Table 2. Results of the studies investigating the relationship between adiposity and low back pain.
| First author (year) | Definition of pain | Variables adjusted for | Main findings (OR/RR/β coefficient (95% CI)) | Conclusions |
|---|---|---|---|---|
| Low back pain | ||||
| Cross-sectional studies | ||||
| Anthropometric fat measurement | ||||
| Yoshimoto (2019) [136] | Responded yes to the question, “Do you have LBP under treatment including follow-up?” | Adjustment for age, smoking habits, alcohol intake, and physical activity. |
Men: Abdominal obesity: LBP vs no LBP: 335 (52.3) vs 13,709 (45.6) No abdominal obesity: LBP vs no LBP: 306 (47.7) vs 56,345 (54.4) Pearson’s chi square: p < 0.001. OR: 1.34 (1.02, 1.76) Women: Abdominal obesity: LBP vs no LBP: 52 (21.1) vs 1749 (12.3) No abdominal obesity: LBP vs no LBP: 194 (78.9) vs 12,502 (87.7) Pearson’s chi square: p < 0.001. OR: 1.70 (0.94, 3.08) |
The proportion of abdominal obesity was significantly higher in participants with LBP than in those without LBP for each sex. The presence of abdominal obesity was significantly associated with LBP among men, but not among women. |
| Hussien (Egypt, 2019) [138] | Continuous or recurrent localised LBP ≥ 3 months. Pain intensity rating on the VAS of ≥ 1. |
No adjustments made. | WC: Tb = -0.02, p = 0.7 HC: Tb = 0.04, p = 0.6 WHR: Tb = -0.04, p = 0.5 |
There were no associations between the anthropometric measures and pain intensity. |
| Kulandaivelan (2018) [135] | Pain lasting > 1 day in the past 12 months | NA |
Presence of pain: OR: 1.39 (1.08, 1.81) |
Abdominal obesity increases the risk of low back pain. |
| Brady (2018) [33] | Responded yes to LBP in the past month. | Age, sex |
Presence of pain WC 109.6 ± 16.8 vs 101.0 ± 9.3 cm OR: 1.1 (1.0, 1.1) |
Participants who had back pain in the past month had a higher waist circumference compared to those without back pain. |
| Machado (2018) [130] | Disabling pain in the last 1 year | Gender, BMI, WC, self-rate health, multi-morbidity, chronic musculoskeletal pain other than LBP, frequent LBP, physical activity, low gait speed, fatigue, sitting, sleep, depression symptoms, depression diagnosis, fear beliefs |
Presence of disabling LBP WC (male ≥102 cm, female ≥88) OR 0.47 (0.11–2.14) |
WC, dichotomised into high and low, was not associated with LBP. |
| Ogwumike (Nigeria, 2016) [133] | Presence of back pain in the past year. | Age |
Presence of pain WC: 1.51 (0.94, 2.40) WHtR: 1.70 (1.07, 2.75) WHR: 1.04 (0.66, 1.67) |
Waist height ratio (WHtR) was found to be associated with LBP in post-menopausal women. |
| Chou (2016) [7] | Cohort split into two groups: 1. No pain/disability or low intensity pain (<50) and low disability (<3) 2. High intensity pain (≥50) or high disability (≥3) |
Age, emotional disorder, education and mobility |
High-intensity pain and/or disability vs low-intensity pain and/or disability (Estimated marginal means) WHR (SD): 0.96 (0.006) vs 0.97 (0.006), p = 0.04 |
WHR was higher in those with either high intensity pain or high disability compared to those with no or low intensity pain or no or low disability. |
| Frilander (2015) [123] | Yes response to chronic LBP and radiating LBP (0 = no, 1 = below knee, 2 = above knee) | Age, smoking, education |
Chronic LBP (WC, <94 cm ref) 94–101.9cm: OR 1.04 (0.63–1.73) ≥102cm: OR 1.24 (0.75–2.03) Radiating LBP (WC <94 cm ref) 94–101.9cm: OR 1.03 (0.69–1.53) ≥102cm: OR 1.31 (0.88–1.96) |
