The following article is part of conference coverage from the 2018 American College of Rheumatology and Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting in Chicago, Illinois. Rheumatology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in rheumatology. Check back for the latest news from ACR/ARHP 2018 .

CHICAGO — Metabolic syndrome, and specifically the component of abdominal obesity, may be associated with pain intensity and number of painful sites in adults with radiographic knee osteoarthritis (OA), according to a study presented at the 2018 ACR/ARHP Annual Meeting, held October 19-24, 2018, in Chicago, Illinois. Weight loss may therefore represent an effective approach for controlling osteoarthritic pain.

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The authors of this prospective cohort study sought to examine the association between metabolic syndrome and pain severity and the number of painful sites in people diagnosed with radiographic knee OA.

A total of 1099 adults from a population-based cohort study were enrolled and followed for 2.6 years (n=875), 5.1 years (n=768), and 10.7 years (n=563). The authors collected data on demographics, lifestyle, psychological health, comorbidities, blood pressure, glucose levels, triglyceride profiles, and high-density lipoprotein (HDL) cholesterol. Diagnoses for metabolic syndrome in this cohort met the National Cholesterol Education Program-Adult Treatment Panel III criteria. Radiographic knee OA was evaluated with X-ray, and knee pain was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index pain questionnaire. Pain trajectories were identified with group-based trajectory modelling, and associations were analyzed with multi-nominal logistic regression.

In this cohort, 32% of individuals had metabolic syndrome and 60% of patients had radiographic knee OA at baseline. In study participants with radiographic knee OA, 3 trajectories were identified for pain severity (marginal pain, 50%; mild pain, 35%; and moderate pain, 15%), and 3 trajectories were defined for the number of painful sites (low number, 10%; medium number, 38%; and high number, 52%). In univariate analyses, metabolic syndrome was found to be associated with increased risk for mild pain (relative risk [RR], 1.47; 95% CI, 1.10-1.96) and for moderate pain (RR, 2.22; 95% CI, 1.54-3.20) compared with marginal pain. Metabolic syndrome was also found to be linked to an increased risk for experiencing a medium number of painful sites (RR, 2.25; 95% CI, 1.11-4.54) and a high number of painful sites (RR, 3.36; 95% CI, 1.70-6.63) compared with a low number of painful sites. In multivariate analyses, abdominal obesity was the only component that was found to be associated with increased risk for mild pain (RR, 1.70; 95% CI, 1.17-2.49), for moderate pain (RR, 2.75; 95% CI, 1.63-4.64), as well as with a medium number of pain sites (RR, 2.82; 95% CI, 1.39-5.70) and a high number of pain sites (RR, 3.60; 95% CI, 1.79-7.24).

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”[Metabolic syndrome] is predominantly associated with trajectories of pain severity and number of painful sites through abdominal obesity, suggesting that weight loss is the most important way of controlling OA pain,” concluded the study authors.

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Pan F, Tian J, Cicuttini F, Jones G. Metabolic syndrome and trajectories of pain severity and number of painful sites in knee osteoarthritis: data from 10.7-year prospective study. Presented at: 2018 ACR/ARHP Annual Meeting; October 19-24, 2018; Chicago, IL. Abstract 455.

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