Mapping the association between back pain and type 2 diabetes: A cross-sectional and longitudinal study of adult Spanish twins
Back pain and type 2 diabetes often co-occur, resulting in greater impact on people's health and complexity in their care. Plausible causal mechanisms for this association have been proposed, yet the nature of the link remains unclear. We therefore explored the direction of the association betw...
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| description | Back pain and type 2 diabetes often co-occur, resulting in greater impact on people's health and complexity in their care. Plausible causal mechanisms for this association have been proposed, yet the nature of the link remains unclear. We therefore explored the direction of the association between type 2 diabetes and chronic back pain in twins, controlling for genetics and early environmental confounding.
2,096 and 1,098 twins were included in the cross-sectional and longitudinal analyses, respectively. Any or severe (≥ 9) low back pain (LBP), neck pain (NP), and spinal pain (concurrent LBP and NP) and type 2 diabetes were investigated. Sequential analyses were performed using logistic regression. Firstly, twins were analysed unpaired (adjusted age and gender): total sample analyses. Then, to control for genetic and shared environmental factors, a co-twin case-control analysis was performed including monozygotic and dizygotic twin pairs discordant for back pain (cross-sectional only).
In the cross-sectional total sample analyses, type 2 diabetes was associated with chronic spinal pain (OR 1.61; 95%CI 1.12 to 2.31), severe chronic spinal pain (OR 3.33; 95%CI 1.47 to 7.53), chronic NP (OR 1.37; 95%CI 1.01 to 1.85), severe chronic NP (OR 2.28; 95%CI 1.24 to 4.21), and severe chronic LBP (OR 1.63; 95%CI 1.00 to 2.64). After further adjustment for genetic and shared environmental factors, none of the associations remained significant. The longitudinal analyses indicated that the presence of type 2 diabetes did not increase the risk of future back pain, or vice-versa, after two to four years.
Chronic back pain (spinal pain, NP, or LBP) was associated with the prevalence of type 2 diabetes. Associations are stronger for severe cases of pain. Future research should investigate the temporal relationships between these conditions with longer follow up in twins. |
| doi_str_mv | 10.1371/journal.pone.0174757 |
| format | Article |
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2,096 and 1,098 twins were included in the cross-sectional and longitudinal analyses, respectively. Any or severe (≥ 9) low back pain (LBP), neck pain (NP), and spinal pain (concurrent LBP and NP) and type 2 diabetes were investigated. Sequential analyses were performed using logistic regression. Firstly, twins were analysed unpaired (adjusted age and gender): total sample analyses. Then, to control for genetic and shared environmental factors, a co-twin case-control analysis was performed including monozygotic and dizygotic twin pairs discordant for back pain (cross-sectional only).
In the cross-sectional total sample analyses, type 2 diabetes was associated with chronic spinal pain (OR 1.61; 95%CI 1.12 to 2.31), severe chronic spinal pain (OR 3.33; 95%CI 1.47 to 7.53), chronic NP (OR 1.37; 95%CI 1.01 to 1.85), severe chronic NP (OR 2.28; 95%CI 1.24 to 4.21), and severe chronic LBP (OR 1.63; 95%CI 1.00 to 2.64). After further adjustment for genetic and shared environmental factors, none of the associations remained significant. The longitudinal analyses indicated that the presence of type 2 diabetes did not increase the risk of future back pain, or vice-versa, after two to four years.
Chronic back pain (spinal pain, NP, or LBP) was associated with the prevalence of type 2 diabetes. Associations are stronger for severe cases of pain. Future research should investigate the temporal relationships between these conditions with longer follow up in twins.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0174757</identifier><identifier>PMID: 28369107</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Analysis ; Authorship ; Autoimmune diseases ; Back pain ; Biology and Life Sciences ; Biomedical research ; Chronic Pain - epidemiology ; Comorbidity ; Complications and side effects ; Correlation analysis ; Cross-Sectional Studies ; Data collection ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus, Type 2 - epidemiology ; Environmental factors ; Exercise ; Female ; Follow-Up Studies ; Health aspects ; Health sciences ; Hospitals ; Humans ; Immunology ; Longitudinal Studies ; Low Back Pain - epidemiology ; Male ; Medicine and Health Sciences ; Menopause ; Metabolism ; Middle Aged ; Neck Pain - epidemiology ; Osteoporosis ; Pain ; Physical Sciences ; Prevalence ; Psychobiology ; Registries ; Regression analysis ; Risk ; Risk factors ; Sex Factors ; Spain - epidemiology ; Spine ; Studies ; Twins ; Twins, Dizygotic ; Twins, Monozygotic ; Type 2 diabetes</subject><ispartof>PloS one, 2017-04, Vol.12 (4), p.e0174757</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Dario et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Dario et al 2017 Dario et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-f3ece851655b9de8b4c1e779d78d85bddbe892b4f379e36175ba5fc201c989603</citedby><cites>FETCH-LOGICAL-c692t-f3ece851655b9de8b4c1e779d78d85bddbe892b4f379e36175ba5fc201c989603</cites><orcidid>0000-0002-4818-7017</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378369/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378369/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28369107$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dario, Amabile</creatorcontrib><creatorcontrib>Ferreira, Manuela</creatorcontrib><creatorcontrib>Refshauge, Kathryn</creatorcontrib><creatorcontrib>Harmer, Alison</creatorcontrib><creatorcontrib>Sánchez-Romera, Juan</creatorcontrib><creatorcontrib>Pérez-Riquelme, Francisco</creatorcontrib><creatorcontrib>Cisneros, Ligia</creatorcontrib><creatorcontrib>Ordoñana, Juan</creatorcontrib><creatorcontrib>Ferreira, Paulo</creatorcontrib><title>Mapping the association between back pain and type 2 diabetes: A cross-sectional and longitudinal study of adult Spanish twins</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Back pain and type 2 diabetes often co-occur, resulting in greater impact on people's health and complexity in their care. Plausible causal mechanisms for this association have been proposed, yet the nature of the link remains unclear. We therefore explored the direction of the association between type 2 diabetes and chronic back pain in twins, controlling for genetics and early environmental confounding.
