CHRONIC LOW BACK PAIN COMORBIDITIES: UNRAVELLING IMPAIRED GLUCOSE METABOLISM

Chronic low back pain (CLBP) is a global health problem. The first step for developing effective
treatments is a better understanding of underlying mechanisms, including its comorbidities.
Cumulative findings, including breakthrough findings from our own group, point to impaired glucose
metabolism as an important CLBP comorbidity. In addition to its metabolic role, the insulin-like
growth factor 1 (IGF1)/ growth hormone (GH) axis plays a key role in pain modulation. Therefore,
the project aims to examine whether DNA methylation in the IGF1/GH axis genes and their functional
proteins predicts postprandial glycemic responses to standardized drinks, standardized meals, and
real-life meals in patients with CLBP. This will be examined using two (i.e., 1 in CLBP and 1 in healthy
controls) double-blind, randomized cross-over experiments (high versus low glycaemic index
beverages). After the 14-day experimental phase, all participants will be studied for an additional
week to examine whether the experimental findings have ecological validity, i.e., whether they can
be confirmed in response to real-life meals in their home environment. Genome-wide changes in
DNA methylation will be studied using next generation sequencing, and the findings will be validated
using pyrosequencing in another lab. The project allows identification of a biomarker for a potentially
very significant CLBP comorbidity, including identifying targetable mechanisms to develop innovative,
personalized treatments