TY - JOUR

T1 - ISSLS Prize in Clinical Science 2020. Examining causal effects of body mass index on back pain: a Mendelian randomization study

AU - Elgaeva, Elizaveta E.

AU - Tsepilov, Yakov

AU - Freidin, Maxim B.

AU - Williams, Frances M.K.

AU - Aulchenko, Yurii

AU - Suri, Pradeep

N1 - Publisher Copyright: © 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020/4/1

Y1 - 2020/4/1

N2 - Purpose: Measures of body fat accumulation are associated with back pain, but a causal association is unclear. We hypothesized that BMI would have causal effects on back pain. We conducted a two-sample Mendelian randomization (MR) study to assess the causal effect of body mass index (BMI) on the outcomes of (1) back pain and (2) chronic back pain (duration > 3 months). Methods: We identified genetic instrumental variables for BMI (n = 60 variants) from a meta-analysis of genome-wide association studies (GWAS) conducted by the Genetic Investigation of ANthropometric Traits consortium in individuals of European ancestry (n = 322,154). We conducted GWAS of back pain and chronic back pain (n = 453,860) in a non-overlapping sample of individuals of European ancestry. We used inverse-variance weighted (IVW) meta-analysis as the primary method to estimate causal effects. Results: The IVW analysis showed evidence supporting a causal association of BMI on back pain, with a 1-standard deviation (4.65 kg/m2) increase in BMI conferring 1.15 times the odds of back pain (95% confidence interval [CI]: 1.06–1.25, p = 0.001]; effects were directionally consistent in secondary analysis and sensitivity analyses. The IVW analysis supported a causal association of BMI on chronic back pain (OR 1.20 per 1 SD deviation increase in BMI [95% CI 1.09–1.32; p = 0.0002]), and effects were directionally consistent in secondary analysis and sensitivity analyses. Conclusion: In this first MR study of BMI and back pain, we found a significant causal effect of BMI on both back pain and chronic back pain.

AB - Purpose: Measures of body fat accumulation are associated with back pain, but a causal association is unclear. We hypothesized that BMI would have causal effects on back pain. We conducted a two-sample Mendelian randomization (MR) study to assess the causal effect of body mass index (BMI) on the outcomes of (1) back pain and (2) chronic back pain (duration > 3 months). Methods: We identified genetic instrumental variables for BMI (n = 60 variants) from a meta-analysis of genome-wide association studies (GWAS) conducted by the Genetic Investigation of ANthropometric Traits consortium in individuals of European ancestry (n = 322,154). We conducted GWAS of back pain and chronic back pain (n = 453,860) in a non-overlapping sample of individuals of European ancestry. We used inverse-variance weighted (IVW) meta-analysis as the primary method to estimate causal effects. Results: The IVW analysis showed evidence supporting a causal association of BMI on back pain, with a 1-standard deviation (4.65 kg/m2) increase in BMI conferring 1.15 times the odds of back pain (95% confidence interval [CI]: 1.06–1.25, p = 0.001]; effects were directionally consistent in secondary analysis and sensitivity analyses. The IVW analysis supported a causal association of BMI on chronic back pain (OR 1.20 per 1 SD deviation increase in BMI [95% CI 1.09–1.32; p = 0.0002]), and effects were directionally consistent in secondary analysis and sensitivity analyses. Conclusion: In this first MR study of BMI and back pain, we found a significant causal effect of BMI on both back pain and chronic back pain.

KW - Epidemiology

KW - Low back pain

KW - Obesity

KW - Prognosis

KW - Risk factor

KW - OBESITY

KW - RISK

KW - INSIGHTS

UR - http://www.scopus.com/inward/record.url?scp=85075880314&partnerID=8YFLogxK

U2 - 10.1007/s00586-019-06224-6

DO - 10.1007/s00586-019-06224-6

M3 - Article

C2 - 31797139

AN - SCOPUS:85075880314

VL - 29

SP - 686

EP - 691

JO - European Spine Journal

JF - European Spine Journal

SN - 0940-6719

IS - 4

ER -