2024-03-29T14:50:59Z
https://niigata-u.repo.nii.ac.jp/oai
oai:niigata-u.repo.nii.ac.jp:00033919
2022-12-15T04:04:11Z
453:455
471:561:562
関節リウマチ症例における機能障害性腰痛の頻度と関連する因子
Prevalence of and factors associated with dysfunctional low back pain in patients with rheumatoid arthritis
Miura, Kazuto
177882
Rheumatoid arthritis
Low back pain
Body mass index
Spinopelvic malalignment
Vertebral fractures
Methotrexate
新潟大学
博士(医学)
Purpose: To investigate the prevalence of and factors associated with dysfunctional low back pain (LBP) in patients with rheumatoid arthritis (RA). Methods: This cross-sectional study included 1276 RA outpatients from two hospitals. The Roland–Morris Disability Questionnaire was used to address the functional–dysfunctional state criterion. Clinical variables, such as medical status, disease activity, bone mineral density, and spinopelvic alignment parameters, were compared between patients with and without dysfunctional LBP. Results: Mean age and disease duration were 64.6 and 13.4 years, respectively; the prevalence of dysfunctional LBP was 32.8%. On univariate analysis, significant differences existed in many variables, except sex, body weight, C-reactive protein (CRP) level, and prevalence of biological agent users, between patients with and without dysfunctional LBP. Multivariate logistic regression analysis revealed body mass index (BMI; odds ratio [OR], 1.116; P<0.001), onset age of RA (OR, 1.020; P=0.020), disease duration of RA (OR, 1.043; P<0.001), methotrexate (MTX) use (OR, 0.609; P=0.007), vertebral fractures (OR, 2.189; P=0.001), vertebral endplate and/or facet erosion (OR, 1.411; P=0.043), disease activity score (DAS) in 28 joints-CRP (DAS-28CRP) (OR, 1.587; P=0.001), pelvic tilt (PT; OR, 1.023; P=0.019), and sagittal vertical axis (SVA; OR, 1.007; P=0.043) as associated factors. Conclusion: The factors associated with dysfunctional LBP in patients with RA were more vertebral fractures, higher DAS28CRP, vertebral endplate and/or facet erosion, higher BMI, longer disease duration, greater PT, older onset age, greater SVA, and less MTX use. Strictly controlling patients’ body weight and disease activity with MTX and avoiding spinopelvic malalignment through vertebral fracture prevention are important.
European Spine Journal. 2019, 28(5), 976-982.
新大院博(医)甲第896号
thesis
2019-09-20
application/pdf
application/pdf
13101甲第4636号
https://niigata-u.repo.nii.ac.jp/record/33919/files/r1nmk896.pdf
https://niigata-u.repo.nii.ac.jp/record/33919/files/r1nmk896_a.pdf
eng
info:doi/10.1007/s00586-019-05938-x
【○!C】 The Author(s) 2019