BACKGROUND Previous studies have only investigated how symptom presentation and socio-demographic factors influence care-seeking for low back pain (LBP). However, the influence of health and lifestyle factors remains unclear, and the potential confounding effects of aggregated familial factors (including genetics and the early shared environment) has not been considered extensively. METHODS A cross-sectional analysis was performed on 1605 twins enrolled in the Murcia Twin Registry (Spain). The outcome was seeking medical care for LBP and various self-reported demographic, health, and lifestyle factors were considered predictors. All variables except sleep quality and diabetes were collected in 2013, which were cross-referenced from 2009/2010. A multivariate logistic regression model was performed on the total sample, followed by a co-twin case-control analysis. RESULTS The only significant factor found to increase the odds of seeking medical care for LBP without being affected by familial factors was poor sleep quality (total sample OR=1.58, 95%CI 1.24-2.01; case-control OR=1.75, 95%CI 1.14-2.69). The factors that were associated with reduced odds of seeking medical care for LBP and not confounded by familial factors were male sex (case-control OR=0.55, 95%CI 0.33-0.93), alcohol intake (case-control OR=0.90, 95%CI 0.82-0.99) and a history of diabetes (case-control OR=0.50, 95%CI 0.25-0.97). No other factors significantly influenced medical care-seeking for LBP. CONCLUSIONS People reporting poor sleep quality are more likely to seek medical care for LBP in the long term, with this relationship being independent from aggregated familial factors. Conversely, males, people reporting higher alcohol intake, and people with a history of diabetes are less likely to seek medical care for LBP.

中文翻译：

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在双胞胎成人样本中寻求治疗腰痛的相关因素

背景 先前的研究仅调查了症状表现和社会人口因素如何影响对腰痛 (LBP) 的护理。然而，健康和生活方式因素的影响尚不清楚，聚合家族因素（包括遗传和早期共享环境）的潜在混杂影响尚未得到广泛考虑。方法 对穆尔西亚双胞胎登记处（西班牙）登记的 1605 对双胞胎进行横断面分析。结果是为 LBP 寻求医疗护理，各种自我报告的人口统计学、健康和生活方式因素被认为是预测因素。除睡眠质量和糖尿病外的所有变量均在 2013 年收集，并从 2009/2010 年开始进行交叉引用。对总样本进行多变量逻辑回归模型，其次是双胞胎病例对照分析。结果 在不受家庭因素影响的情况下，唯一能增加 LBP 就医几率的重要因素是睡眠质量差（总样本 OR=1.58，95%CI 1.24-2.01；病例对照 OR=1.75，95%CI 1.14-2.69）。与 LBP 就医几率降低相关且不受家族因素混淆的因素是男性（病例对照 OR=0.55，95%CI 0.33-0.93）、饮酒（病例对照 OR=0.90、95 %CI 0.82-0.99）和糖尿病史（病例对照 OR=0.50，95%CI 0.25-0.97）。没有其他因素显着影响 LBP 就医。结论 从长远来看，报告睡眠质量差的人更有可能为 LBP 寻求医疗护理，这种关系独立于汇总的家族因素。反过来，