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Metabolic syndrome and trajectory of knee pain in older adults

journal contribution
posted on 2023-05-20, 03:52 authored by Feng PanFeng Pan, Jing TianJing Tian, Cicuttini, F, Graeme JonesGraeme Jones
Objectives: To examine the association of metabolic syndrome (MetS) and its components with knee pain severity trajectories.

Methods: Data from a population-based cohort study were utilised. Baseline blood pressure, glucose, triglycerides and high-density lipoprotein (HDL) cholesterol were measured. MetS was defined according to the National Cholesterol Education Program-Adult Treatment Panel III criteria. Radiographic knee osteoarthritis (ROA) was assessed by X-ray. Pain severity was measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain questionnaire at each time-point. Group-based trajectory modelling was used to identify pain trajectories and multi-nominal logistic regression was used for analysis. Mediation analysis was performed to assess whether body mass index (BMI)/central obesity mediated the association between MetS, its components and pain trajectories.

Results: Among 985 participants (Mean ± SD age: 62.9 ± 7.4, 50% female), 32% had MetS and 60% had ROA. Three pain trajectories were identified: 'Minimal pain' (52%), 'Mild pain' (33%) and 'Moderate pain' (15%). After adjustment for potential confounders, central obesity increased risk of belonging to both 'Mild pain' and 'Moderate pain' trajectories as compared to the 'Minimal pain' trajectory group, but MetS [relative risk ratio (RRR): 2.26, 95%CI 1.50-3.39], hypertriglyceridemia (RRR: 1.75, 95%CI 1.16-2.62) and low HDL (RRR: 1.67, 95%CI 1.10-2.52) were only associated with 'Moderate pain' trajectory. BMI/central obesity explained 37-70% of these associations. Results were similar in those with ROA.

Conclusion: MetS and its components are predominantly associated with worse pain trajectories through central obesity, suggesting that the development and maintenance of worse pain trajectories may be caused by MetS.


Publication title

Osteoarthritis and Cartilage








Menzies Institute for Medical Research


W B Saunders Co Ltd

Place of publication

32 Jamestown Rd, London, England, Nw1 7By

Rights statement

© 2019 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved

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Socio-economic Objectives

Clinical health not elsewhere classified; Preventive medicine

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