Abstract
Background: Musculoskeletal pain typically occurs in multiple sites; however, no study has examined whether excessive visceral and subcutaneous adipose tissue are associated with musculoskeletal pain. This study, therefore, aimed to describe the associations between MRI-derived abdominal adipose tissue and chronic musculoskeletal pain.
Methods: Data from a large prospective, population-based cohort study were used (n=32,409; mean [SD] age, 55.0 [7.4] years; women [50.8%]). Abdominal MRI scans were performed at two imaging visits to quantify visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Pain in the neck/shoulder, back, hip, knee, or ‘all over the body’ was assessed at the corresponding visits. Chronic pain was defined if the pain had persisted for ≥3 months. A mixed-effects multinomial logistic regression model was used for the analyses.
Results: In multivariable analyses, there was a dose-response association of VAT, SAT, and their ratio with number of chronic pain sites in both women [VAT: relative risk ratio (RRR)=1.55 per SD, 95% CI(1.47, 1.62); SAT: 1.33(1.29, 1.37); VAT/SAT ratio: 1.33(1.21, 1.46)] and men [VAT: 1.20(1.16, 1.24); SAT: 1.22(1.17, 1.28); VAT/SAT ratio: 1.08(1.04, 1.13)]. The effect estimates of these adipose measures were relatively larger in women than in men.
Conclusion: Abdominal adipose tissue was associated with number of chronic musculoskeletal pain sites, suggesting that excessive and ectopic fat depositions are involved in the pathogenesis of multisite and widespread chronic musculoskeletal pain. The identified stronger effects in women than men may reflect sex differences in fat distribution and hormones.