Lyu Yunshu, Lu Qingxing, Liu Yane, Xie Mengtong, Jiang Lintong, Li Junnan, Wang Ning, Dai Xianglong, Yang Yuqi, Jiang Peiming, Yu Qiong
Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China.
Korean J Pain. 2025 Apr 1;38(2):177-186. doi: 10.3344/kjp.24331. Epub 2025 Mar 6.
Obesity and chronic pain are related in both directions, according to earlier observational research. This research aimed to analyze the causal association between obesity and chronic pain at the genetic level, as well as to assess whether common factors mediate this relationship.
This study used bidirectional two sample Mendelian randomization (MR) technique to analyze the association between obesity and chronic pain. Obesity's summary genome-wide association data were obtained from European ancestry groups, as measured by body mass index (BMI), waist-to-hip ratio, waist circumference (WC), and hip circumference (HC), genome-wide association study data for chronic pain also came from the UK population, including chronic pain at three different sites (back, hip, and headache), chronic widespread pain (CWP), and multisite chronic pain (MCP). Secondly, a two-step MR and multivariate MR investigation was performed to evaluate the mediating effects of several proposed confounders.
The authors discovered a link between chronic pain and obesity. More specifically, a sensitivity analysis was done to confirm the associations between greater BMI, WC, and HC with an increased risk of CWP and MCP. Importantly, the intermediate MR results suggest that education levels and smoking initiation may mediate the causal relationship between BMI on CWP, with a mediation effect of 23.08% and 15.38%, respectively.
The authors' findings demonstrate that the importance of education and smoking in understanding chronic pain's pathogenesis, which is important for the primary prevention and prognosis of chronic pain.
根据早期的观察性研究，肥胖与慢性疼痛在两个方向上都存在关联。本研究旨在分析肥胖与慢性疼痛在基因水平上的因果关联，并评估是否有共同因素介导这种关系。
本研究采用双向两样本孟德尔随机化（MR）技术分析肥胖与慢性疼痛之间的关联。肥胖的全基因组关联汇总数据来自欧洲血统群体，通过体重指数（BMI）、腰臀比、腰围（WC）和臀围（HC）进行测量，慢性疼痛的全基因组关联研究数据也来自英国人群，包括三个不同部位（背部、臀部和头痛）的慢性疼痛、慢性广泛性疼痛（CWP）和多部位慢性疼痛（MCP）。其次，进行了两步MR和多变量MR调查，以评估几个提出的混杂因素的中介作用。
作者发现慢性疼痛与肥胖之间存在联系。更具体地说，进行了敏感性分析，以确认较高的BMI、WC和HC与CWP和MCP风险增加之间的关联。重要的是，中间MR结果表明，教育水平和开始吸烟可能介导BMI与CWP之间的因果关系，中介效应分别为23.08%和15.38%。
作者的研究结果表明，教育和吸烟在理解慢性疼痛发病机制中的重要性，这对慢性疼痛的一级预防和预后很重要。