WC was not associated with incident, chronic LBP. WC was not associated with incident, radiating LBP. |
|
Chronic LBP (Waist-to-height ratio, ≤0.5 ref) >0.5: OR 1.33 (0.75–1.72) Radiating LBP (Waist-to-height ratio, ≤0.5 ref) >0.5: OR 1.44 (1.02–2.04) | ||||
| Muramoto (2014) [132] | Pain intensity rating on the VAS of ≥ 1. | Age | WC: r = 0.2, p<0.005 HC: r = 0.2, p<0.01 WHR: r = 0.2, p<0.01 Multivariate analyses: WC: significant association reported. Data not provided. p<0.05. |
Central obesity was associated with LBP intensity. |
| Briggs (2013) [112] | Positive response to “during the past 3 months, did you have LBP?” | NA |
LBP vs no LBP Men (WC, <102 cm ref) vs women (WC, <88 cm ref) Chi-squared; p<0.001 |
A larger WC increased the odds of reporting LBP. |
| Ojoawo (2011) [116] | Pain rating between 1 and 10. | NA |
Pain intensity HC: r = 0.41, p<0.05 WC: r = 0.24, p>0.05 WHR: r = 0.18, p>0.05 |
Increased HC, but not WC or WHR had a significant relationship with the intensity of pain experienced in women with low back pain. |
| Perry (2009) [117] | Positive response to back pain ever, back pain in past month or chronic back pain lasting >3 months. | Physical characteristics |
Prevalent LBP Male (IQR ref) Univariate Low WC: OR 0.45 (0.23–0.86) High WC: OR 1.12 (0.67–1.86) Multivariate WC: OR 2.20 (1.11, 4.36) |
An increased likelihood of low back pain was associated with greater central adiposity in adolescent males but not females. |
|
Prevalent LBP Female (IQR ref) Univariate: Low WC: OR 1.14 (0.68–1.93) High WC: OR 1.06 (0.62–1.81) WC: OR Data not provided. | ||||
| Shiri (2008) [127] | Dichotomous variable of LBP. Those who recovered in one month, had recurrent or continuous back pain compared with those who recovered in one week or had no back pain. | Age, educational status, occupational status and smoking |
Pain intensity Male (WC, <94.0cm ref) 94.0–101.9cm: OR 1.1 (0.7–1.6) ≥102.0cm: OR 0.7 (0.4–1.1) Female (WC, <80.0cm ref) 80.0–87.9cm: OR 1.3 (0.9–1.8) ≥88.0cm: OR 1.8 (1.3–2.4) |
WC, HC and WHR were significantly associated with LBP in females, but not in males. |
|
Pain intensity Male (HC, lowest tertile ref) Middle tertile: OR = 1.3 (0.9–1.9) Highest tertile: OR = 1.0 (0.6–1.4) Female (HC, lowest tertile ref) Middle third: OR = 1.0 (0.7–1.4) Highest third: OR = 1.6 (1.1–2.1) | ||||
|
Pain intensity Male (WHR, <0.9 ref) 0.9–1.0: OR 0.9 (0.5–1.8) >1.0: OR 0.9 (0.5–1.8) Female (WHR, <0.8 ref) 0.8–0.9: OR 1.2 (0.8–1.5) >0.9: OR 2.3 (1.3–3.9) | ||||
| Toda (2000) [118] | Responded ‘yes’ to duration of current episode of LBP > 3 months or recurrent LBP compared to responded ‘no’ to LBP or low back problems in past 10 years. | NA |
Presence of pain Female (WHR) Control vs negative straight leg raise 86.5 (5.3) vs 90.8 (6.4), p<0.001 Control vs positive straight leg raise 86.5 (5.3) vs 87.3 (6.3), p>0.05 |
Central adiposity may be a risk factor for chronic low back pain with a negative straight leg raise test result in women, but not in men. Positive straight leg raise was not associated with central adiposity. |
|
Presence of pain Male (WHR) Control vs negative straight leg raise 90.2 (4.4) vs 90.5 (4.8), p>0.05 Control vs positive straight leg raise 91.9 (4.0) vs 90.5 (4.8), p>0.05 | ||||
