Gender Difference in Association Between Low Back Pain and Metabolic Syndrome: Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS)

Study Design. Cross-sectional survey. Objective. To investigate the relationship between low back pain (LBP) and metabolic syndrome (Mets) in community-based Japanese subjects. Summary of Background Data. Relatively few reports have demonstrated a relationship between general pain and Mets, and none have addressed the relationship between LBP and Mets. Methods. This study enrolled 2650 people from among residents aged 40 to 74 years in Tadami and Minamiaizu, Fukushima, Japan, who participated in health checkups conducted in 2008. LBP was defined as lower back pain continuing for more than 24 hours and severe enough to merit treatment, or it was based on clinical prediction rules from the clinical diagnosis support tool to identify patients with lumbar spinal stenosis. Mets was defined according to the Japanese criteria recommended by the Japanese Society of Internal Medicine. Prevalence of Mets was recorded for subjects with and without LBP. The relationship between LBP and Mets was investigated, using a generalized linear model. With LBP as the main explanatory variable and Mets as the outcome variable, risk ratios of Mets were calculated for men and women. Results. In this study, we analyzed a total of 1395 subjects. In men, the prevalence of Mets was 21.2% in those without LBP and 24.7% in those with LBP. In women, the prevalence of Mets was 12.4% in those without LBP and 23.7% in those with LBP. After adjusting for factors such as age, body mass index, occupational status, SF-36 mental health, and physical activity level, no relationship was noted between LBP and Mets in men. However, in women, the risk ratio for Mets in subjects with LBP compared with those without LBP was 1.5 (95% confidence interval, 1.0-2.1). Conclusion. We observed a tendency toward higher prevalence of Mets among those with LBP than among those without it in women, but not in men.