Lifestyle Habits as Potential Predictors of Impaired Blood Glucose Regulation in Patients with Chronic Low Back Pain vs. Healthy Controls: A Secondary Analysis of a Randomized Crossover Trial.

BACKGROUND

Chronic low back pain (CLBP) affects over 20% of adults worldwide. Despite the socioeconomic burden caused by this condition, there is no gold standard treatment for CLBP, and its etiology remains nonspecific in 85% of cases. Available evidence indicates that CLBP patients have higher postprandial glycemic responses to beverages that rank high on the glycemic index and that this finding correlates with pain severity. Therefore, understanding modifiable factors that predict blood glucose regulation in CLBP patients could reveal important information for the management of the condition.

OBJECTIVES

This study aimed to (1) examine the relationship between predictor variables and the overall glycemic response, measured by the incremental area under the curve (IAUC), and (2) assess the temporal changes in patients' blood glucose levels immediately after sucrose intake. This dual approach enables a nuanced understanding of both the cumulative and immediate impacts of sucrose intake on glycemic control, facilitating insights into personalized management strategies for mitigating glycemic variability.

STUDY

DESIGN

A secondary analysis of a case-control randomized controlled crossover trial to identify predictive factors for impaired blood glucose regulation.

SETTING

Vrije Universiteit Brussel, Belgium.

METHODS

Individuals with chronic low back pain (CLBP) were randomized to consume either a sucrose or isomaltulose beverage. Body composition, dietary intake, physical activity levels, psychological factors, and blood glucose levels were measured. Multiple linear regression was used to examine the relationship between baseline variables and postprandial glucose response following intake of the high-glycemic index beverages, and a linear mixed model (LMM) was applied to assess the relationship between sucrose intake and identified potential predictors.

RESULTS

Our findings revealed that higher weight (P < 0.001; t = -4.06), higher age (P = 0.003; t = 3.06), higher inflammatory dietary properties (P = 0.025; t = 2.28), worse mental health (P = 0.021; t = 2.34), and lower diet quality (P = 0.002; t = 3.22) were associated with a significant predictive value for altered postprandial sucrose responses.

LIMITATIONS: This study is a secondary analysis of a crossover case-control trial, so causal interpretations should be made cautiously. Additionally, postprandial glucose was measured using a self-monitoring finger-prick device, which lacked real-time data, and the findings were specific to women and may not apply to men.

CONCLUSION

These results confirm the potential relevance of targeting lifestyle factors in people with CLBP.