Association between bone mineral density and lower back pain in the general United States population using the NHANES of 1999–2004

ObjectivesLower back pain (LBP) is a prevalent health issue that has substantial effects on individuals and society. However, the association between bone mineral density (BMD) and LBP remains controversial. In this study we aimed to ascertain whether a relationship exists between BMD and LBP in the...

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Main Authors: Yang Zhou, Chi Li, WangYing Dai, HongLin Teng, Yu Wang, MingYu Zhu, Jing Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1535614/full
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author Yang Zhou
Chi Li
WangYing Dai
HongLin Teng
Yu Wang
MingYu Zhu
Jing Wang
author_facet Yang Zhou
Chi Li
WangYing Dai
HongLin Teng
Yu Wang
MingYu Zhu
Jing Wang
author_sort Yang Zhou
collection DOAJ
description ObjectivesLower back pain (LBP) is a prevalent health issue that has substantial effects on individuals and society. However, the association between bone mineral density (BMD) and LBP remains controversial. In this study we aimed to ascertain whether a relationship exists between BMD and LBP in the United States population.MethodsData from the National Health and Nutrition Examination Survey (NHANES) spanning 1999–2004 were analyzed using a cross-sectional approach. BMD and LBP were assessed using multivariate logistic regression, smoothing curves, and generalized additive models. Subgroup analyses were also performed to ensure data stability and mitigate confounding factors.ResultsIn this population-based study, the data of 107,570 adults were analyzed (mean age: 47.13 ± 18.38 years) and 36.74% of them had LBP. After controlling for all covariates, a positive correlation was established between BMD and LBP [odds ratio (OR) = 1.87, 95% confidence interval (CI) = (1.00, 3.50)]. The two-segment linear regression model revealed a U-shaped relationship between BMD and LBP with a 1.14 g/cm2 inflection point. BMD values <1.14 g/cm2 were linked to a lower likelihood of experiencing LBP [OR = 0.55, 95% CI = (0.45, 0.68)]. However, a BMD >1.14 g/cm2 increased the risk of LBP [OR = 6.15, 95% CI = (4.51, 8.39)].ConclusionsBMP was significantly and positively correlated with LBP. A U-shaped relationship was observed between BMD and LBP, indicating that both insufficient and excessive BMD may increase the risk of LBP.
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spelling doaj-art-e4078850102d42ee92a4d26aba4e3fdf2025-08-20T02:16:50ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-04-011210.3389/fsurg.2025.15356141535614Association between bone mineral density and lower back pain in the general United States population using the NHANES of 1999–2004Yang ZhouChi LiWangYing DaiHongLin TengYu WangMingYu ZhuJing WangObjectivesLower back pain (LBP) is a prevalent health issue that has substantial effects on individuals and society. However, the association between bone mineral density (BMD) and LBP remains controversial. In this study we aimed to ascertain whether a relationship exists between BMD and LBP in the United States population.MethodsData from the National Health and Nutrition Examination Survey (NHANES) spanning 1999–2004 were analyzed using a cross-sectional approach. BMD and LBP were assessed using multivariate logistic regression, smoothing curves, and generalized additive models. Subgroup analyses were also performed to ensure data stability and mitigate confounding factors.ResultsIn this population-based study, the data of 107,570 adults were analyzed (mean age: 47.13 ± 18.38 years) and 36.74% of them had LBP. After controlling for all covariates, a positive correlation was established between BMD and LBP [odds ratio (OR) = 1.87, 95% confidence interval (CI) = (1.00, 3.50)]. The two-segment linear regression model revealed a U-shaped relationship between BMD and LBP with a 1.14 g/cm2 inflection point. BMD values <1.14 g/cm2 were linked to a lower likelihood of experiencing LBP [OR = 0.55, 95% CI = (0.45, 0.68)]. However, a BMD >1.14 g/cm2 increased the risk of LBP [OR = 6.15, 95% CI = (4.51, 8.39)].ConclusionsBMP was significantly and positively correlated with LBP. A U-shaped relationship was observed between BMD and LBP, indicating that both insufficient and excessive BMD may increase the risk of LBP.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1535614/fulllower back painbone mineral densityosteoporosiseconomic impactU-shaped relationship
spellingShingle Yang Zhou
Chi Li
WangYing Dai
HongLin Teng
Yu Wang
MingYu Zhu
Jing Wang
Association between bone mineral density and lower back pain in the general United States population using the NHANES of 1999–2004
Frontiers in Surgery
lower back pain
bone mineral density
osteoporosis
economic impact
U-shaped relationship
title Association between bone mineral density and lower back pain in the general United States population using the NHANES of 1999–2004
title_full Association between bone mineral density and lower back pain in the general United States population using the NHANES of 1999–2004
title_fullStr Association between bone mineral density and lower back pain in the general United States population using the NHANES of 1999–2004
title_full_unstemmed Association between bone mineral density and lower back pain in the general United States population using the NHANES of 1999–2004
title_short Association between bone mineral density and lower back pain in the general United States population using the NHANES of 1999–2004
title_sort association between bone mineral density and lower back pain in the general united states population using the nhanes of 1999 2004
topic lower back pain
bone mineral density
osteoporosis
economic impact
U-shaped relationship
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1535614/full
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