Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Unidad Asociada de I+D+i al Instituto de Química Médica (IQM) CSIC-URJC, Alcorcón, Spain.
High Performance Experimental Pharmacology Research Group, Universidad Rey Juan Carlos (PHARMAKOM), Alcorcón, Spain.
Front Endocrinol (Lausanne). 2024 Mar 6;15:1340465. doi: 10.3389/fendo.2024.1340465. eCollection 2024.
Over 1.9 billion adult people have overweight or obesity. Considered as a chronic disease itself, obesity is associated with several comorbidities. Chronic pain affects approximately 60 million people and its connection with obesity has been displayed in several studies. However, controversial results showing both lower and higher pain thresholds in subjects with obesity compared to individuals with normal weight and the different parameters used to define such association (e.g., pain severity, frequency or duration) make it hard to draw straight forward conclusions in the matter. The objective of this article is to examine the relationship between overweight and obesity (classified with BMI as recommended by WHO) and self-perceived pain intensity in adults.
A literature search was conducted following PRISMA guidelines using the databases CINAHL, Cochrane Library, EMBASE, PEDro, PubMed, Scopus and Web of Science to identify original studies that provide BMI values and their associated pain intensity assessed by self-report scales. Self-report pain scores were normalized and pooled within meta-analyses. The Cochrane's Q test and I index were used to clarify the amount of heterogeneity; meta-regression was performed to explore the relationship between each outcome and the risk of bias.
Of 2194 studies, 31 eligible studies were identified and appraised, 22 of which provided data for a quantitative analysis. The results herein suggested that adults with excess weight (BMI ≥ 25.0) or obesity (BMI ≥ 30.0) but not with overweight (pre-obesity) alone (BMI 25.0-29.9), are more likely to report greater intensities of pain than individuals of normal weight (BMI 18.5-24.9). Subgroup analyses regarding the pathology of the patients showed no statistically significant differences between groups. Also, influence of age in the effect size, evaluated by meta-regression, was only observed in one of the four analyses. Furthermore, the robustness of the findings was supported by two different sensitivity analyses.
Subjects with obesity and excess weight, but not overweight, reported greater pain intensities than individuals with normal weight. This finding encourages treatment of obesity as a component of pain management. More research is required to better understand the mechanisms of these differences and the clinical utility of the findings.
https://doi.org/10.17605/OSF.IO/RF2G3, identifier OSF.IO/RF2G3.
超过 19 亿成年人超重或肥胖。肥胖本身被认为是一种慢性疾病，与多种合并症有关。慢性疼痛影响约 6000 万人，其与肥胖的关系在几项研究中已经显示。然而，一些研究结果显示肥胖患者的疼痛阈值较低，而另一些研究结果显示肥胖患者的疼痛阈值较高，此外，用于定义这种关联的参数也不同（例如，疼痛的严重程度、频率或持续时间），这使得很难得出关于肥胖与疼痛之间关系的明确结论。本文的目的是检查超重和肥胖（按照世界卫生组织推荐的 BMI 进行分类）与成年人自我感知疼痛强度之间的关系。
按照 PRISMA 指南，使用 CINAHL、Cochrane 图书馆、EMBASE、PEDro、PubMed、Scopus 和 Web of Science 数据库进行文献检索，以确定提供 BMI 值及其相关自我报告量表评估的疼痛强度的原始研究。自我报告的疼痛评分在荟萃分析中进行标准化和汇总。使用 Cochrane's Q 检验和 I 指数来明确异质性的程度；进行元回归以探索每个结果与偏倚风险之间的关系。
在 2194 项研究中，确定了 31 项符合条件的研究并进行了评估，其中 22 项提供了定量分析的数据。本研究结果表明，超重（BMI≥25.0）或肥胖（BMI≥30.0）但非单纯超重（BMI 25.0-29.9）的成年人比体重正常（BMI 18.5-24.9）的成年人更有可能报告更强烈的疼痛。对患者病理的亚组分析显示，组间无统计学差异。此外，通过元回归评估，年龄对效应大小的影响仅在四项分析中的一项中观察到。此外，两项不同的敏感性分析支持研究结果的稳健性。
超重和肥胖患者（但非单纯超重患者）比体重正常的人报告更强烈的疼痛强度。这一发现鼓励将肥胖作为疼痛管理的一个组成部分进行治疗。需要进一步研究以更好地理解这些差异的机制和研究结果的临床实用性。
https://doi.org/10.17605/OSF.IO/RF2G3，标识符 OSF.IO/RF2G3。