| Han (1997) [113] | Responded yes to LBP in past 12 months. Chronic LBP defined as responded yes to a total of twelve weeks or more. | Age, smoking, education |
WCtertiles 86.9cm and 95.9cm for males, 75.0cm and 84.0cm for females, lowest tertile ref. Male (chronic LBP) Middle tertile: OR 0.94 (0.78–1.14) Highest tertile: OR 1.13 (0.94–1.37) Male (LBP past 12 months) Middle tertile: OR 0.89 (0.78–1.02) Highest tertile: OR 0.97 (0.85–1.12) Female (chronic LBP) Middle tertile: OR 1.26 (1.08–1.48) Highest tertile: OR 1.49 (1.27–1.75) Female (LBP past 12 months) Middle tertile: OR 1.12 (1.00–1.27) Highest tertile: OR 1.21 (1.06–1.37) |
Women with a large waist (increased central adiposity) have a significantly increased likelihood of low back pain. There was no association for men. |
|
WHRtertiles 0.872 and 0.936 for males, 0.756 and 0.815 for females, lowest tertile Male (chronic LBP) Middle tertile: OR 0.93 (0.77–1.13) Highest tertile: OR 0.98 (0.80–1.19) Male (LBP past 12 months) Middle tertile: OR 0.97 (0.85, 1.11) Highest tertile: OR 1.00 (0.79–1.06) Female (chronic LBP) Middle tertile: OR 1.27 (1.09–1.50) Highest tertile: OR 1.35 (1.15–1.58) Female (LBP past 12 months) Middle tertile: 1.02 (0.91–1.15) Highest tertile: 1.14 (1.01–1.30) | ||||
| Direct fat measurement | ||||
| Endo (2019) [131] | Responded yes to “Do you have any low back pain at present?” | NA |
Female (No LBP vs LBP) Fat mass, kg (SD): 15.2 (6.4) vs 15.4 (6.2), p = 0.55 Male (No LBP vs LBP) Fat mass, kg (SD): 11.7 (5.0) vs 11.9 (5.1), p = 0.51 |
There were no significant differences in fat mass between participants with LBP and without LBP, in either female or male groups. |
| Brady (2018) [33] | Responded yes to LBP in the past month. | Age, sex |
Presence of pain Fat mass 39.9 ± 12.3 vs. 33.9 ± 9.8%, p = 0.04 OR: 1.1 (1.0, 1.1) |
Participants who reported having back pain in the past month had higher fat-mass compared to those without back pain. |
| Nava-Bringas (2018) [137] | Chronic low back pain (>3 months) and radiographic evidence of lumbar osteoarthritis (including facet joint osteoarthritis and disc degeneration). Pain score of ≥1 over the past 7 days. |
No adjustments made. |
Pain intensity Fat mass rho: -0.239 p = 0.2 % body fat rho: 0.09 p = 0.7 |
There was no correlation between fat mass or percentage body fat and back pain. |
| Brooks (2016) [122] | VAS score, minimum of 2.0 and maximum of 10.0. | NA |
Pain intensity Abdominal to lumbar fat mass ratio r = 0.32, p = 0.007 |
Abdominal adiposity was associated with chronic LBP. |
| Chou (2016) [7] | Cohort split into two groups: 1. No pain/disability or low intensity pain (<50) and low disability (<3) 2. High intensity pain (≥50) or high disability (≥3) |
Age, emotional disorder, education and mobility |
No or Low-Intensity Pain/Disability vs High-Intensity Pain and/or Disability (Estimated marginal means) Fat mass, kg (SD): 23.2 (0.3) vs 24.5 (0.7), p = 0.10 FMI, kg/m2 (SD): 7.6 (0.1) vs 8.0 (0.2), p = 0.08 |
There were no significant differences in fat mass or FMI between those with no or low intensity pain/disability compared with those with high intensity pain/disability. |
| Iizuka (2015) [121] | Incident pain defined as responded yes to “Do you have low back pain at present?” Chronic pain defined as responded yes to “Have you had chronic low back pain persisting for three months or more?” | Age, gender |
