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Alexander Real Chierika Ukogu Divya Krishnamoorthy Nicole Zubizarreta Samuel K. Cho Andrew C. Hecht James C. Iatridis 《The spine journal》2019,19(2):225-231
Background Context
Low back pain (LBP) is a common complaint in clinical practice of multifactorial origin. Although obesity has been thought to contribute to LBP primarily by altering the distribution of mechanical loads on the spine, the additional contribution of obesity-related conditions such as diabetes mellitus (DM) to LBP has not been thoroughly examined.Purpose
To determine if there is a relationship between DM and LBP that is independent of body mass index (BMI) in a large cohort of adult survey participants.Study Design
Retrospective analysis of prospectively collected National Health and Nutrition Examination Survey (NHANES) data to characterize associations between LBP, DM, and BMI in adults subdivided into 6 subpopulations: normal weight (BMI 18.5–25), overweight (BMI 25–30), and obese (BMI >30) diabetics and nondiabetics. Diabetes was defined with glycohemoglobin A1c (HbA1c) ≥6.5%.Patient Sample
11,756 participants from NHANES cohort.Outcome Measures
Percentage of LBP reported.Methods
LBP reported in the 1999-2004 miscellaneous pain NHANES questionnaire was the dependent variable examined. Covariates included HbA1c, BMI, age, and family income ratio to poverty as continuous variables as well as race, gender, and smoking as binary variables. Individuals were further subdivided by weight class and diabetes status. Regression and graphical analyses were performed on the study population as a whole and also on subpopulations.Results
Increasing HbA1c did not increase the odds of reporting LBP in the full cohort. However, multivariate logistic regression of the 6 subpopulations revealed that the odds of LBP significantly increased with increasing HbA1c levels in normal weight diabetics. No other subpopulations reported significant relationships between LBP and HbA1c. LBP was also significantly associated with BMI for normal weight diabetics and also for obese subjects regardless of their DM status.Conclusions
LBP is significantly related to DM status, but this relationship is complex and may interact with BMI. These results support the concept that LBP may be improved in normal weight diabetic subjects with improved glycemic control and weight loss, and that all obese LBP subjects may benefit from improved weight loss alone. 相似文献3.
K.-C. Sung D.-C. Seo S.-J. Lee M.-Y. Lee S.H. Wild C.D. Byrne 《Nutrition, metabolism, and cardiovascular diseases : NMCD》2019,29(5):489-495
Background and aims
It is not known whether non alcoholic fatty liver disease (NAFLD) is a risk factor for diabetes in non obese, non centrally-obese subjects. Our aim was to investigate relationships between fatty liver, insulin resistance and a biomarker score for liver fibrosis with incident diabetes at follow up, in subjects who were neither obese nor centrally-obese.Methods and results
As many as 70,303 subjects with a body mass index (BMI) < 25 kg/m2 and without diabetes were followed up for a maximum of 7.9 years. At baseline, fatty liver was identified by liver ultrasound, insulin resistance (IR) by homeostatic model assessment of insulin resistance (HOMA-IR) ≥2.0, and central obesity by waist circumference (waist circumference ≥90 cm (men) and ≥85 cm (women). The Fibrosis-4 (FIB-4 score) was used to estimate extent of liver fibrosis. Cox proportional hazards models adjusted for confounders were used to estimate hazard ratios (aHRs) for incident diabetes. As many as 852 incident cases of diabetes occurred during follow up (median [IQR] 3.71 [2.03] years). Mean ± SD BMI was 22.8 ± 1.8 and 21.7 ± 2.0 kg/m2 in subjects with and without diabetes at follow up. In subjects without central obesity and with fatty liver, aHRs (95% CI) for incident diabetes at follow up were 2.17 (1.56, 3.03) for men, and 2.86 (1.50,5.46) for women. Similar aHRs for incident diabetes occurred with fatty liver, IR and the highest quartile of FIB-4 combined, in men; and there was a non significant trend toward increased risk in women.Conclusions
In normal weight, non-centrally obese subjects NAFLD is an independent risk factor for incident diabetes. 相似文献4.
Preventing sports injury has rarely been cited as an appropriate action to respond to the obesity epidemic, and in fact a recent letter has suggested that those playing sport are as responsible for their predicament as those who are obese. This opinion piece argues that it is time for better prevention and management of sports injury to be seen as part of the complex solution to preventing obesity, rather than being a self-inflicted problem that governments should continue to ignore. 相似文献
5.
