyonggi University) ;
  • Kim, Jaehee (Graduate School of Alternative Medicine, Kyonggi University)
  • 이모선 (경기대학교 대학원 대체의학과) ;
  • 김재희 (경기대학교 대체의학대학원)
  • Published : 2012.12.30
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Abstract

Background: The relationship between fat mass, muscle mass and chronic low back pain is unclear and little is known about it. The aim of this study was to investigate the association between body composition and the risk of chronic low back pain in young and middle-aged Korean adults. Methods: Data from 1807 men and 1810 women aged 19 to 64 years who participated in the fourth Korea National Health and Nutrition Examination Survey in 2009 were evaluated. Chronic low back pain was defined as pain lasting for more than three months. Sociodemographic, lifestyle, anthropometric and body composition variables were analyzed using logistic regression. Results: The prevalence of chronic low back pain was higher in women (11.5%) than in men (6.4%). In men, the risk for chronic low back pain was significantly associated with education level and alcohol use. In women, the risk factors were age, education level, occupation, physical activity, menopausal status, body mass index and waist circumference. After adjusting for covariates, total and trunk fat mass and total and appendicular lean body mass were not associated as risk for chronic low back pain in both genders. Conclusions: Fat mass and muscle mass may not be associated with chronic low back pain in young and middle- aged Korean adults.

연구배경: 체지방 및 근육과 만성 요통과의 상관성은 불분명하며, 이에 관한 연구는 매우 미흡하다. 이에 본 연구는 청년층과 중년층 한국인의 신체조성과 만성 요통 위험과의 관련성을 파악하는 것을 목적으로 하였다 방법: 제4기 2009년 국민건강영양조사에 참가한 19세에서 64세의 남자 1807명과 여자 1810명의 자료를 분석하였다. 3개월 이상 통증이 지속된 경우를 만성요통으로 정의하였다. 사회인구학적, 생활습관, 신체계측 및 신체조성 변인들과 만성요통 위험과의 관계를 로지스틱 회귀분석을 이용하여 분석하였다. 결과: 여자(11.5%)가 남자(6.4%)보다 만성요통 유병률이 더 유의하게 높았다. 남자의 경우 만성요통 여부는 교육 수준과 음주와 유의한 관련이 있었다. 여자의 경우 만성요통 위험요인들은 연령, 교육수준, 직업, 규칙적인 운동습관, 폐경여부, 체질량지수와 허리둘레인 것으로 나타났다. 이러한 요인들을 공변량으로 통제하여 다중 로지스틱 회귀 분석한 결과, 남녀 모두에서 만성요통 위험은 총 체지방, 복부지방, 총 제지방 및 사지 제지방과 유의한 관련이 없었다. 결론: 청년층과 중년층 한국인의 체지방과 근육량은 만성 요통 위험과의 관련이 없는 것으로 사료된다.

