Fat mass contributes to musculoskeletal pain risk

By Lucy Piper, Senior medwireNews Reporter

People with high fat mass could be at an increased risk of musculoskeletal pain, say researchers.

The impact was greater for women than for men and the researchers found that the most severe category of musculoskeletal pain – widespread pain – remained significantly associated with a high fat to muscle mass ratio even after taking into account age, gender and arthritis.

This suggests that the association between fat mass and musculoskeletal pain is not solely caused by a greater severity of osteoarthritis (OA), researcher Hyun Ah Kim (Hallym University Sacred Heart Hospital, Kyunggi-do, Korea) and colleagues note in Arthritis & Rheumatology.

“[A] recent study showing that clinically relevant weight loss in older obese patients with knee OA decreased pain independent of muscle strength, knee-joint alignment, or structural damage at baseline as assessed by imaging, corroborates our hypothesis that obesity has a role in pain aggravation independent of joint damage”, they add.

Among 1530 individuals aged an average of 60.8 years participating in the study, total fat mass increased significantly with greater distribution of pain, from an average 15.9 kg in patients with no pain to 19.1 kg in patients with widespread pain.

The same was true for the ratio of fat mass to muscle mass, which increased from an average 0.38 to 0.50, whereas total lean mass was significantly and negatively associated with pain distribution.

The associations of total fat mass and the fat/muscle ratio with pain were only significant in women, however, and may reflect the greater contribution of fat mass to body mass index in women compared with men, the team suggests.

This hypothesis was supported by multivariate analysis findings that showed pain was more strongly associated with the fat/muscle mass ratio.

Fat mass was no longer significantly associated with widespread pain after taking into account self-reported arthritis in addition to gender and age, whereas the fat/muscle ratio was. Patients in the second, third and fourth quartiles for fat/muscle ratio were a significant 1.83-, 2.07-, and 1.94-fold more likely to have widespread pain than those in the lowest quartile.

“Understanding the relation between fat mass and pain may provide insights into preventative measures and therapeutic strategies for musculoskeletal pain”, Kim et al comment.

They also looked at the effects of the metabolic syndrome as a plausible mechanism linking obesity and pain, but found it had no significant effect independent of body mass index.

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