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. 2022 Nov 21;17(11):e0277991.
doi: 10.1371/journal.pone.0277991. eCollection 2022.

Associations between cardiovascular disease risk factors and spinal pain may be moderated by sex and health-related physical activity (CHAMPS Study-DK)

Amber M Beynon  1   2 , Niels Wedderkopp  3   4 , Charlotte Leboeuf-Yde  5 , Jan Hartvigsen  6   7 , Bruce F Walker  2 , Jeffrey J Hébert  2   4
Affiliations

Associations between cardiovascular disease risk factors and spinal pain may be moderated by sex and health-related physical activity (CHAMPS Study-DK)

Amber M Beynon et al. PLoS One. .

Abstract

Background: Spinal pain has been previously linked with cardiovascular disease risk factors in children. This study investigated the prospective associations between cardiovascular disease risk factors and non-traumatic spinal pain occurrences in children, and examined the moderating role of sex and health-related physical activity in these relationships.

Methods: We used prospective data from the Childhood Health, Activity, and Motor Performance School Study Denmark (CHAMPS Study-DK). The exposure variables were a clustered cardiovascular risk score and homeostasis assessment model-estimated insulin resistance (HOMA-IR) score collected in 2008 and 2010. The spinal pain outcome comprised the number of weeks of non-traumatic spinal pain from 2008-2010 and 2010-2012. Potential confounders included age, sex, and time spent in moderate-to-vigorous intensity physical activity. We constructed age-adjusted mixed negative binominal regression models to investigate the prospective associations of cardiovascular disease risk factors and non-traumatic spinal pain, while considering the potential moderating roles of sex and physical activity in these relationships.

Results: Girls with low HOMA-IR scores and boys with low clustered cardiovascular disease risk scores, who engaged in higher levels of moderate-to-vigorous physical activity, reported more weeks of spinal pain, compared to girls with high HOMA-IR scores (p = 0.001) and boys with high clustered cardiovascular disease risk scores (p = 0.024). whereas boys with higher clustered cardiovascular disease risk who had less time in moderate-to-vigorous physical activity reported more weeks of spinal pain than boys with low clustered cardiovascular disease risk score (p = 0.024).

Conclusion: Our results show that cardiovascular disease risk factors are related to future occurrences of non-traumatic spinal pain. However, these relationships appear complex and dependent on the nature of the interactions with sex and physical activity.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Predictive margins of HOMA-IR and clustered cardiovascular risk for phase 1.
a. HOMA-IR in girls with 95% CI. b. HOMA-IR in boys with 95% CI. c. Clustered cardiovascular disease risk in girls with 95% CI. d. Clustered cardiovascular disease risk in boys with 95% CI. No significant 2-way interaction with cardiovascular disease risk factor and moderate-to-vigorous physical activity.
Fig 2
Fig 2. Predictive margins of HOMA-IR and clustered cardiovascular risk for phase 2.
a. HOMA-IR in girls with 95% CI. b. HOMA-IR in boys with 95% CI. c. Clustered cardiovascular disease risk in girls with 95% CI. d. Clustered cardiovascular disease risk in boys with 95% CI. *Significant 2-way interaction with cardiovascular disease risk factor and moderate-to-vigorous physical activity.
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