Abstract
Background: Back pain is now recognized as a major contributor to global disability. While the correlation between BMI and back pain risk has been confirmed, there is a lack of research on the association between obesity indices that accurately reflect fat distribution and back pain risk. Additionally, no studies have investigated whether the association is modified by any genetic factor, and remains unclear about the meditating role of triglyceride glucose (TyG).</p>
Methods: This prospective study involved participants from the UK Biobank without back pain at baseline. Cox regressions were utilized to analyze the relationships between BMI, waist circumference, hip circumference, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and A Body Shape Index (ABSI) with back pain risk. The interactions between these obesity indices and genetic risk were also examined. Additionally, we investigated the meditating role of TyG for further understanding.</p>
Results: The multivariate Cox regression indicated that high levels of obesity indices were significantly correlated with back pain [BMI: hazard ratio (HR) = 1.45, 95% confidence interval (CI): 1.40-1.49, p < 0.001; Waist circumference: HR = 1.38, 95% CI: 1.34-1.42, p < 0.001; Hip circumference: HR = 1.36, 95% CI: 1.32-1.41, p < 0.001; WHR: HR = 1.30, 95% CI: 1.25-1.35, p < 0.001; WHtR: HR = 1.50, 95% CI: 1.45-1.55, p < 0.001; ABSI: HR = 1.14, 95% CI: 1.10-1.18, p < 0.001]. No significant multiplicative or additive interactions were found between any obesity indices and genetic susceptibility. Moreover, we found that TyG mediated the relationship between obesity indices and back pain incidence, with mediation proportions of 8.9, 10.2, 10.6, 19.8, 9.1, and 31.3% for high BMI, high waist circumference, high hip circumference, high WHR, high WHtR and high ABSI, respectively.</p>
Conclusion: Obesity is significantly and positively related to back pain risk with TyG playing a partial mediating role, but no significant interaction was observed between obesity and genetic susceptibility. As a result, focusing on obesity and metabolic dysfunction in obese individuals is crucial for reducing the risk of back pain.</p>