Presence of pain (total body fat mass) OR 1.02 (0.94, 1.02) Chronic pain (total body fat mass) OR 0.98 (0.93, 1.03) Presence of pain plus intensity (total body fat mass) β -0.05 (-0.07, 0.03) |
Total body fat mass did not have a significant relationship with incidence, chronicity or intensity of present LBP. |
| Bihari (2011) [14] | Not specified | No adjustments | Backache vs no musculoskeletal disorders (total body fat mass) OR 1.2 (0.9–1.7) |
Higher body fat percentage was not associated with back pain. |
| Ojoawo (2011) [116] | Pain rating between 1 and 10. | NA |
Pain intensity (body fat %) r = 0.67, p<0.01 |
Increased body fat percentage has a significant relationship with the intensity of pain experienced in women with low back pain. |
| Urquhart (2011) [6] | Pain intensity measured on the Chronic Pain Grade Questionnaire, 0–100. Low pain intensity <50 High pain intensity ≥50 |
Age, sex, height, physical activity, fat or lean tissue |
Pain intensity (total fat mass) OR 1.19 (1.04–1.38) Pain intensity (upper limb fat mass) OR 1.18 (0.93–1.50) Pain intensity (lower limb fat mass) OR 1.51 (1.04–2.20) |
Greater total and lower limb fat mass were associated with higher levels of low back pain intensity. |
| Hodselmans (2010) [115] | Responded yes to LBP for >3 months. | NA |
Predicted normative data vs LBP participants (fat mass %) Mean (SD): 26.4 (6.1) vs 30.4 (8.2) p<0.001 |
Patients with chronic LBP have an increased body fat percentage. |
| Toda (2000) [118] | Responded ‘yes’ to duration of current episode of LBP > 3 months or recurrent LBP compared to responded ‘no’ to LBP or low back problems in past 10 years. | NA |
Presence of pain Female (body fat %) Control vs negative straight leg raise 27.9 (6.7) vs 30.5 (6.5), p = 0.03 Control vs positive straight leg raise 28.6 (7.0) vs 27.9 (6.7), p>0.05 |
Body fat mass percentage may be a risk factor for chronic LBP without a positive straight leg raise test result in women, but in not men. Positive straight leg raise was not associated with central adiposity. |
|
Presence of pain Male (body fat %) Control vs negative straight leg raise 22.6 (5.7) vs 22.3 (6.1), p>0.05 Control vs positive straight leg raise 24.9 (4.4) vs 22.3 (6.1), p>0.05 | ||||
| Case control studies | ||||
| Anthropometric fat measurement | ||||
| Dario (2016) [105] | Responded yes to “Have you ever suffered from chronic LBP?” with chronic defined as lasting at least 6 months. | Smoking, leisure physical activity |
Presence of pain Chronic LBP (WC) OR 1.06 (0.93–1.22) Chronic LBP (WHR) OR 1.02 (0.89–1.17) |
WC and WHR are not associated with chronic LBP. |
| Yip (2001) [104] | Not specified | Source of recruitment (random subjects from population-based study vs family clinic subjects), menopausal status |
LBP ≥ 1 day WC: OR 0.67 (0.41–1.09) HC: OR 0.80 (0.49–1.31) WHR: OR 0.72 (0.47–1.11) LBP ≥ 14 days WC: OR 0.52 (0.29–0.92) HC: OR 1.10 (0.62–0.70) WHR: OR 0.43 (0.26–0.70) |
High WHR ratios was inversely associated with the risk of severe LBP in middle-aged women. |
| Hultman (1993) [111] | 3 groups: Group 1: never had LBP or slight LBP impairment Group 2: had several or at least one episode of LBP, no LBP for 2 months pre-study Group 3: ≥3 years of chronic LBP, > 3 months of sick leave in the previous year |
NA |
Presence of pain Fat volume % (skin folds) Group 1: 30 (6) Group 2: 28 (6) Group 3: 28 (6) Data not provided. |
