Association between metabolic syndrome and risk of incident low back pain: A retrospective cohort study using real-world data from Japan

Objectives: Obesity is a well-established risk factor for low back pain (LBP). Emerging evidence suggests that other metabolic abnormalities may also be associated with LBP; however, the association between metabolic syndrome (MetS) and LBP remains unclear. This study assessed the association of Met...

Full description

Saved in:
Bibliographic Details
Main Authors: Shinsuke Okawa, Takuya Yamada, Mari Irie, Kumi Sugimoto, Yoshiharu Fukuda
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Preventive Medicine Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2211335525002013
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849715616068403200
author Shinsuke Okawa
Takuya Yamada
Mari Irie
Kumi Sugimoto
Yoshiharu Fukuda
author_facet Shinsuke Okawa
Takuya Yamada
Mari Irie
Kumi Sugimoto
Yoshiharu Fukuda
author_sort Shinsuke Okawa
collection DOAJ
description Objectives: Obesity is a well-established risk factor for low back pain (LBP). Emerging evidence suggests that other metabolic abnormalities may also be associated with LBP; however, the association between metabolic syndrome (MetS) and LBP remains unclear. This study assessed the association of MetS with the risk of incident LBP using longitudinal real-world data from Japan. Methods: Health insurance claims and health checkup data from prefectural government employees across all Japanese prefectures except Tokyo (April 1, 2018–March 31, 2023) were linked. Incident LBP was identified from claims, and MetS status from checkups. Participants who underwent a health checkup between April 1, 2018 and March 31, 2019 with no LBP that year were followed from April 1, 2019 to March 31, 2023. Cox proportional hazards models estimated hazard ratios (HRs) and 95 % confidence intervals (CIs) to explore the association of MetS with LBP risk. Results: Among 111,095 participants (mean follow-up: 3.3 years, 362,911.7 person-years), 16,894 developed LBP (15.2 %). MetS was associated with a significantly higher LBP risk (HR = 1.24; 95 % CI, 1.19–1.30). In sex-stratified analyses, the HR was 1.23 (95 % CI, 1.17–1.29) for males and 1.34 (95 % CI, 1.17–1.54) for females. Participants with abdominal obesity with additional MetS components had a greater LBP risk than those with abdominal obesity alone. Conclusion: MetS may be a predictor of incident LBP, highlighting the potential value of MetS management in LBP prevention.
format Article
id doaj-art-e7802d8c3f224a11a964a6762edf178d
institution DOAJ
issn 2211-3355
language English
publishDate 2025-08-01
publisher Elsevier
record_format Article
series Preventive Medicine Reports
spelling doaj-art-e7802d8c3f224a11a964a6762edf178d2025-08-20T03:13:18ZengElsevierPreventive Medicine Reports2211-33552025-08-015610316210.1016/j.pmedr.2025.103162Association between metabolic syndrome and risk of incident low back pain: A retrospective cohort study using real-world data from JapanShinsuke Okawa0Takuya Yamada1Mari Irie2Kumi Sugimoto3Yoshiharu Fukuda4Teikyo University Graduate School of Public Health, Itabashi-Ku, Tokyo, JapanCorresponding author at: Teikyo University Graduate School of Public Health, Address: 2-11-1, Kaga, Itabashi-Ku, Tokyo 173-8605, Japan.; Teikyo University Graduate School of Public Health, Itabashi-Ku, Tokyo, JapanTeikyo University Graduate School of Public Health, Itabashi-Ku, Tokyo, JapanTeikyo University Graduate School of Public Health, Itabashi-Ku, Tokyo, JapanTeikyo University Graduate School of Public Health, Itabashi-Ku, Tokyo, JapanObjectives: Obesity is a well-established risk factor for low back pain (LBP). Emerging evidence suggests that other metabolic abnormalities may also be associated with LBP; however, the association between metabolic syndrome (MetS) and LBP remains unclear. This study assessed the association of MetS with the risk of incident LBP using longitudinal real-world data from Japan. Methods: Health insurance claims and health checkup data from prefectural government employees across all Japanese prefectures except Tokyo (April 1, 2018–March 31, 2023) were linked. Incident LBP was identified from claims, and MetS status from checkups. Participants who underwent a health checkup between April 1, 2018 and March 31, 2019 with no LBP that year were followed from April 1, 2019 to March 31, 2023. Cox proportional hazards models estimated hazard ratios (HRs) and 95 % confidence intervals (CIs) to explore the association of MetS with LBP risk. Results: Among 111,095 participants (mean follow-up: 3.3 years, 362,911.7 person-years), 16,894 developed LBP (15.2 %). MetS was associated with a significantly higher LBP risk (HR = 1.24; 95 % CI, 1.19–1.30). In sex-stratified analyses, the HR was 1.23 (95 % CI, 1.17–1.29) for males and 1.34 (95 % CI, 1.17–1.54) for females. Participants with abdominal obesity with additional MetS components had a greater LBP risk than those with abdominal obesity alone. Conclusion: MetS may be a predictor of incident LBP, highlighting the potential value of MetS management in LBP prevention.http://www.sciencedirect.com/science/article/pii/S2211335525002013Low back painMetabolic syndromeReal-world dataHealth checkupHealth insurance claims
spellingShingle Shinsuke Okawa
Takuya Yamada
Mari Irie
Kumi Sugimoto
Yoshiharu Fukuda
Association between metabolic syndrome and risk of incident low back pain: A retrospective cohort study using real-world data from Japan
Preventive Medicine Reports
Low back pain
Metabolic syndrome
Real-world data
Health checkup
Health insurance claims
title Association between metabolic syndrome and risk of incident low back pain: A retrospective cohort study using real-world data from Japan
title_full Association between metabolic syndrome and risk of incident low back pain: A retrospective cohort study using real-world data from Japan
title_fullStr Association between metabolic syndrome and risk of incident low back pain: A retrospective cohort study using real-world data from Japan
title_full_unstemmed Association between metabolic syndrome and risk of incident low back pain: A retrospective cohort study using real-world data from Japan
title_short Association between metabolic syndrome and risk of incident low back pain: A retrospective cohort study using real-world data from Japan
title_sort association between metabolic syndrome and risk of incident low back pain a retrospective cohort study using real world data from japan
topic Low back pain
Metabolic syndrome
Real-world data
Health checkup
Health insurance claims
url http://www.sciencedirect.com/science/article/pii/S2211335525002013
work_keys_str_mv AT shinsukeokawa associationbetweenmetabolicsyndromeandriskofincidentlowbackpainaretrospectivecohortstudyusingrealworlddatafromjapan
AT takuyayamada associationbetweenmetabolicsyndromeandriskofincidentlowbackpainaretrospectivecohortstudyusingrealworlddatafromjapan
AT mariirie associationbetweenmetabolicsyndromeandriskofincidentlowbackpainaretrospectivecohortstudyusingrealworlddatafromjapan
AT kumisugimoto associationbetweenmetabolicsyndromeandriskofincidentlowbackpainaretrospectivecohortstudyusingrealworlddatafromjapan
AT yoshiharufukuda associationbetweenmetabolicsyndromeandriskofincidentlowbackpainaretrospectivecohortstudyusingrealworlddatafromjapan