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. 2025 Feb 24;25(1):753.
doi: 10.1186/s12889-025-21904-3.

Association between a body shape index and low back pain: a cross-sectional study highlighting gender-specific differences in NHANES data

Shiwei Xie #  1 , Heng Xiao #  1 , Gengwu Li  1 , Jigen Zheng  1 , Fan Zhang #  2   3 , Yuping Lan #  4   5 , Mingwei Luo #  6   7
Affiliations

Association between a body shape index and low back pain: a cross-sectional study highlighting gender-specific differences in NHANES data

Shiwei Xie et al. BMC Public Health. .

Abstract

Background: This study aimed to investigate the association between A Body Shape Index (ABSI) and low back pain, with a focus on gender and age differences, using cross-sectional data from the NHANES database.

Methods: A total of 14,268 participants were included from four NHANES cycles (1999-2004 and 2009-2010). Low back pain was assessed based on self-reported pain over the past three months, and ABSI was calculated using waist circumference, height, and weight. Multivariate logistic regression models were used to evaluate the association between ABSI and low back pain, adjusting for potential confounders. Restricted cubic spline (RCS) analysis was conducted to assess non-linear relationships, and subgroup analyses were performed based on gender, age and BMI.

Results: Higher ABSI was significantly associated with an increased risk of low back pain (OR for highest quartile = 1.27, 95% CI: 1.07-1.50, p = 0.008). RCS analysis indicated a linear relationship between ABSI and low back pain, with the risk significantly rising when ABSI exceeded 0.85. Subgroup analyses revealed that this association was more pronounced in males (OR = 25.89, 95% CI: 3.11-215.86, p = 0.004) and participants aged ≥ 60 years (OR = 11.11, 95% CI: 2.61-47.26, p = 0.002), while no significant association was observed in females.

Conclusions: The ABSI was associated with low back pain. This association was more prominent in males and older adults. Our findings suggest that ABSI may provide a more nuanced understanding of low back pain risk, particularly in populations with abdominal obesity. Further studies are needed to explore the underlying mechanisms and potential clinical applications of ABSI in low back pain risk assessment.

Keywords: A body shape index (ABSI); Abdominal obesity; Gender differences; Low back pain; NHANES.

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Conflict of interest statement

Declarations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: The survey protocols received approval from the Ethics Review Board of the National Center for Health Statistics (NCHS), and documented consent was obtained from participants (Protocol #98 − 12, Continuation of Protocol #2005-06).

Figures

Fig. 1
Fig. 1
Inclusion and exclusion criteria flowchart
Fig. 2
Fig. 2
Restricted Cubic Spline (RCS) analysis of the association between ABSI and low back pain risk
Fig. 3
Fig. 3
Forest plot of stratified analysis and interaction effects for the association between ABSI and low back pain by gender and age
See this image and copyright information in PMC

References

    1. Chou R. Low back Pain. Ann Intern Med. 2021;174(8):Itc113–28. - PubMed
    1. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736–47. - PubMed
    1. Patrick N, Emanski E, Knaub MA. Acute and chronic low back pain. Med Clin North Am. 2014;98(4):777–89. xii. - PubMed
    1. Moore JE. Chronic low back pain and psychosocial issues. Phys Med Rehabil Clin N Am. 2010;21(4):801–15. - PubMed
    1. Knezevic NN, Candido KD, Vlaeyen JWS, Van Zundert J, Cohen SP. Low back pain. Lancet. 2021;398(10294):78–92. - PubMed

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