2,096 and 1,098 twins were included in the cross-sectional and longitudinal analyses, respectively. Any or severe (≥ 9) low back pain (LBP), neck pain (NP), and spinal pain (concurrent LBP and NP) and type 2 diabetes were investigated. Sequential analyses were performed using logistic regression. Firstly, twins were analysed unpaired (adjusted age and gender): total sample analyses. Then, to control for genetic and shared environmental factors, a co-twin case-control analysis was performed including monozygotic and dizygotic twin pairs discordant for back pain (cross-sectional only).
In the cross-sectional total sample analyses, type 2 diabetes was associated with chronic spinal pain (OR 1.61; 95%CI 1.12 to 2.31), severe chronic spinal pain (OR 3.33; 95%CI 1.47 to 7.53), chronic NP (OR 1.37; 95%CI 1.01 to 1.85), severe chronic NP (OR 2.28; 95%CI 1.24 to 4.21), and severe chronic LBP (OR 1.63; 95%CI 1.00 to 2.64). After further adjustment for genetic and shared environmental factors, none of the associations remained significant. The longitudinal analyses indicated that the presence of type 2 diabetes did not increase the risk of future back pain, or vice-versa, after two to four years.
Chronic back pain (spinal pain, NP, or LBP) was associated with the prevalence of type 2 diabetes. Associations are stronger for severe cases of pain. Future research should investigate the temporal relationships between these conditions with longer follow up in twins.</description><subject>Age</subject><subject>Analysis</subject><subject>Authorship</subject><subject>Autoimmune diseases</subject><subject>Back pain</subject><subject>Biology and Life Sciences</subject><subject>Biomedical research</subject><subject>Chronic Pain - epidemiology</subject><subject>Comorbidity</subject><subject>Complications and side effects</subject><subject>Correlation analysis</subject><subject>Cross-Sectional Studies</subject><subject>Data collection</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Environmental factors</subject><subject>Exercise</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health aspects</subject><subject>Health sciences</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunology</subject><subject>Longitudinal Studies</subject><subject>Low Back Pain - epidemiology</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Menopause</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Neck Pain - epidemiology</subject><subject>Osteoporosis</subject><subject>Pain</subject><subject>Physical Sciences</subject><subject>Prevalence</subject><subject>Psychobiology</subject><subject>Registries</subject><subject>Regression analysis</subject><subject>Risk</subject><subject>Risk factors</subject><subject>Sex Factors</subject><subject>Spain - epidemiology</subject><subject>Spine</subject><subject>Studies</subject><subject>Twins</subject><subject>Twins, Dizygotic</subject><subject>Twins, Monozygotic</subject><subject>Type 2 diabetes</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl-L1DAUxYso7rr6DUQDguDDjEnTNokPwrD4Z2BlwVVfw22SdrJ2mtqkrvPiZzed6S5TUPAp4d7fObncnCR5SvCSUEZeX7uhb6FZdq41S0xYxnJ2LzklgqaLIsX0_tH9JHnk_TXGOeVF8TA5STktBMHsNPn9CbrOtjUKG4PAe6csBOtaVJpwY0w8QX1HHdgWQatR2HUGpUhbiH3j36AVUr3zfuGNGmXQ7LHGtbUNg7ZjwcfLDrkKgR6agK46aK3foHBjW_84eVBB482T6TxLvr5_9-X84-Li8sP6fHWxUIVIw6KiRhmekyLPS6ENLzNFDGNCM655XmpdGi7SMqsoE4YWhOUl5JVKMVGCiwLTs-T5wbdrnJfT6rwknFOe5phkkVgfCO3gWna93UK_kw6s3BdcX0vog1WNkZwB1pRAIUSVcVCiEhgqheMXcAXaRK-302tDuTVamTb00MxM553WbmTtfsqcsvFnosGLyaB3Pwbjwz9Gnqga4lS2rVw0U1vrlVxlEcNZhmmkln-hYBx0a1UMT2VjfSZ4NRNEJphfoYbBe7m--vz_7OW3OfvyiN0YaMLGu2YYc-PnYHYA99HqTXW3OYLlmP3bbcgx-3LKfpQ9O976neg27PQPagIAsA</recordid><startdate>20170403</startdate><enddate>20170403</enddate><creator>Dario, Amabile</creator><creator>Ferreira, Manuela</creator><creator>Refshauge, Kathryn</creator><creator>Harmer, Alison</creator><creator>Sánchez-Romera, Juan</creator><creator>Pérez-Riquelme, Francisco</creator><creator>Cisneros, Ligia</creator><creator>Ordoñana, Juan</creator><creator>Ferreira, Paulo</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-4818-7017</orcidid></search><sort><creationdate>20170403</creationdate><title>Mapping the association between back pain and type 2 diabetes: A cross-sectional and longitudinal study of adult Spanish