Reducing abdominal adiposity 'may be considered a target for chronic pain management', says team
Excess abdominal fat is associated with widespread chronic pain, particularly in women, according to a study that's said to be 'the first study of its kind'. It was published on 10 September in the open access journal Regional Anesthesia & Pain Medicine.
Reducing excess fat deposits in the abdomen may help reduce chronic musculoskeletal (MSK) pain, especially if it’s experienced at multiple body sites, the researchers suggest.
Previously published research has shown that obesity is associated with MSK pain, but it’s not known if excess fat tissue is linked to chronic MSK pain and at multiple body sites, say the researchers.
The article's first author is Zemene Demelash Kifle, who is based at the University of Tasmania Menzies Institute for Medical Research in Australia. The team drew on data for 32,409 participants in the UK Biobank study who completed questionnaires and underwent health assessments.
Around half of the participants were women (51 per cent), and their average age was 55.
Two rounds of MRI scans and pain assessments
The participants received MRI scans of their abdomen that measured the amount of fat around the abdominal organs (visceral adipose tissue or VAT) and the amount of fat just under the skin that can be pinched (subcutaneous adipose tissue (SAT)).
When attending for their scan, participants were asked if they had experienced any pain in their neck/shoulder, back, hip, knee or ’all over the body’ for more than three months.
The MRI scan and pain assessments were repeated around two years later for 638 participants. Comprehensive analyses showed a dose-response association between the number of chronic pain sites and VAT, SAT, the ratio of the two, and weight (BMI).
The association was stronger in women among whom the odds ratio of a higher number of chronic pain sites were twice as high for VAT, and 60 per cent greater for both SAT and the VAT:SAT ratio. In men, these odds ratios were 34 per cent, 39 per cent, and 13 per cent higher, respectively.
Higher levels of fat tissue were also associated with greater odds of reporting chronic pain, and again the association was more pronounced in women.
All these associations remained even after adjusting for age, height, ethnicity, household income, educational attainment, alcohol intake, smoking status, physical activity, coexisting conditions, sleep duration, psychological problems and length of follow-up.
Reducing abdominal adiposity may be considered a target for chronic pain management, particularly in those with pain in multiple sites and widespread pain [Zemene Demelash Kifle et al]
Caveats and conclusions
As their study was observational in nature, the team acknowledges that it cannot establish cause and effect and that there other limitations. These include the relatively small size of the repeat imaging sample, and the absence of an assessment of severity in the pain questionnaire. More follow-up visits would also have allowed more information to be gathered on patterns and fluctuations in the number of chronic pain sites, they add.
But Zemene Demelash Kifle and colleagues conclude: ‘Abdominal adipose tissue was associated with chronic musculoskeletal pain, suggesting that excessive and ectopic fat depositions may be involved in the pathogenesis of multisite and widespread chronic musculoskeletal pain.’
The authors add: ‘Therefore, reducing abdominal adiposity may be considered a target for chronic pain management, particularly in those with pain in multiple sites and widespread pain.’
And they suggest that the stronger associations seen in women may be a consequence of sex differences in fat distribution and hormones.
To access the full version of the article – titled MRI-derived abdominal adipose tissue is associated with multisite and widespread chronic pain doi: 10.1136/rapm-2024-105535 – click
Author: I A McMillan
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