There were no differences in fat volume between those with no, intermittent and chronic LBP. |
| Direct fat measures | ||||
| Sakai (2017) [107] | Persistent moderate to severe LBP for minimum previous 3 months | NA |
Male (LBP vs no LBP) Upper limb fat mass (g) 1781.18 ± 728.75 vs 1655.43 ± 656.38, p = 0.24 Lower limb fat mass (g) 4509.52 ± 1530.68 vs 4054.76 ± 1391.11, p = 0.05 Body fat % 35.77 ± 6.71 vs 27.69 ± 7.57, p<0.001 |
Body fat percentage was significantly higher in participants with LBP in both male and females. Additionally, lower limb fat mass was significantly greater in males with LBP. |
|
Female (LBP vs no LBP) Upper limb fat mass 1978.41 ± 553.97 vs 2053.18 ± 998.24, p = 0.59 Lower limb fat mass 4902.61 ± 1338.75 vs 4861.08 ± 1826.70, p = 0.87 Body fat % 41.05 ± 4.09 vs 34.25 ± 8,84, p<0.001 | ||||
| Dario (2016) [105] | Responded yes to “Have you ever suffered from chronic LBP?” with chronic defined as lasting at least 6 months. | Smoking, leisure physical activity |
Presence of pain Chronic LBP (body fat %) OR 1.15 (1.01–1.32) |
Body fat percentage was associated with LBP prevalence in women. |
| Spyropoulos (2008) [108] | Complained about LBP symptoms for a minimum of 15 months. | NA |
Healthy women vs women with chronic LBP (body fat %) 31.3 (5.2) vs 34.7 (5.1), p = 0.035 |
Body fat percentage was significantly higher in women working in offices with chronic LBP compared to healthy controls. |
| Celan (2005) [103] | Responded yes to previous LBP and also responded yes to having 3 times or more previous episodes. | NA |
No low back problems vs recurrent low back problems (body fat %) 25.54 vs 26.39, p = 0.43 |
There were no significant differences in body fat percentage between those with and without low back pain. |
| Cohort | ||||
| Anthropometric fat measures | ||||
| Muthuri (2020) [100] | All ages (except 68 yo): Responded yes to the question about whether they had sciatica, lumbago or recurring/severe backache all or most of the time (ever at ages 36 and 43 and in the previous 12 months at ages 53 and 60–64). Age 68: Responded yes to the question about whether they had experienced any ache or pain in the previous month which had lasted for 1 day or longer. |
Age, BMI, sex, education, occupational class and time-varying covariates (height, cigarette smoking status, physical activity and symptoms of anxiety and depression). |
Follow-up 36 to 43 yo: 7 years 43 to 53 yo: 10 years 53 to 60–64 yo: 7–10 years 60–64 to 68 yo: 4–8 years Presence of pain 36 years: 1.08 (0.97, 1.21) 43 years: 1.14 (1.02, 1.26) 53 years: 1.23 (1.07, 1.40) 60–64 years: 1.06 (0.92, 1.21) |
Higher WC was associated with increased odds of back pain between the ages 36 and 68. |
| Shiri (2019) [96] | Assessed by the number of days of LBP in the last 12 months | Age, gender, BMI, physical activity, walking or cycling to work, depression, strenuous physical work, using vibrating tools, keeling or squatting, standing or leaning forward, LBP past 30 days |
11 year follow-up Presence of pain LBP > 7 days (WC, normal ref) Increased: OR 1.07 (0.88–1.31) Obese: OR 1.40 (1.16–1.68) LBP > 30 days (WC, normal ref) Increased: OR 0.98 (0.77–1.26) Obese: OR 1.41 (1.13–1.76) |
Individuals with an obese WC were at a higher risk of larger number of days of LBP than those with a normal WC. |
| Dario (2017) [93] | Responded yes to “Have you ever suffered from chronic LBP?” | Age, gender |
