Meert Lotte, Picavet H Susan J, Vervullens Sophie, Meeus Mira, Van Kuijk Sander M J, Verschuren W M Monique, Smeets Rob J E M
Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium.
Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands.
Clin Rheumatol. 2025 Feb;44(2):839-853. doi: 10.1007/s10067-024-07251-5. Epub 2024 Dec 18.
To examine (a) the association between metabolic factors and chronic musculoskeletal pain (CMP), (b) metabolic predictors of CMP 10 years later, and (c) the association and evolution of metabolic factors across different CMP trajectory groups.
Data from the longitudinal Doetinchem Cohort Study were used. We used round 4 (2003-2007), with 4519 participants aged 36-75 years, as the baseline for the present study, with follow-up measurements in round 5 (2008-2012), and 6 (2013-2017), including self-reported pain and metabolic factors, which were measured either via self-report or physical assessment. For the three research aims, (a) generalized linear mixed-effects models, (b) binary logistic regression analyses and (c) linear mixed-effects models were used.
(a) Female sex, higher age, presence of diabetes, higher BMI, lower diastolic blood pressure (BP), and elevated cystatin C were significantly associated with CMP in multivariable logistic analyses. (b) Female sex and elevated BMI were predictors of CMP 10 years later. (c) Those pain-free for 10 years had the lowest BMI levels compared to other CMP groups (development, recovery, persistent, and recurrent CMP). BMI was higher in the persistent CMP group than in the development and recovery groups. The pain-free group had higher diastolic BP compared to those in the persistent CMP group. Participants in the persistent CMP group had higher Cystatin C levels than the free, development and recovery CMP groups. Regarding the evolution of metabolic factors over time, BMI, glucose and diastolic BP evolved differently across the CMP trajectory groups.
Our findings indicate the importance of metabolic factors, especially BMI, in the onset and progression of CMP. These findings underscore the need to consider metabolic health in the prevention and treatment of CMP. Key Points • Metabolic factors are associated with the presence of chronic musculoskeletal pain. • Female sex and elevated BMI are predictive of musculoskeletal pain (MP) 10 years later. • Metabolic factors evolve differently over time across different pain trajectory groups, with variations in BMI, glucose, and diastolic blood pressure.
研究（a）代谢因素与慢性肌肉骨骼疼痛（CMP）之间的关联；（b）10年后CMP的代谢预测因素；（c）不同CMP轨迹组中代谢因素的关联及演变情况。
使用多廷赫姆队列纵向研究的数据。我们将第4轮（2003 - 2007年）的4519名年龄在36 - 75岁的参与者作为本研究的基线，在第5轮（2008 - 2012年）和第6轮（2013 - 2017年）进行随访测量，包括通过自我报告或体格检查测量的自我报告疼痛和代谢因素。针对三个研究目标，分别使用了（a）广义线性混合效应模型、（b）二元逻辑回归分析和（c）线性混合效应模型。
（a）在多变量逻辑分析中，女性、较高年龄、糖尿病的存在、较高的体重指数（BMI）、较低的舒张压（BP）以及升高的胱抑素C与CMP显著相关。（b）女性和升高的BMI是10年后CMP的预测因素。（c）与其他CMP组（CMP的发展、恢复、持续和复发组）相比，持续10年无疼痛的人群BMI水平最低。持续CMP组的BMI高于发展组和恢复组。无疼痛组的舒张压高于持续CMP组。持续CMP组参与者的胱抑素C水平高于无疼痛、发展和恢复CMP组。关于代谢因素随时间的演变，BMI、血糖和舒张压在不同的CMP轨迹组中变化不同。
我们的研究结果表明代谢因素，尤其是BMI，在CMP的发生和发展中具有重要作用。这些结果强调在CMP的预防和治疗中需要考虑代谢健康。要点：• 代谢因素与慢性肌肉骨骼疼痛的存在相关。• 女性和升高的BMI可预测10年后的肌肉骨骼疼痛（MP）。• 代谢因素在不同疼痛轨迹组中随时间演变不同，BMI、血糖和舒张压存在差异。