Keywords

References

  1. Frymoyer JW, Cats-Baril WL. An overview of the incidences and costs of low back pain. Orthop Clin North Am 1991;22(2):263-71.
  2. Lee CG, Ahn HO, Ryu SY, Park J, Kim KS, Kim YO. A study on the medical insurance utilization of workers suffering from low back pain in an area. J Prev Med Public Health 1997; 30(4):764-78.
  3. Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum 2012;64(6):2028-37. https://doi.org/10.1002/art.34347
  4. Macfarlane GJ, Beasley M, Jones EA, Prescott GJ, Docking R, Keeley P, et al. The prevalence and management of low back pain across adulthood: results from a population-based cross-sectional study (the MUSICIAN study). Pain 2012;153(1):27-32. https://doi.org/10.1016/j.pain.2011.08.005
  5. Korea Centers for Disease Control and Prevention. Korea Health Statistics 2009: Korea National Health and Nutrition Examination Survey (KNHANESIV-3). Osong:Korea Centers for Disease Control and Prevention;2010.
  6. Perrot S, Allaert FA, Concas V, Laroche F. "When will I recover?" A national survey on patients' and physicians' expectations concerning the recovery time for acute back pain. Eur Spine J 2009;18(3):419-29. https://doi.org/10.1007/s00586-008-0868-6
  7. Andersson GB. Epidemiological features of chronic low-back pain. Lancet 1999;354(9178):581-5. https://doi.org/10.1016/S0140-6736(99)01312-4
  8. Brisby H. Pathology and possible mechanisms of nervous system response to disc degeneration. J Bone Joint Surg Am 2006;88 Suppl 2:68-71.
  9. McQuade KJ, Turner JA, Buchner DM. Physical fitness and chronic low back pain. An analysis of the relationships among fitness, functional limitations, and depression. Clin Orthop Relat Res 1988;(233):198-204.
  10. Lee JH, Ooi Y, Nakamura K. Measurement of muscle strength of the trunk and the lower extremities in subjects with history of low back pain. Spine (Phila Pa 1976) 1995;20(18):1994-6. https://doi.org/10.1097/00007632-199509150-00006
  11. Jhun HJ, Park JY. Estimated number of korean adults with back pain and population-based associated factors of back pain: data from the fourth Korea national health and nutrition examination survey. J Korean Neurosurg Soc 2009;46(5):443-50. https://doi.org/10.3340/jkns.2009.46.5.443
  12. Leclerc A, Gourmelen J, Chastang JF, Plouvier S, Niedhammer I, Lanoe JL. Level of education and back pain in France: the role of demographic, lifestyle and physical work factors. Int Arch Occup Environ Health 2009;82(5):643-52. https://doi.org/10.1007/s00420-008-0375-4
  13. Leino-Arjas P, Hänninen K, Puska P. Socioeconomic variation in back and joint pain in Finland. Eur J Epidemiol 1998;14(1):79-87. https://doi.org/10.1023/A:1007448402954
  14. Schneider S, Randoll D, Buchner M. Why do women have back pain more than men? A representative prevalence study in the federal republic of Germany. Clin J Pain 2006;22(8):738-47. https://doi.org/10.1097/01.ajp.0000210920.03289.93
  15. Schneider S, Schmitt H, Zoller S, Schiltenwolf M. Workplace stress, lifestyle and social factors as correlates of back pain: a representative study of the German working population. Int Arch Occup Environ Health 2005;78(4):253-69. https://doi.org/10.1007/s00420-004-0576-4
  16. Urquhart DM, Berry P, Wluka AE, Strauss BJ, Wang Y, Proietto J, et al. 2011 Young Investigator Award winner: Increased fat mass is associated with high levels of low back pain intensity and disability. Spine (Phila Pa 1976) 2011;36(16):1320-5. https://doi.org/10.1097/BRS.0b013e3181f9fb66
  17. Heuch I, Hagen K, Heuch I, Nygaard O, Zwart JA. The impact of body mass index on the prevalence of low back pain: the HUNT study. Spine (Phila Pa 1976) 2010;35(7):764-8. https://doi.org/10.1097/BRS.0b013e3181ba1531
  18. Leboeuf-Yde C. Alcohol and low-back pain: a systematic literature review. J Manipulative Physiol Ther 2000;23(5):343-6. https://doi.org/10.1016/S0161-4754(00)90209-4
  19. Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between obesity and low back pain: a meta-analysis. Am J Epidemiol 2010;171(2):135-54. https://doi.org/10.1093/aje/kwp356
  20. Snijder MB, van Dam RM, Visser M, Seidell JC. What aspects of body fat are particularly hazardous and how do we measure them? Int J Epidemiol 2006;35(1):83-92. https://doi.org/10.1093/ije/dyi253
  21. Park SS, Han GS, Kim GD, Lee KS, Lee KJ. Lim DC. Comparative analysis between low back pain patients and healthy people on lumbar extension strength and body composition. Korean J Sports Sci 2010;19(2):1113-24.
  22. Toda Y, Segal N, Toda T, Morimoto T, Ogawa R. Lean body mass and body fat distribution in participants with chronic low back pain. Arch Intern med 2000;160(21):3265-9. https://doi.org/10.1001/archinte.160.21.3265
  23. Korea Centers for Disease Control and Prevention. Progress reports in the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV-1). Osong:Korea Centers for Disease Control and Prevention;2007.
  24. Lee K. Soft tissue composition and the risk of low bone mineral density: the Fourth Korea National Health And Nutrition Examination Survey (KNHANES IV-3), 2009. Calcif Tissue Int 2012;90(3):186-92. https://doi.org/10.1007/s00223-012-9573-x
  25. Fuller NJ, Laskey MA, Elia M. Assessment of the composition of major body regions by dual-energy X-ray absorptiometry (DEXA), with special reference to limb muscle mass. Clin Physiol 1992;12(3):253-66. https://doi.org/10.1111/j.1475-097X.1992.tb00831.x
  26. Kim IH, Khang YH, Muntaner C, Chun H, Cho SI. Gender, precarious work, and chronic diseases in South Korea. Am J Ind Med 2008;51(10):748-57. https://doi.org/10.1002/ajim.20626
  27. Lim JH, Kim SY. Factors affecting colorectal cancer screening behaviors: Based on the 4th Korea National Health and Nutrition Examination Survey. Korean J Health Educ Promt 2011;28(1): 69-80.
  28. Xu Y, Bach E, Orhede E. Occupation and risk for the occurrence of low-back pain (LBP) in Danish employees. Occup Med (Lond) 1996;46(2):131-6. https://doi.org/10.1093/occmed/46.2.131
  29. Oksuz E. Prevalence, risk factors, and preference-based health states of low back pain in a Turkish population. Spine (Phila Pa 1976) 2006;31(25):E968-72. https://doi.org/10.1097/01.brs.0000247787.25382.3c
  30. Han TS, Schouten JS, Lean ME, Seidell JC. The prevalence of low back pain and associations with body fatness, fat distribution and height. Int J Obes Relat Metab Disord 1997; 21(7):600-7. https://doi.org/10.1038/sj.ijo.0800448