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. 2017 Nov 25;7(11):e018521.
doi: 10.1136/bmjopen-2017-018521.

Is there an association between vitamin D status and risk of chronic low back pain? A nested case-control analysis in the Nord-Trøndelag Health Study

Ingrid Heuch  1 , Ivar Heuch  2 , Knut Hagen  3   4 , Xiao-Mei Mai  5 , Arnulf Langhammer  5 , John-Anker Zwart  1   6
Affiliations

Is there an association between vitamin D status and risk of chronic low back pain? A nested case-control analysis in the Nord-Trøndelag Health Study

Ingrid Heuch et al. BMJ Open. .

Abstract

Objectives: To explore potential associations between vitamin D status and risk of chronic low back pain (LBP) in a Norwegian cohort, and to investigate whether relationships depend on the season of blood sample collection.

Design: A nested case-control study in a prospective data set.

Setting: The Norwegian community-based Nord-Trøndelag Health Study (HUNT). Data were collected in the HUNT2 (1995-1997) and HUNT3 (2006-2008) surveys.

Main outcome measure: Chronic LBP, defined as LBP persisting at least 3 months continuously during the past year.

Participants: Among individuals aged 19-55 years without LBP in HUNT2, a data set was generated including 1685 cases with LBP in HUNT3 and 3137 controls without LBP.

Methods: Blood samples from the participants collected in HUNT2 were analysed for serum 25-hydroxyvitamin D (25(OH)D) level. Associations with LBP in HUNT3 were evaluated by unconditional logistic regression analysis with adjustment for age, sex, work status, physical activity at work and in leisure time, education, smoking, and body mass index.

Results: No association between vitamin D status and risk of chronic LBP was found in the total data set (OR per 10 nmol/L 25(OH)D=1.01, 95% CI 0.97 to 1.06) or in individuals with blood samples collected in summer/autumn (OR per 10 nmol/L 25(OH)D=0.99, 95% CI 0.93 to 1.06). For blood samples drawn in winter/spring, associations differed significantly between women and men (p=0.004). Among women a positive association was seen (OR per 10 nmol/L 25(OH)D=1.11, 95% CI 1.02 to 1.20), but among men no significant association was observed (OR per 10 nmol/L 25(OH)D=0.90, 95% CI 0.81 to 1.01).

Conclusions: Overall, no association between vitamin D status and risk of LBP was demonstrated. The association suggested in women for the winter/spring season cannot be regarded as established.

Keywords: back pain; epidemiology; vitamin D and low back.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart showing participants for statistical analysis in the nested case–control study. 25(OH)D, 25-hydroxyvitamin D; HUNT, Nord-Trøndelag Health Study; LBP, low back pain.
See this image and copyright information in PMC

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References

    1. Lambeek LC, Bosmans JE, Van Royen BJ, et al. . Effect of integrated care for sick listed patients with chronic low back pain: economic evaluation alongside a randomised controlled trial. BMJ 2010;341:c6414 10.1136/bmj.c6414 - DOI - PMC - PubMed
    1. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet 2017;389:736–47. 10.1016/S0140-6736(16)30970-9 - DOI - PubMed
    1. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357:266–81. - PubMed
    1. Wintermeyer E, Ihle C, Ehnert S, et al. . Crucial role of vitamin D in the musculoskeletal system. Nutrients 2016;8:319 10.3390/nu8060319 - DOI - PMC - PubMed
    1. Straube S, Moore RA, Derry S, et al. . Vitamin D and chronic pain. Pain 2009;141:10–13. 10.1016/j.pain.2008.11.010 - DOI - PubMed

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