Comparison Based on current LBP Severity.

Low back pain (LBP) is a major public health issue, and lifestyle-related factors (LRFs) are increasingly recognized as key contributors to LBP. However, comprehensive studies using recent data concerning the association between LBP and LRFs remain limited. In this study, a nationally representative sample of Japanese adults were surveyed to evaluate the relationship between LRFs and LBP and to explore how these factors relate to both the severity and chronicity of LBP. A cross-sectional nationwide survey was conducted among 5000 randomly selected Japanese adults aged 20–90 years; valid responses were obtained from 2188. Participants were analyzed using three different methods: (1) those with or without current LBP, (2) those with no/mild or moderate/severe pain, and (3) those with or without chronic LBP. Key LRFs included body mass index, alcohol consumption, smoking, exercise habits, comorbidities (dyslipidemia, diabetes, and hypertension), and self-image regarding body shape. Multivariable logistic regression analysis revealed that current LBP was significantly associated with body mass index (odds ratio [OR]=1.04, 95% confidence interval [CI]: 1.00–1.07), alcohol consumption (OR=1.37, 95% CI: 1.04–1.80), smoking (OR=1.63, 95% CI: 1.21–2.20), and dyslipidemia (OR=1.51, 95% CI: 1.06–2.13), and the severity of LBP was associated with smoking (OR=1.77, 95% CI: 1.19–2.64), lack of exercise (OR=1.55, 95% CI: 1.10–2.15), and dyslipidemia (OR=1.64, 95% CI: 1.06–2.55). In addition, smoking was the only LRF significantly associated with chronic LBP (OR=1.70, 95% CI: 1.23–2.34). Multiple LRFs are associated with the prevalence of LBP. Stratified analysis provided deeper insight into specific risk factors for LBP. In particular, dyslipidemia is linked to pain severity, whereas smoking is associated with both severity and chronicity. Future longitudinal studies should focus on the influence of these key LRFs on onset, severity, and chronicity of LBP.

下腰痛（Low back pain, LBP）是重大公共卫生问题，生活方式相关危险因素（lifestyle-related factors, LRFs）日益被认定为下腰痛的关键致病因素。然而，基于最新数据探究下腰痛与生活方式相关危险因素之间关联的综合性研究仍较为匮乏。本研究针对具有全国代表性的日本成年人群开展调查，以评估生活方式相关危险因素与下腰痛的关联，并探究这些因素与下腰痛严重程度及慢性病程的相关性。本研究针对5000名随机选取的20~90岁日本成年人开展全国性横断面调查，最终回收有效问卷2188份。研究采用三种分组方式对受试者进行分析：① 存在当前下腰痛与无当前下腰痛者；② 无/轻度疼痛与中度/重度疼痛者；③ 存在慢性下腰痛与无慢性下腰痛者。本研究纳入的关键生活方式相关危险因素包括体质量指数（body mass index）、饮酒行为、吸烟情况、运动习惯、合并症（comorbidities，包括血脂异常、糖尿病及高血压）以及体型自我认知。多因素logistic回归分析显示，当前下腰痛与体质量指数（比值比（odds ratio, OR）=1.04，95%置信区间（confidence interval, CI）：1.00~1.07）、饮酒（OR=1.37，95%CI：1.04~1.80）、吸烟（OR=1.63，95%CI：1.21~2.20）及血脂异常（dyslipidemia，OR=1.51，95%CI：1.06~2.13）显著相关；下腰痛严重程度与吸烟（OR=1.77，95%CI：1.19~2.64）、缺乏运动（OR=1.55，95%CI：1.10~2.15）及血脂异常（OR=1.64，95%CI：1.06~2.55）显著相关。此外，吸烟是唯一与慢性下腰痛显著相关的生活方式相关危险因素（OR=1.70，95%CI：1.23~2.34）。多种生活方式相关危险因素与下腰痛的患病率相关。分层分析进一步明确了下腰痛的特异性危险因素。具体而言，血脂异常与疼痛严重程度相关，而吸烟则与疼痛严重程度及慢性病程均存在关联。未来的纵向研究应聚焦于上述关键生活方式相关危险因素对下腰痛发病、严重程度及慢性病程的影响。