2 to 4 year follow-up: Incident chronic LBP Total sample (WC, no pain ref) OR 0.98 (0.74–1.30) Within MZ and DZ twins (WC, no pain ref) OR 0.48 (0.16–1.50) Total sample (WHR, no pain ref) OR 1.05 (0.81–1.36) Within MZ and DZ twins (WHR, no pain ref) OR 0.47 (0.18–1.21) |
Risk of chronic back pain was no higher for individuals with an increased WC or WHR. |
| Hussain (2017) [92] | Pain categorised into 3 groups from the Chronic Pain Grade Questionnaire; no pain (0), low pain (<50), high pain (≥50) | Age, education, smoking status, socio-economic indexes for areas, mental component score of SF-36 |
12 year follow-up: Male (WC, no pain ref) Low intensity LBP OR 1.11 (0.98–1.27) High intensity LBP OR 1.25 (1.07–1.46) |
A larger WC was significantly associated with high intensity LBP compared to no pain in both male and females. A larger WC was also significantly associated with low intensity LBP in females, but not in males. When WC was split into quartiles, each quartile had significantly higher pain levels compared to the lowest WC quartile in both males and females, except for quartile 2 in females. |
| Female (WC, no pain ref) Low intensity LBP OR 1.13 (1.03–1.24) High intensity LBP OR 1.36 (1.22–1.52) | ||||
|
12 year follow-up: Pain intensity Male (WC, quartile 1 ref) Quartile 2: OR 1.43 (1.10–1.84) Quartile 3: OR 1.78 (1.36–2.34) Quartile 4: OR 1.50 (1.12–2.00) | ||||
|
Pain intensity Female (WC, quartile 1 ref) Quartile 2: OR 1.20 (0.96–1.50) Quartile 3: OR 1.42 (1.13–1.78) Quartile 4: OR 2.09 (1.65–2.65) | ||||
| Heuch (2015) [88] | Responded yes to “During the last year, have you had pain and/or stiffness in your muscles and limbs that has lasted for at least 3 consecutive months?” and responded lower back to “Where did you have pain and/or stiffness?” | Age, education, work status physical activity, smoking, HDL-cholesterol, triglycerides, blood pressure, body weight, BMI, WC, HC |
11 year follow-up: Female Incident LBP WC: RR 1.08 (1.03–1.13) WHR: RR 1.03 (0.99–1.08) HC: 1.07 (1.02, 1.12) Recurrent or persistent LBP WC: RR 1.07 (1.04–1.10) WHR: RR 1.02 (0.99–1.05) HC: 1.07 (1.04, 1.10) |
WC was associated with recurrence/persistence and incidence of pain in women but not in men. WHR was not associated with LBP in women or men. |
| Male Incidence LBP WC: RR 1.06 (1.00–1.13) WHR: RR 1.04 (0.98–1.10) HC: 1.06 (1.00, 1.12) Recurrence or persistent LBP WC: RR 1.02 (0.97–1.07) WHR: RR 1.01 (0.97–1.06) HC: 1.02 (0.97, 1.06) | ||||
| Shiri (2013) [87] | Responded yes to “Have you had low back trouble (pain, ache, or unpleasant sensations) during the preceding 12 months?” and responded greater than 7 days to “What is the total length of time you have had low back trouble during the preceding 12 months?” | Age, gender, educational status, occupational status, smoking |
6 year follow-up: Presence of non-specific LBP > 7 days (WC baseline, normal ref) Male Increased: OR 1.1 (0.6–2.0) Obese: OR 0.9 (0.5–1.8) 1cm increase: OR 1.00 (0.98–1.03) Female Increased: OR 1.7 (0.9–2.8) Obese: OR 1.1 (0.6–2.0) 1cm increase: OR 1.01 (0.99–1.03) |
Baseline WC and average WC over 7 years were not associated with non-specific LBP in males or females, with the exception of an obese WC in females. |
|
