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通过饮食干预减肥对肥胖程度较高的成年人疼痛特征、功能活动能力和炎症的影响。

Effects of weight loss through dietary intervention on pain characteristics, functional mobility, and inflammation in adults with elevated adiposity.

作者信息

Ward Susan J, Coates Alison M, Carter Sharayah, Baldock Katherine L, Berryman Carolyn, Stanton Tasha R, Yandell Catherine, Buckley Jonathan D, Tan Sze-Yen, Rogers Geraint B, Hill Alison M

机构信息

Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia.

Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.

出版信息

Front Nutr. 2024 May 22;11:1274356. doi: 10.3389/fnut.2024.1274356. eCollection 2024.

Abstract

BACKGROUND

The relationship between adiposity and pain is complex. Excess weight increases the risk for chronic musculoskeletal pain (CMP), driven by increased biomechanical load and low-grade systemic inflammation. Pain limits physical function, impacting energy balance contributing to weight gain. The primary aims of this study were to profile pain characteristics in participants with overweight or obesity and determine if weight loss through dietary-induced energy restriction, and presence of CMP, or magnitude of weight loss, was associated with changes in adiposity, pain, functional mobility, and inflammation.

METHODS

This was a secondary analysis of data from adults (25-65 years) with overweight or obesity (BMI 27.5-34.9 kg/m) enrolled in a 3-month, 30% energy-restricted dietary intervention to induce weight loss (January 2019-March 2021). Anthropometric measures (weight, waist circumference and fat mass), pain prevalence, pain severity (McGill Pain Questionnaire, MPQ), pain intensity (Visual Analog Scale, VAS), functional mobility (timed up and go, TUG) and inflammation (high sensitivity C-Reactive Protein, hsCRP) were assessed at baseline and 3-months.

RESULTS

One hundred and ten participants completed the intervention and had weight and pain assessed at both baseline and 3-months. Participants lost 7.0 ± 0.3 kg, representing 7.9% ± 3.7% of body mass. At 3-months, functional mobility improved (TUG -0.2 ± 0.1 s, 95% CI -0.3, -0.1), but there was no change in hsCRP. Compared to baseline, fewer participants reported CMP at 3-months ( = 56, 51% to  = 27, 25%,  < 0.001) and presence of multisite pain decreased from 22.7% to 10.9% ( < 0.001). Improvements in anthropometric measures and functional mobility did not differ between those presenting with or without CMP at baseline. Improvements in pain were not related to the magnitude of weight loss.

CONCLUSION

Weight loss was effective in reducing pain prevalence and improving functional mobility, emphasizing the importance of considering weight-loss as a key component of pain management.

CLINICAL TRIAL REGISTRATION

identifier, ACTRN12618001861246.

摘要

背景

肥胖与疼痛之间的关系较为复杂。体重超标会增加慢性肌肉骨骼疼痛(CMP)的风险,这是由生物力学负荷增加和低度全身性炎症所致。疼痛会限制身体功能,影响能量平衡,进而导致体重增加。本研究的主要目的是剖析超重或肥胖参与者的疼痛特征,并确定通过饮食诱导能量限制实现体重减轻、CMP的存在与否或体重减轻的幅度是否与肥胖、疼痛、功能活动能力及炎症的变化相关。

方法

这是一项对年龄在25至65岁之间、超重或肥胖(BMI为27.5至34.9kg/m²)的成年人的数据进行的二次分析。这些参与者参加了一项为期3个月、能量限制30%的饮食干预以诱导体重减轻(2019年1月至2021年3月)。在基线和3个月时评估人体测量指标(体重、腰围和脂肪量)以及疼痛患病率、疼痛严重程度(麦吉尔疼痛问卷,MPQ)、疼痛强度(视觉模拟量表,VAS)、功能活动能力(计时起立行走测试,TUG)和炎症指标(高敏C反应蛋白hsCRP)。

结果

110名参与者完成了干预,并在基线和3个月时进行了体重和疼痛评估。参与者体重减轻了7.0±0.3kg,占体重的7.9%±3.7%。在3个月时,功能活动能力有所改善(TUG -0.2±0.1秒,95%CI -0.3,-0.1),但hsCRP没有变化。与基线相比,3个月时报告患有CMP的参与者减少(基线时n = 56,占51%;3个月时n = 27,占25%,P<0.001),多部位疼痛的发生率从22.7%降至了10.9%(P<0.001)。在基线时有无CMP的参与者之间,人体测量指标和功能活动能力的改善情况并无差异。疼痛的改善与体重减轻的幅度无关。

结论

体重减轻对于降低疼痛患病率和改善功能活动能力有效,这凸显了将体重减轻视为疼痛管理关键组成部分的重要性。

临床试验注册

标识符,ACTRN12618001861246。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f90/11150618/c61ebd66a6fe/fnut-11-1274356-g001.jpg

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