体质指数和腰臀比对中老年妇女腰椎前凸和骶骨倾斜度的影响

目的：探讨下腰痛患者体质指数（BMI）和腰臀比（wHR）对腰椎前凸和骶骨倾斜度的影响，讨论肥胖致下腰痛的机制。方法：对98例患有下腰痛的中老年妇女进行Roland功能障碍问卷（RDQ），测量身高、体重、腰围和臀围，并计算BMI和WHR。按BMI将病例分成正常组、超重组和肥胖组，按WHR将病例分成非向心性肥胖组和向心性肥胖组。立位摄腰椎X线侧位片，测量腰椎曲线指数（LCI）、腰椎前凸度（Cobb角）和骶骨倾斜角（SSA），对各组所测量的数据进行统计学分析。结果：超重组、肥胖组的LCI、Cobb角、SSA和RDQ明显高于正常组，向心性肥胖组的LCI、Cobb角、SSA和RDQ明显高于非向心性肥胖组。结论：体质指数超过24kg／m^2或腰臀比超过0．85时，均使腰椎前凸和骶骨倾斜度加大、RDQ评分增高。超重、肥胖，或向心性肥胖可致下腰痛。腰椎前凸和骶骨倾斜度增大，可能是肥胖致下腰痛的解剖基础之一。

Effect of BMI and WHR on lumbar lordosis and sacrum slant angle in middle and elderly women

Objective: To investigate the effect of body mass index(BMI) and waist hip ratio(WHR) on lumbar lordosis and sacrum slant angle in the patients with low back pain,and to discuss the theory of low back pain induced by obesity. Methods: The Roland Disability Questionnaire(RDQ)was answered by 98 middle and elderly women with low back pain,who- se body height,body weight,waist circumference,and hip circumference were measured and used to calculate their MBI and WHR. According to BMI,all the cases were divided into normal,overweight and obesity groups. These cases were also divided into noncentral and central obesity groups according to WHR. The lateral X-ray films of the lumbar spine were studied by measuring LCI,Cobb angle,and SSA. The data of all groups were analyzed statistically. Results: LCI,Cobb angle,SSA and RDQ scores in the overweight and obesity groups are significantly higher than those in the normal group. LCI,Cobb angle,SSA,and RDQ scores in the central obesity group are significantly higher than those in the noncentral obesity group. Conclusion: BMI exceeding 24 kg/m² or WHR exceeding 0.85 may increase the measurements of Cobb angle,SSA and RDQ scores. Low back pain may occur because of overweight,obesity,or central obesity. The anatomy foundation of the increasing lumbar lordosis and sacrum slant angle may be the one of reasons of low back pain in obese person.