Liu Huili, Wen Bei, Bai Xue, Chen Ming'an, Li Min
Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China.
Department of Anesthe-siology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2025 Feb 18;57(1):178-184. doi: 10.19723/j.issn.1671-167X.2025.01.027.
To investigate the relationship between the weight-adjusted waist index (WWI) and acute, subacute pain or chronic pain among American adults.
There was a cross-sectional study. Data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) concerning waist circumference, weight, pain status and covariates (age, gender, race, marital status, education level and income, physical activity, alcohol consumption, smoking status, and diabetes) were extracted for analysis. Multinomial Logistic regression was conducted across the three models to investigate the associations between WWI and acute, subacute and chronic pain. Model 1 did not involve any adjustments. Model 2 involved adjustments for age, gender, race, marital status, education level, and income. Model 3 was further adjusted for physical activity, alcohol consumption, smoking, and diabetes status.
This study involved 12 694 participants with an average age of (50.6±18.7) years. Among all the participants, 9 614 people (75.74%) had no pain, 870 people (6.85%) experienced acute pain, 354 people (2.79%) suffered from subacute pain, and 1 856 people (14.62%) experienced chronic pain. The WWI of all the participants was (10.95±0.85) cm/$\sqrt{\mathrm{kg}}$, divided into four groups based on quartiles: Group Q1 (7.90-10.36) cm/$\sqrt{\mathrm{kg}}$, group Q2 (10.37-10.94) cm/$\sqrt{\mathrm{kg}}$, group Q3 (10.95-11.53) cm/$\sqrt{\mathrm{kg}}$ and group Q4 (11.54-15.20) cm/$\sqrt{\mathrm{kg}}$. With the increase of WWI, the analysis revealed a significant statistical difference in the participants' acute and chronic pain status (all < 0.001). In Model 1, the prevalence of acute pain was lower in group Q2 and group Q4 compared with group Q1 (group Q2: =0.765, 95%: 0.615-0.953, =0.017; group Q4: = 0.648, 95%: 0.503-0.835, < 0.001). Compared with group Q1, the prevalence of chronic pain increased in group Q2, group Q3, and group Q4 (group Q2: =1.365, 95%: 1.149-1.622, < 0.001; group Q3=1.291, 95%: 1.082-1.541, =0.005; group Q4: =1.874, 95%: 1.579-2.224, < 0.001). In Model 2, compared with group Q1, an increase in chronic pain prevalence was still associated with an increase in WWI in other three groups (group Q2: =1.359, 95%: 1.137-1.624, =0.001; group Q3: =1.260, 95% 1.039-1.528, =0.019; group Q4: =1.735, 95%: 1.413-2.132, < 0.001). In Model 3, group Q4 had a 49.2% increased prevalence of chronic pain compared to group Q1 ( = 1.492, 95%: 1.208-1.842, < 0.001). However, in Models 2 and 3, no significant relationship was observed between acute pain and WWI (all >0.05). And none of the three models identified a significant association between subacute pain and WWI (all >0.05).
For American adults, there was no significant correlation between WWI and acute pain or subacute pain. However, as WWI increases, so does the prevalence of chronic pain. Further validation of this conclusion through large-scale prospective studies is warranted.
探讨体重调整腰围指数（WWI）与美国成年人急性、亚急性疼痛或慢性疼痛之间的关系。
进行了一项横断面研究。提取了1999 - 2004年国家健康与营养检查调查（NHANES）中关于腰围、体重、疼痛状况及协变量（年龄、性别、种族、婚姻状况、教育水平和收入、身体活动、饮酒、吸烟状况及糖尿病）的数据进行分析。在三个模型中进行多项逻辑回归，以研究WWI与急性、亚急性和慢性疼痛之间的关联。模型1未进行任何调整。模型2对年龄、性别、种族、婚姻状况、教育水平和收入进行了调整。模型3进一步对身体活动、饮酒、吸烟和糖尿病状况进行了调整。
本研究纳入12694名参与者，平均年龄为（50.6±18.7）岁。在所有参与者中，9614人（75.74%）无疼痛，870人（6.85%）经历急性疼痛，354人（2.79%）遭受亚急性疼痛，1856人（14.62%）经历慢性疼痛。所有参与者的WWI为（10.95±0.85）cm/$\sqrt{\mathrm{kg}}$，根据四分位数分为四组：Q1组（7.90 - 10.36）cm/$\sqrt{\mathrm{kg}}$，Q2组（10.37 - 10.94）cm/$\sqrt{\mathrm{kg}}$，Q3组（10.95 - 11.53）cm/$\sqrt{\mathrm{kg}}$和Q4组（11.54 - 15.20）cm/$\sqrt{\mathrm{kg}}$。随着WWI的增加，分析显示参与者的急性和慢性疼痛状况存在显著统计学差异（均<0.001）。在模型1中，与Q1组相比，Q2组和Q4组的急性疼痛患病率较低（Q2组：=0.765，95%：0.615 - 0.953，=0.017；Q4组：=0.648，95%：0.503 - 0.835，<0.001）。与Q1组相比，Q2组、Q3组和Q4组的慢性疼痛患病率增加（Q2组：=1.365，95%：1.149 - 1.622，<0.001；Q3组=1.291，95%：1.082 - 1.541，=0.005；Q4组：=1.874，95%：1.579 - 2.224，<0.001）。在模型2中，与Q1组相比，其他三组慢性疼痛患病率的增加仍与WWI的增加相关（Q2组：=1.359，95%：1.137 - 1.624，=0.001；Q3组：=1.260，95% 1.039 - 1.528，=0.019；Q4组：=1.735，95%：1.413 - 2.132，<0.001）。在模型3中，与Q1组相比，Q4组慢性疼痛患病率增加49.2%（=1.492，95%：1.208 - 1.842，<0.001）。然而，在模型2和3中，未观察到急性疼痛与WWI之间存在显著关系（均>0.05）。且三个模型均未发现亚急性疼痛与WWI之间存在显著关联（均>0.05）。
对于美国成年人，WWI与急性疼痛或亚急性疼痛之间无显著相关性。然而，随着WWI的增加，慢性疼痛的患病率也随之增加。有必要通过大规模前瞻性研究对这一结论进行进一步验证。
