BACKGROUND Although some recent studies have indicated an association between metabolic syndrome (MetS) and musculoskeletal disease, little is known about the association of MetS with low back pain (LBP). The present study aimed to investigate sex differences in the association of MetS and the clustering of MetS components with LBP among middle-aged Japanese individuals. METHODS Study subjects were 45,192 adults (30,695 men, 14,497 women) aged 40-64 years who underwent annual health checkups conducted from April 2013 to March 2014. MetS was defined according to the criteria of the Examination Committee of Criteria for MetS in Japan as abdominal obesity plus at least two of dyslipidemia, high blood pressure, or high blood glucose. Information on LBP and health-related lifestyles were collected using a self-administered questionnaire. Logistic regression modeling was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for LBP. RESULTS After adjusting for age and lifestyle factors, the OR of MetS for LBP was 1.15 (95% CI 0.95-1.40) in men and 2.16 (95% CI 1.32-3.53) in women. Compared to subjects without abdominal obesity, the presence of abdominal obesity significantly increased the OR for LBP among men (abdominal obesity only: OR 1.34, 95% CI 1.02-1.76; abdominal obesity plus one component: OR 1.24, 95% CI 1.01-1.52; abdominal obesity plus two or more components: OR 1.26, 95% CI 1.02-1.55). Among women, adding other components of MetS to abdominal obesity significantly increased ORs for LBP (abdominal obesity only: OR 1.70, 95% CI 0.94-3.08; abdominal obesity plus one component: OR 1.66, 95% CI 1.06-2.60; abdominal obesity plus two or more components: OR 2.30, 95% CI 1.41-3.78). CONCLUSIONS This large-scale cross-sectional study indicated that MetS was significantly associated with LBP among women only and that a sex-difference existed in the association between the clustering of MetS components and LBP. Clustering of MetS components by sex may need to be considered for the prevention of LBP, although further prospective studies are needed to clarify the causality.

中文翻译：

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一项大规模的横断面研究显示，日本中年成年人代谢综合征与腰痛之间的性别差异。

背景技术尽管最近的一些研究表明代谢综合征（MetS）和肌肉骨骼疾病之间存在关联，但是关于MetS与下背痛（LBP）的关联知之甚少。本研究旨在调查中年日本人在MetS关联以及MetS成分与LBP聚类中的性别差异。方法研究对象为45192名成人（30695名男性，14497名女性），年龄40-64岁，接受了2013年4月至2014年3月进行的年度健康检查。根据日本MetS标准考试委员会的标准，MetS定义为腹部肥胖加上血脂异常，高血压或高血糖中的至少两种。使用自我管理的问卷收集有关LBP和健康相关生活方式的信息。使用逻辑回归模型计算LBP的优势比（OR）和95％置信区间（CI）。结果在调整了年龄和生活方式因素后，男性的Let的MetS OR为1.15（95％CI 0.95-1.40），女性为2.16（95％CI 1.32-3.53）。与没有腹部肥胖的受试者相比，腹部肥胖的存在显着增加了男性LBP的OR（仅腹部肥胖：OR 1.34，95％CI 1.02-1.76；腹部肥胖加一种成分：OR 1.24，95％CI 1.01-1.52 ；腹部肥胖症加上两种或两种以上成分：OR 1.26，95％CI 1.02-1.55）。在女性中，将MetS的其他成分添加到腹部肥胖中会明显增加LBP的OR（仅腹部肥胖：OR 1.70，95％CI 0.94-3.08；腹部肥胖加一种成分：OR 1.66，95％CI 1.06-2.60；腹部肥胖加两个或多个组件：或2。30，95％CI 1.41-3.78）。结论这项大规模的横断面研究表明，MetS仅与女性中的LBP显着相关，并且MetS成分的聚类与LBP之间的关联存在性别差异。可能需要考虑按性别对MetS成分进行聚类，以预防LBP，尽管还需要进一步的前瞻性研究来阐明因果关系。