Ryan Cormac G, Vijayaraman Arutchelvam, Denny Victoria, Ogier Alison, Ells Louisa, Wellburn Shaun, Cooper Lesley, Martin Denis J, Atkinson Greg
Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.
Specialist Weight Management Service, South Tees Hospitals NHS Foundation Trust, NHS, Middlesbrough, United Kingdom.
PLoS One. 2017 Jun 12;12(6):e0179227. doi: 10.1371/journal.pone.0179227. eCollection 2017.
To quantify the influence of baseline pain levels on weight change at one-year follow-up in patients attending a National Health Service specialist weight management programme.
We compared one-year follow-up weight (body mass) change between patient sub-groups of none-to-mild, moderate, and severe pain at baseline. A mean sub-group difference in weight change of ≥5kg was considered clinically relevant.
Of the 141 complete cases, n = 43 (30.5%) reported none-to-mild pain, n = 44 (31.2%) reported moderate pain, and n = 54 (38.3%) reported severe pain. Covariate-adjusted mean weight loss (95%CI) was similar for those with none-to-mild (8.1kg (4.2 to 12.0kg)) and moderate pain (8.3kg (4.9 to 11.7kg). The mean weight loss of 3.0kg (-0.4 to 6.4kg) for the severe pain group was 5.1kg (-0.6 to 10.7, p = 0.08) lower than the none-to-mild pain group and 5.3kg (0.4 to 10.2kg, p = 0.03) lower than the moderate pain group.
Patients with severe pain upon entry to a specialist weight management service in England achieve a smaller mean weight loss at one-year follow-up than those with none-to-moderate pain. The magnitude of the difference in mean weight loss was clinically relevant, highlighting the importance of addressing severe persistent pain in obese patients undertaking weight management programmes.
量化在参加国民医疗服务体系专科体重管理项目的患者中，基线疼痛水平对一年随访时体重变化的影响。
我们比较了基线时无痛至轻度疼痛、中度疼痛和重度疼痛患者亚组之间一年随访时的体重（体重）变化。体重变化的亚组平均差异≥5kg被认为具有临床相关性。
在141例完整病例中，n = 43例（30.5%）报告无痛至轻度疼痛，n = 44例（31.2%）报告中度疼痛，n = 54例（38.3%）报告重度疼痛。无痛至轻度疼痛患者（8.1kg（4.2至12.0kg））和中度疼痛患者（8.3kg（4.9至11.7kg））经协变量调整后的平均体重减轻（95%CI）相似。重度疼痛组的平均体重减轻3.0kg（-0.4至6.4kg），比无痛至轻度疼痛组低5.1kg（-0.6至10.7kg，p = 0.08），比中度疼痛组低5.3kg（0.4至10.2kg，p = 0.03）。
在英国，进入专科体重管理服务时伴有重度疼痛的患者在一年随访时的平均体重减轻幅度小于无痛至中度疼痛的患者。平均体重减轻差异的幅度具有临床相关性，突出了在肥胖患者进行体重管理项目时解决重度持续性疼痛的重要性。
