Research Study Abstract

Spinal pain is prospectively associated with cardiovascular risk factors in girls but not boys (CHAMPS study-DK)

  • Published on June 19, 2019

To examine the prospective associations between spinal pain exposures and risk factors for cardiovascular disease in children and explore the mediating role of health-related physical activity.

Students were recruited from ten public primary schools. Each week from November 2008 to October 2010, parents reported spinal pain occurrences in their children via text messaging. Clustered cardiovascular risk was estimated with a composite score comprising fasting serum triglycerides, homeostasis assessment model-estimated insulin resistance (HOMA-IR), total to high-density lipoprotein cholesterol ratio, and systolic blood pressure. Additional outcomes were fasting serum insulin and glucose concentrations and body mass index categories. Associations were explored with multilevel mixed regression models and reported with beta coefficients (β) and percent difference scores. All models were adjusted for potential confounders.

Data from 1022 children (53% female) with mean ± SD age of 8.4 ± 1.4 years were included. Girls with spinal pain had greater clustered cardiovascular risk (β [95% CI]; percent difference [95% CI] = .41 [.02–.80]; 3.3% [.2–6.4%]) than those without spinal pain. Similar outcomes were observed for log insulin (percent difference [95% CI] = 3.4% [.6–6.2%]) and log HOMA-IR = (percent difference [95% CI] = 3.8% [.4–7.3%]). Remaining associations between spinal pain and cardiovascular risk in girls were nonsignificant. There were no associations between spinal pain and cardiovascular risk in boys. Moderate-to-vigorous-intensity physical activity did not appear to mediate this relationship.

These findings suggest a potentially important link between spinal pain and cardiovascular risk in girls that may be independent of health-related physical activity.


  • Jeffrey J. Hebert 1,2
  • Heidi Klakk 3,4
  • Claudia Franz 3
  • Martin Sénéchal 1,5
  • Neil Manson 6,7,8
  • Niels Wedderkopp 9,10


  • 1

    Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 5A3, Canada

  • 2

    School of Psychology and Exercise Science, Murdoch University, Perth, Australia

  • 3

    Department of Sport Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark

  • 4

    Department of Physiotherapy and Research Center for Health Science, University College Lillebælt, Odense, Denmark

  • 5

    Cardiometabolic Exercise and Lifestyle Laboratory, Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada

  • 6

    Canada East Spine Centre, Saint John, NB, Canada

  • 7

    Department of Orthopaedic Surgery, Saint John Regional Hospital, Saint John, NB, Canada

  • 8

    Department of Orthopaedic Surgery, Dalhousie University, Halifax, NS, Canada

  • 9

    Orthopedic Department, Hospital of Southwestern Jutland, Esbjerg, Denmark

  • 10

    Department of Regional Health Research, University of Southern Denmark, Odense, Denmark


European Spine Journal


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