Presence of non-specific LBP (WC 7 year average, normal ref) Male Increased: OR 0.8 (0.5–1.5) Obese: OR 0.8 (0.4–1.6) 1cm increase: OR 1.00 (0.98–1.02) Female Increased: OR 1.5 (0.9–2.6) Obese: OR 1.7 (1.0–3.0) 1cm increase: OR 1.01 (0.99–1.04) | ||||
| Direct fat measurement | ||||
| Muthuri (2020) [100] | 60–64 years: Responded yes to the question about whether they had sciatica, lumbago or recurring/severe backache all or most of the time in the previous 12 months. 68 years: Responded yes to the about whether they had experienced any ache or pain in the previous month which had lasted for 1 day or longer. |
Sex, lean mass index, fat mass index, education at age 26, occupational class at age 53 and the following covariates (assessed at age 60–64): height, cigarette smoking status, physical activity and symptoms of anxiety and depression |
Follow-up: 60–64 to 68 yo: 4–8 years Presence of pain: FMI OR: 1.24 (1.04, 1.45) |
Higher fat mass index was associated with higher odds of back pain at age 68. |
| Brady (2019) [97] | High pain intensity >50 out of 100 | Age, gender, strenuous physical activity, mental health component score, total lean tissue mass |
3 year follow-up: Pain intensity Fat mass: OR 1.05 (1.01–1.09) |
Individuals with greater fat mass had a greater risk of high intensity LBP. |
| Dario (2017) [93] | Responded yes to “Have you ever suffered from chronic LBP?” | Age, gender |
2–4 year follow-up: Incident chronic LBP Total sample (percent fat, no pain ref) OR 0.87 (0.66–1.14) Within MZ and DZ twins (percent fat, no pain ref) OR 1.00 (0.35–2.85) |
Percentage fat mass was not predictive of LBP in adult twins. |
| Hashimoto (2017) [95] | Did not have LBP in the past or the present at baseline. | Maximal oxygen uptake, age, drinking, smoking |
20 year follow-up: Incident LBP Persistent LBP per 10,000 men years (body fat percentage quartiles) Q1: reference Q2: OR 0.86 (0.43–1.71) Q3: OR 1.46 (0.79–2.72) Q4: OR 2.12 (1.13–3.98) |
Individuals within the highest quartile of body fat mass were more likely to develop LBP compared to those in the lowest quartiles. |
| Hussain (2017) [92] | Pain categorised into 3 groups from the Chronic Pain Grade Questionnaire; no pain (0), low pain (<50), high pain (≥50) | Age, education, smoking status, socio-economic indexes for areas, mental component score of SF-36 |
12 year follow-up: Pain intensity Male (no pain ref) Low intensity LBP (percent fat) OR 1.28 (1.09–1.51) High intensity LBP (percent fat) OR 1.45 (1.19–1.77) Low intensity LBP (fat mass) OR 1.11 (0.97–1.27) High intensity LBP (fat mass) OR 1.23 (1.05–1.44) |
Both males and females with a higher percentage fat mass and total fat mass were at higher risk of high intensity LBP compared to individuals with no pain. Individuals with a higher percentage fat mass were at higher risk of low intensity LBP compared to those with no pain. Females, but not males, with larger total fat mass were at higher risk of low intensity LBP compared to no pain. |
|
12 year follow-up: Pain intensity Female (no pain ref) Low intensity LBP (percent fat) OR 1.41 (1.25-.1.59) High intensity LBP (percent fat) OR 1.39 (1.22–1.57) Low intensity LBP (fat mass) OR 1.28 (1.16–1.41) High intensity LBP (fat mass) OR 1.27 (1.15–1.40) | ||||
DZ = dizygotic, HC = hip circumference, IQR = inter-quartile range, LBP = low back pain, MZ = monozygotic, NA = not available, OR = odds ratio, RR = relative risk, SD = standard deviation WC = waist circumference, WHR = waist-hip ratio.