Mechanisms of association between obesity and chronic pain in the elderly

Lhasa Ray, Richard B. Lipton, Molly E. Zimmerman, Mindy Joy Katz, Carol A. Derby

Research output: Contribution to journalArticle

87 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)53-59
Number of pages7
JournalPain
Volume152
Issue number1
DOIs
StatePublished - Jan 2011

Fingerprint

Chronic Pain
Obesity
Pain
Insulin Resistance
Abdominal Obesity
Inflammation
Comorbidity
Logistic Models
Osteoarthritis
C-Reactive Protein
Fasting
Body Mass Index
Quality of Life
Insulin

Keywords

  • Chronic pain
  • Elderly
  • Metabolic syndrome
  • Obesity

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine
  • Neurology
  • Pharmacology

Cite this

Mechanisms of association between obesity and chronic pain in the elderly. / Ray, Lhasa; Lipton, Richard B.; Zimmerman, Molly E.; Katz, Mindy Joy; Derby, Carol A.

In: Pain, Vol. 152, No. 1, 01.2011, p. 53-59.

Research output: Contribution to journalArticle

@article{6016fde568ff400689c47ae08494c533,
title = "Mechanisms of association between obesity and chronic pain in the elderly",
abstract = "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.",
keywords = "Chronic pain, Elderly, Metabolic syndrome, Obesity",
author = "Lhasa Ray and Lipton, {Richard B.} and Zimmerman, {Molly E.} and Katz, {Mindy Joy} and Derby, {Carol A.}",
year = "2011",
month = "1",
doi = "10.1016/j.pain.2010.08.043",
language = "English (US)",
volume = "152",
pages = "53--59",
journal = "Pain",
issn = "0304-3959",
publisher = "Elsevier",
number = "1",

}

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 Joy

AU - Derby, Carol A.

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

UR - http://www.scopus.com/inward/record.url?scp=78650416594&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650416594&partnerID=8YFLogxK

U2 - 10.1016/j.pain.2010.08.043

DO - 10.1016/j.pain.2010.08.043

M3 - Article

C2 - 20926190

AN - SCOPUS:78650416594

VL - 152

SP - 53

EP - 59

JO - Pain

JF - Pain

SN - 0304-3959

IS - 1

ER -