阐明导致患有膝关节骨关节炎或有患膝关节骨关节炎风险的成年人在疼痛相关经历方面存在差异的因素。
Elucidating factors contributing to disparities in pain-related experiences among adults with or at risk for knee osteoarthritis.
作者信息
Mickle Angela M, Domenico Lisa H, Tanner Jared J, Terry Ellen L, Cardoso Josue, Glover Toni L, Booker Staja, Addison Adriana, Gonzalez Cesar E, Garvan Cynthia S, Redden David, Staud Roland, Goodin Burel R, Fillingim Roger B, Sibille Kimberly T
机构信息
College of Medicine, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL, United States.
College of Dentistry, Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, United States.
出版信息
Front Pain Res (Lausanne). 2023 Feb 22;4:1058476. doi: 10.3389/fpain.2023.1058476. eCollection 2023.
BACKGROUND AND PURPOSE
We and others have reported ethnic/race group differences in clinical pain, physical function, and experimental pain sensitivity. However, recent research indicates that with consideration for socioenvironmental factors, ethnicity/race differences become less or non-significant. Understanding of factors contributing to pain inequities are needed. Guided by the and , we evaluate the contributions of environmental and behavioral factors on previously reported ethnic/race group differences in: (1) clinical pain, (2) physical function, and (3) experimental pain in individuals with knee pain.
METHODS
Baseline data from Understanding of Pain and Limitations in Osteoarthritis Disease (UPLOAD) and UPLOAD-2 studies were analyzed. Participants were adults 45 to 85 years old who self-reported as non-Hispanic white (NHW) or black (NHB) with knee pain. A health assessment and quantitative sensory testing were completed. Sociodemographics, environmental, health, clinical and experimental pain, and physical functioning measures were included in nested regressions.
RESULTS
Pooled data from 468 individuals, 57 ± 8 years of age, 63% women, and 53% NHB adults. As NHB adults were younger and reported greater socioenvironmental risk than the NHW adults, the term sociodemographic groups is used. With inclusion of recognized environmental and behavioral variables, sociodemographic groups remained a significant predictor accounting for <5% of the variance in clinical pain and physical function and <10% of variance in experimental pain.
CONCLUSION
The incorporation of environmental and behavioral factors reduced relationships between sociodemographic groups and pain-related outcomes. Pain sites, BMI, and income were significant predictors across multiple models. The current study adds to a body of research on the complex array of factors contributing to disparities in pain-related outcomes.
背景与目的
我们及其他研究人员已报告了临床疼痛、身体功能及实验性疼痛敏感性方面的种族/族裔差异。然而，近期研究表明，考虑到社会环境因素，种族/族裔差异会变小或不显著。我们需要了解导致疼痛不平等的因素。在[具体理论]和[具体理论]的指导下，我们评估环境和行为因素对先前报告的种族/族裔群体在以下方面差异的影响：（1）临床疼痛，（2）身体功能，（3）膝关节疼痛个体的实验性疼痛。
方法
对骨关节炎疾病疼痛与限制理解（UPLOAD）及UPLOAD - 2研究的基线数据进行分析。参与者为45至85岁的成年人，他们自我报告为患有膝关节疼痛的非西班牙裔白人（NHW）或黑人（NHB）。完成了健康评估和定量感觉测试。社会人口统计学、环境、健康、临床和实验性疼痛以及身体功能测量指标被纳入嵌套回归分析。
结果
汇总了468名个体的数据，年龄57±8岁，女性占63%，NHB成年人占53%。由于NHB成年人比NHW成年人更年轻且报告的社会环境风险更高，因此使用社会人口统计学群体这一术语。纳入公认的环境和行为变量后，社会人口统计学群体仍是临床疼痛和身体功能方差不足5%、实验性疼痛方差不足10%的显著预测因素。
结论
纳入环境和行为因素后，社会人口统计学群体与疼痛相关结局之间的关系减弱。疼痛部位、体重指数和收入在多个模型中均为显著预测因素。本研究为有关导致疼痛相关结局差异的复杂因素的研究增添了内容。
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