TY - JOUR
T1 - Mechanisms of association between obesity and chronic pain in the elderly
AU - Ray, Lhasa
AU - Lipton, Richard B.
AU - Zimmerman, Molly E.
AU - Katz, Mindy J.
AU - Derby, Carol A.
N1 - Funding Information:
This publication was made possible by NIH/NIA Grant P01AG03949 and by CTSA Grant UL1 RR025750 , from the National Center for Research Resources (NCRR) , a component of the National Institutes of Health (NIH), and NIH roadmap for Medical Research. The contents are solely the responsibility of the authors and do not necessarily represent the official view of the NCRR or NIH. All the authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
PY - 2011/1
Y1 - 2011/1
N2 - Chronic pain is more common in the elderly and impairs functioning and quality of life. Though obesity, defined by body mass index (BMI), has been associated with pain prevalence among older adults, the mechanism of this association remains unclear. We examined components of the metabolic syndrome, insulin resistance, a marker of inflammation, and the presence of painful comorbidities as possible mediators of this association. Participants were 407 individuals aged ≥70 in the Einstein Aging Study. Chronic pain and pain over the last 3 months were defined using the Total Pain Index (TPI). Insulin resistance was modeled as fasting insulin, HOMA and QUICKI. High sensitivity C-reactive protein was used as a marker of inflammation. Cross-sectional logistic regression models were constructed to assess the associations of these factors with prevalent pain, adjusted for other known pain correlates. Prevalence of chronic pain was 52%. Of the clinical components of metabolic syndrome, central obesity was significantly associated with pain (OR 2.03, 95% CI 1.36-3.01). After adjustment for insulin resistance, inflammation, and pain-related comorbidities, central obesity predicted higher TPI scores (OR 1.55, 95% CI 1.04-2.33) and nearly doubled the risk of chronic pain (OR 1.70, 95% CI 1.05-2.75). Central obesity is the metabolic syndrome component showing the strongest independent association with pain, and the relationship is not explained by markers of insulin resistance or inflammation, nor by the presence of osteoarthritis or neuropathy.
AB - Chronic pain is more common in the elderly and impairs functioning and quality of life. Though obesity, defined by body mass index (BMI), has been associated with pain prevalence among older adults, the mechanism of this association remains unclear. We examined components of the metabolic syndrome, insulin resistance, a marker of inflammation, and the presence of painful comorbidities as possible mediators of this association. Participants were 407 individuals aged ≥70 in the Einstein Aging Study. Chronic pain and pain over the last 3 months were defined using the Total Pain Index (TPI). Insulin resistance was modeled as fasting insulin, HOMA and QUICKI. High sensitivity C-reactive protein was used as a marker of inflammation. Cross-sectional logistic regression models were constructed to assess the associations of these factors with prevalent pain, adjusted for other known pain correlates. Prevalence of chronic pain was 52%. Of the clinical components of metabolic syndrome, central obesity was significantly associated with pain (OR 2.03, 95% CI 1.36-3.01). After adjustment for insulin resistance, inflammation, and pain-related comorbidities, central obesity predicted higher TPI scores (OR 1.55, 95% CI 1.04-2.33) and nearly doubled the risk of chronic pain (OR 1.70, 95% CI 1.05-2.75). Central obesity is the metabolic syndrome component showing the strongest independent association with pain, and the relationship is not explained by markers of insulin resistance or inflammation, nor by the presence of osteoarthritis or neuropathy.
KW - Chronic pain
KW - Elderly
KW - Metabolic syndrome
KW - Obesity
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U2 - 10.1016/j.pain.2010.08.043
DO - 10.1016/j.pain.2010.08.043
M3 - Article
C2 - 20926190
AN - SCOPUS:78650416594
SN - 0304-3959
VL - 152
SP - 53
EP - 59
JO - Pain
JF - Pain
IS - 1
ER -