twins</title><author>Dario, Amabile ; Ferreira, Manuela ; Refshauge, Kathryn ; Harmer, Alison ; Sánchez-Romera, Juan ; Pérez-Riquelme, Francisco ; Cisneros, Ligia ; Ordoñana, Juan ; Ferreira, Paulo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-f3ece851655b9de8b4c1e779d78d85bddbe892b4f379e36175ba5fc201c989603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age</topic><topic>Analysis</topic><topic>Authorship</topic><topic>Autoimmune diseases</topic><topic>Back pain</topic><topic>Biology and Life Sciences</topic><topic>Biomedical research</topic><topic>Chronic Pain - 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Plausible causal mechanisms for this association have been proposed, yet the nature of the link remains unclear. We therefore explored the direction of the association between type 2 diabetes and chronic back pain in twins, controlling for genetics and early environmental confounding.
2,096 and 1,098 twins were included in the cross-sectional and longitudinal analyses, respectively. Any or severe (≥ 9) low back pain (LBP), neck pain (NP), and spinal pain (concurrent LBP and NP) and type 2 diabetes were investigated. Sequential analyses were performed using logistic regression. Firstly, twins were analysed unpaired (adjusted age and gender): total sample analyses. Then, to control for genetic and shared environmental factors, a co-twin case-control analysis was performed including monozygotic and dizygotic twin pairs discordant for back pain (cross-sectional only).
In the cross-sectional total sample analyses, type 2 diabetes was associated with chronic spinal pain (OR 1.61; 95%CI 1.12 to 2.31), severe chronic spinal pain (OR 3.33; 95%CI 1.47 to 7.53), chronic NP (OR 1.37; 95%CI 1.01 to 1.85), severe chronic NP (OR 2.28; 95%CI 1.24 to 4.21), and severe chronic LBP (OR 1.63; 95%CI 1.00 to 2.64). After further adjustment for genetic and shared environmental factors, none of the associations remained significant. The longitudinal analyses indicated that the presence of type 2 diabetes did not increase the risk of future back pain, or vice-versa, after two to four years.
Chronic back pain (spinal pain, NP, or LBP) was associated with the prevalence of type 2 diabetes. Associations are stronger for severe cases of pain. Future research should investigate the temporal relationships between these conditions with longer follow up in twins.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28369107</pmid><doi>10.1371/journal.pone.0174757</doi><tpages>e0174757</tpages><orcidid>https://orcid.org/0000-0002-4818-7017</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_1883825014 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Age Analysis Authorship Autoimmune diseases Back pain Biology and Life Sciences Biomedical research Chronic Pain - epidemiology Comorbidity Complications and side effects Correlation analysis Cross-Sectional Studies Data collection Diabetes Diabetes mellitus Diabetes Mellitus, Type 2 - epidemiology Environmental factors Exercise Female Follow-Up Studies Health aspects Health sciences Hospitals Humans Immunology Longitudinal Studies Low Back Pain - epidemiology Male Medicine and Health Sciences Menopause Metabolism Middle Aged Neck Pain - epidemiology Osteoporosis Pain Physical Sciences Prevalence Psychobiology Registries Regression analysis Risk Risk factors Sex Factors Spain - epidemiology Spine Studies Twins Twins, Dizygotic Twins, Monozygotic Type 2 diabetes |
| title | Mapping the association between back pain and type 2 diabetes: A cross-sectional and longitudinal study of adult Spanish twins |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-11T12%3A13%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Mapping%20the%20association%20between%20back%20pain%20and%20type%202%20diabetes:%20A%20cross-sectional%20and%20longitudinal%20study%20of%20adult%20Spanish%20twins&rft.jtitle=PloS%20one&rft.au=Dario,%20Amabile&rft.date=2017-04-03&rft.volume=12&rft.issue=4&rft.spage=e0174757&rft.pages=e0174757-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0174757&rft_dat=%3Cgale_plos_%3EA488304403%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1883825014&rft_id=info:pmid/28369107&rft_galeid=A488304403&rft_doaj_id=oai_doaj_org_article_87a0d31a699f48ac9f90afc07478cade&rfr_iscdi=true |