The association of biomarkers with pain and function in acute and subacute low back pain: a secondary analysis of an RCT.
The association of biomarkers with pain and function in acute and subacute low back pain: a secondary analysis of an RCT.
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DOI：
10.1186/s12891-022-06027-9
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发表时间：
2022-12-05
影响因子：
2.3
通讯作者：
Sowa, Gwendolyn
中科院分区：
文献类型：
--
作者：
Tonelli Enrico, Valerio;Schneider, Michael;Haas, Mitchell;Vo, Nam;Huang, Wan;McFarland, Christine;Weber, Nick;Sowa, Gwendolyn
下背痛（LBP）是一种常见的肌肉骨骼疾病，也是全球残疾的主要原因。以前的研究已经发现生物标志物与LBP患者的疼痛和疼痛相关的残疾有关。本研究旨在探讨急性或亚急性轴性腰痛患者血清生物标志物与疼痛和残疾之间的关系。本研究是母随机对照试验的辅助研究。参与者被随机分为三个干预组：两种类型的脊柱操作或医疗护理之一。在母研究中，招募了107名在入组前3个月内经历新的LBP发作的成年人。在本研究中，107名参与者中有90名同意在治疗开始前立即采集血液样本。基于先前的文献选择了七种生物标志物并进行了分析。临床结局为基线和4周时评估的疼痛和奥斯韦斯特里功能障碍指数（ODI）。斯皮尔曼氏|R|用于研究每个干预组内每种生物标志物的初始水平与基线时疼痛和ODI评分的相关性，以及与基线至4周（治疗结束）结局评分变化的相关性。在基线时，7种生物标志物中有4种与疼痛相关，|R| ≥ .20：神经肽Y（NPY）（r = 0.23，p = 0.028）、E-选择素（r = 0.22，p = 0.043）、维生素D（r =-0.32，p = 0.002）和C-反应蛋白（CRP）（r = 0.37，p = 0.001）。没有基线生物标志物与残疾相关，|R| ≥ 0.20。对于基线生物标志物与4周结局变化的相关性，维生素D显示与残疾和/或疼痛变化相关（|R| ≥ 0.20，p > 0.05），而CRP、NPY和E-选择素沿着TNFα、P物质和RANTES显示至少一种与疼痛或残疾变化相关（|R| ≥ 0.20，p > .05）。在90例LBP患者中，分析的生物标志物，特别是维生素D，代表了一小部分潜在的候选人，可用于进一步研究，旨在个性化患者护理。总的来说，本研究中调查的相关性是确定LBP直接机制和预测操作相关治疗或医疗护理结果的第一步。 ClinicalTrials.gov标识符：NCT 01211613，注册日期：2010年9月29日，https://clinicaltrials.gov/ct2/show/NCT01211613? term=schneider&cond=Low+Back+Pain&cntry=US&state= US%3APA & draw =2&rank=1
Low back pain (LBP) is a common musculoskeletal condition and a major cause of disability worldwide. Previous studies have found associations of biomarkers with pain and pain-related disability in LBP patients. This study aimed to explore the association between serum biomarkers and pain and disability in patients with acute or subacute axial LBP. This study was ancillary to a parent randomized controlled trial. Enrolled participants were randomized into three intervention groups: one of two types of spinal manipulation or medical care. In the parent study, 107 adults who experienced a new episode of LBP within 3 months prior to enrollment were recruited. For this study, 90 of these 107 participants consented to have blood samples obtained, which were drawn immediately before the beginning of treatment. Seven biomarkers were chosen based on previous literature and analyzed. Clinical outcomes were pain and Oswestry Disability Index (ODI) evaluated at baseline and 4 weeks. Spearman’s |r| was used to study the association of initial levels of each biomarker with pain and ODI scores at baseline and with changes in outcome scores from baseline to 4 weeks (end of treatment) within each intervention group. At baseline, 4 of 7 biomarkers had an association with pain that was |r| ≥ .20: neuropeptide Y (NPY) (r = 0.23, p = .028), E-Selectin (r = 0.22, p = .043), vitamin D ((r = − 0.32, p = .002), and c-reactive protein (CRP) (r = 0.37, p = .001). No baseline biomarker had an association with disability that was |r| ≥ 0.20. For the correlations of baseline biomarkers with 4-week change in outcomes, vitamin D showed a correlation with change in disability and/or pain (|r| ≥ 0.20, p > .05) in manipulation-related groups, while CRP, NPY, and E-selectin along with TNFα, Substance P and RANTES showed at least one correlation with change in pain or disability (|r| ≥ 0.20, p > .05) in at least one of the treatment groups. In 90 LBP patients, the analyzed biomarkers, especially vitamin D, represent a small set of potential candidates for further research aimed at individualizing patient care. Overall, the associations investigated in the current study are an initial step in identifying the direct mechanisms of LBP and predicting outcomes of manipulation-related treatments or medical care. ClinicalTrials.gov Identifier: NCT01211613, Date of Registration: September 29, 2010, https://clinicaltrials.gov/ct2/show/NCT01211613?term=schneider&cond=Low+Back+Pain&cntry=US&state=US%3APA&draw=2&rank=1
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影响因子：
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