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Lumbar Bone Mass Predicts Low Back Pain in Males

Hoozemans, Marco J. M., PhD*,†; Koppes, Lando L. J., PhD; Twisk, Jos W. R., PhD§; van Dieën, Jaap H., PhD*

doi: 10.1097/BRS.0b013e31825409d8
Diagnostics
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Study Design. Longitudinal study of lumbar bone mass as predictor of low back pain (LBP).

Objective. To investigate whether low bone mineral content (BMC) and bone mineral density (BMD) values at the age of 36 years are associated with the prevalence of LBP at the age of 42 years among the study population of the Amsterdam Growth and Health Longitudinal Study.

Summary of Background Data. Results of epidemiological, clinical, and in vitro studies indicate that spinal injuries, caused by mechanical loading, might be a cause of LBP. BMC and BMD are determinants of spinal strength. We therefore hypothesized that BMC and BMD are associated with LBP.

Methods. At the age of 36 years, the lumbar BMC and BMD were determined by dual-energy x-ray absorptiometry in 140 men and 152 women. At the age of 42 years, the participants were asked whether they had experienced LBP in the previous 12 months. Logistic regression analyses were performed to determine odds ratios (ORs)—adjusted for stature, body weight, physical activity, and smoking—for the relationship of BMC and BMD with LBP.

Results. BMC and BMD at the age of 36 years were significantly associated with the reported 12-month prevalence of LBP at the age of 42 years. This association, however, was observed only for men and not for women. Men within the quartile with the lowest BMC or BMD values had higher odds for LBP with ORs of 4.78 (95% confidence interval, 1.52–15.00) and 3.48 (95% confidence interval, 1.23–9.85), respectively.

Conclusion. For a male population that is not characterized by osteoporosis or old age, lower lumbar BMC and BMD values at the age of 36 years are associated with an increased risk of reporting to have had LBP in the previous 12 months at the age of 42 years.

Bone mineral content (BMC) and bone mineral density (BMD) were longitudinally studied in relation to low back pain. For males, low BMC and BMD values were associated with an increased risk of low back pain. For females, no significant associations were observed.

*Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, the Netherlands

CORAL—Centre for Orthopaedic Research Alkmaar, Department of Orthopaedic Surgery, Medical Centre Alkmaar, the Netherlands

TNO, Department Work and Health, Hoofddorp, the Netherlands

§Institute for Research in Extramural Medicine (EMGO), VU University Medical Center, Amsterdam, the Netherlands.

Address correspondence and reprint requests to Marco J. M. Hoozemans, PhD, Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, Van der Boechorststraat 9, 1081 BT Amsterdam, the Netherlands; E-mail: m.j.m.hoozemans@vu.nl

Acknowledgment date: October 23, 2009. First revision date: May 28, 2011. Second revision date: January 24, 2012. Acceptance date: February 27, 2012.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

© 2012 Lippincott Williams & Wilkins, Inc.