■生殖系统中的荷尔蒙波动与下腰痛(LBP)的发生之间的关系已被广泛观察到。然而,可能指示激素和生殖因素的特定变量的因果影响,例如更年期年龄(ANM),初潮年龄(AAM),月经周期长度(LMC),初生年龄(AFB),末次活产年龄(ALB)和下背痛患者首次性交年龄(AFS)尚不清楚.
■本研究采用双向孟德尔随机化(MR),使用来自全基因组协会研究(GWAS)和FinnGen联盟的公开汇总统计数据来研究激素和生殖因素对LBP的因果关系。各种MR方法,包括逆方差加权(IVW),MR-Egger回归,和加权中位数,被利用。进行了敏感性分析,以确保研究结果的稳健性和有效性。随后,采用多因素孟德尔随机化(MVMR)来评估生殖和激素因素对LBP风险的直接因果影响。
■实施Bonferroni校正并进行严格的质量控制后,MR的结果表明,LBP和AAM的风险降低之间存在值得注意的关联(OR=0.784,95%CI:0.689-0.891;p=3.53E-04),AFB(OR=0.558,95%CI:0.436-0.715;p=8.97E-06),ALB(OR=0.396,95%CI:0.226-0.692;p=0.002),和AFS(OR=0.602,95%CI:0.518-0.700;p=3.47E-10)。此外,在反向MR分析中,我们没有观察到LBP对ANM的显著因果效应,AAM,LMC和AFS。MVMR分析显示,在调整BMI后,AFB对LBP的因果效应具有持续的意义。
■我们的研究探讨了ANM,AAM,LMC,AFB,AFS,ALB和LBP的患病率。我们发现初潮早,第一次出生时的早期年龄,最后一次活产的年龄较早和首次发生性行为的年龄较早可能会降低LBP的风险.这些见解增强了我们对LBP风险因素的理解,为筛查提供有价值的指导,预防,以及高危女性的治疗策略。
UNASSIGNED: The relationship between hormonal fluctuations in the reproductive system and the occurrence of low back pain (LBP) has been widely observed. However, the causal impact of specific variables that may be indicative of hormonal and reproductive factors, such as age at menopause (ANM), age at menarche (AAM), length of menstrual cycle (LMC), age at first birth (AFB), age at last live birth (ALB) and age first had sexual intercourse (AFS) on low back pain remains unclear.
UNASSIGNED: This study employed Bidirectional Mendelian randomization (MR) using publicly available summary statistics from Genome Wide Association Studies (GWAS) and FinnGen Consortium to investigate the causal links between hormonal and reproductive factors on LBP. Various MR methodologies, including inverse-variance weighted (IVW), MR-Egger regression, and weighted median, were utilized. Sensitivity analysis was conducted to ensure the robustness and validity of the findings. Subsequently, Multivariate Mendelian randomization (MVMR) was employed to assess the direct causal impact of reproductive and hormone factors on the risk of LBP.
UNASSIGNED: After implementing the Bonferroni correction and conducting rigorous quality control, the results from MR indicated a noteworthy association between a decreased risk of LBP and AAM (OR=0.784, 95% CI: 0.689-0.891; p=3.53E-04), AFB (OR=0.558, 95% CI: 0.436-0.715; p=8.97E-06), ALB (OR=0.396, 95% CI: 0.226-0.692; p=0.002), and AFS (OR=0.602, 95% CI: 0.518-0.700; p=3.47E-10). Moreover, in the reverse MR analysis, we observed no significant causal effects of LBP on ANM, AAM, LMC and AFS. MVMR analysis demonstrated the continued significance of the causal effect of AFB on LBP after adjusting for BMI.
UNASSIGNED: Our study explored the causal relationship between ANM, AAM, LMC, AFB, AFS, ALB and the prevalence of LBP. We found that early menarche, early age at first birth, early age at last live birth and early age first had sexual intercourse may decrease the risk of LBP. These insights enhance our understanding of LBP risk factors, offering valuable guidance for screening, prevention, and treatment strategies for at-risk women.