军队在职干部腰身指数与心血管危险因素相关性探讨 总被引:1,自引:1,他引:0
目的 研究用腰身指数(腰围/身高比值WHtR)作为腹型肥胖指标探讨与心血管危险因素的相关性。方法 对2005年3月~2006年12月入住广州疗养院的军队在职干部共495人进行身高、体重、腰围、血压、心率、生化等检测,并进行统计学分析。结果 腰身指数异常组的年龄、体重、SBP、DBP、FBS、TC、TG以及尿酸均显著高于腰身指数正常组,HDL-C的结果则相反(P〈0.01~P〈0.001);同时腰身指数与年龄、体重、SBP、DBP、FBS、TC、TG呈显著正相关,与HDL-C呈显著负相关(P〈0.05~P〈0.001)。结论 腰身指数可作为有效的腹型肥胖参考指标,腰身指数异常者其心血管危险因素水平比正常者高,及时控制腰身指数可以有效改善人群的健康状况。 相似文献
6.
瘦蛋白 (leptin)是由肥胖基因编码、脂肪细胞分泌的一种分子量为 16kDa的蛋白质 ,是一种重要的代谢调节信号 ,对人和动物的采食量、能量代谢、繁殖性能等具有重要调节功能 ,对人肥胖病的治疗和改善动物的生产性能、胴体组成等有良好的潜在应用前景 .主要概述了瘦蛋白基因的克隆、转录、表达调控以及瘦蛋白受体与信号转导等分子生物学特性 相似文献
7.
At our center, since 1982, a body mass index (BMI) of less than 30 has been a prerequisite for placing a patient on the waiting
list for renal transplantation. This decision was made because obese transplant recipients seemed to have a less than favorable
post-transplant outcome. The aim of this study was to evaluate whether this requirement is still justified. Forty-six patients
with a BMI above 30 underwent primary cadaveric renal transplantation between 1972 and 1993. For each of these obese patients,
five consecutive non-obese (BMI 20–25) control patients were selected. Patient and graft survival, causes of graft loss, and
acute rejection rate were evaluated for the two patient groups before and after the year 1982. Within the first 30 post-transplant
days, one patient (2 %) and 11 grafts (24 %) were lost in the group of obese patients whereas seven patients (3 %) and 36
grafts (16 %) were lost in the control group. Among the obese patients, renal circulatory complications were a major cause
of graft loss. In the period 1973–1981, the 1-year patient survival rate was 65 % among obese patients versus 75 % among controls
from 1982 to 1993, this was 90 % versus 93 %. From 1973 to 1981, the 1-year graft survival rate was 25 % among obese patients
versus 53 % among controls (P < 0.05); from 1982 to 1993, it was 68 % versus 84 % (P = NS). Multivariate analysis showed that the immunosuppressive regimen,
age of the patient, BMI, and cold ischemia time of the graft had a significant influence on graft survival. The acute rejection
rate within the first 30 days was 28 % among obese patients and 35 % among controls (P = NS). We conclude that a BMI below
or equal to 30 is still justified as a prerequisite for placement on the waiting list for renal transplantation, for despite
an overall improvement, the outcome of renal transplantation in obese patients remains worse than that in non-obese patients.
Received: 3 February 1997 Received after revision: 4 April 1997 Accepted: 8 April 1997 相似文献
8.
A review of incisional hernia repairs: preoperative weight loss and selective use of the mesh repair 总被引:3,自引:0,他引:3
At the Shouldice Clinic pre-operative weight loss is used prior to incisional hernia repairs. Mesh repair is selectively used, based on specific hernia characteristics. A series of 236 patients were reviewed and followed up for 36 months. Data were available on 188 patients (80%). There were 15 recurrences (8%). The number of obese patients was reduced from 67 (35.6%) to 25 (13.3%) through the weight loss program. The hernia diameter, gastrointestinal complications, and surgical site infection were significantly related to recurrence but not the type of repair, obesity, location, or previous recurrences. The risk factors of incisional hernias include size, intestinal complications and infections. A selective use has a comparable result to the exclusive use of mesh repair. Weight reduction has yet to be shown to affect the rate of recurrence, and further prospective studies are required. 相似文献
9.
Identification of differentially expressed genes in omental adipose tissues of obese patients by suppression subtractive hybridization 总被引:1,自引:0,他引:1
Qiu J. Ni Y. H. Gong H. X. Fei L. Pan X. Q. Guo M. Chen R. H. Guo X. R. 《南京医科大学学报(自然科学版)》2007,27(5):427-427
To identify differentially expressed genes between obese individuals and normal control, we have undertaken suppression subtractive hybridization (SSH). Omental adipose tissues were obtained via abdominal surgery for appendicitis in both 13 obese subjects[BMI (body mass index) 〉 30 kg/m(2)] and 13 normal subjects (BMI 〉 18 and 〈 25 kg/m(2)). 相似文献
10.