Discover the surprising connection between belly fat and chronic pain. A new study reveals how excess abdominal fat can contribute to widespread musculoskeletal pain.
MEDICAL NEWS
A study using the United Kingdom Biobank data looked at 32,409 participants, who had abdominal MRIs, for any association with increased abdominal fat tissue and widespread or multisite chronic pain syndromes. It looked at MRI findings of the amount of abdominal visceral adipose tissue (VAT-fat around the abdominal organs) and subcutaneous abdominal adipose tissue (SAT-fat just under the abdominal wall skin) and complaints of neck/shoulder, back, hip, knee or all over the body chronic pain. The subjects were about evenly divided between women and men, with a mean age of 55 years.
The researchers found an association of both VAT and SAT with the number of chronic musculoskeletal pain sites in both women and men. They reported that higher amounts of VAT and SAT correlated to higher numbers of chronic musculoskeletal pain sites. For women each standard deviation increase in VAT was correlated to a two times higher risk of having more sites of chronic musculoskeletal pain, while for men, each standard deviation increase in VAT was associated with a 34% increased risk of having more sites of chronic musculoskeletal pain. For women, each standard deviation increase in SAT was associated with a 60% increased risk of having more chronic musculoskeletal pain sites and for men, a 39% increased risk. The authors adjusted for age, height, ethnicity, household income, highest education level, alcohol frequency, smoking status, physical activity, comorbid conditions, sleep duration, psychological problems and follow-up time, but still found that the association between increased VAT and SAT and the number of chronic musculoskeletal pain persisted. The researchers stated that the results suggested that excessive abdominal adipose tissue may be implicated in the pathogenesis of chronic musculoskeletal pain. The fact that women had higher correlations between abdominal fat and chronic musculoskeletal pain site might reflect different fat distribution or hormonal effects.
Theories as to why this may occur include: VAT and SAT have been linked to increased levels of cytokines such as interleukin-6 and C-reactive protein and adipokines such as leptin. These are markers of body inflammation which have been proposed as a possible cause of musculoskeletal pain. Chronic inflammation may also affect peripheral nerves, which may possibly be another cause of chronic pain.
Comments:
In this first ever large study of MRI measured abdominal fat volume, an association between higher levels of both VAT and SAT to increased number of sites of musculoskeletal pain were found in both men and women. The authors tried to control for socioeconomic and activity levels and still found this association held.
Weaknesses of the study include the fact that although an association (or correlation) was found between abdominal fat tissue and the number of chronic musculoskeletal pain sites, it doesn’t prove that abdominal fat is in fact a cause of chronic musculoskeletal pain. In addition, 97% of the subjects were white so it may not be applicable to other ethnic groups. In this type of study there can also be unmeasured confounding variables which might affect results.
This study adds an additional potential risk factor for chronic pain of increased abdominal fat, as documented by MRI. Further study is needed, but this data does suggest that weight loss leading to decreased fat deposits might possibly decrease chronic musculoskeletal pain via a metabolic mechanism.
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Reference
Kifle ZD, Tian J, Aitken D, et al. MRI-derived abdominal adipose tissue is associated with multisite and widespread chronic pain. Regional Anesthesia & Pain Medicine Published Online First: 10 September 2024. Retrieved from: https://rapm.bmj.com/content/rapm/early/2024/08/06/rapm-2024-105535.full.pdf
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