Abstract
ObjectiveWe aimed to study 19-year body mass index (BMI) patterns and their (1) bidirectional relationship with musculoskeletal pain and (2) mortality risk. Study design and SettingWe used data from the Chingford study and group-based trajectory modelling to define 19-year BMI patterns. We investigated whether baseline back, hand, hip, and knee pain (as single- and multi-site) predicted 19-year BMI trajectory, and whether 19-year BMI patterns predicted pain in year 20. We explored BMI trajectories and mortality risk over 25 years (life expectancy). ResultsWe included 938 women (mean age: year-1=54, year-20=72) and found seven distinct 19-year BMI trajectories: two normal-weighted (reference), slightly overweight, lower and upper overweight-to-obese, lower and upper obese. BMI patterns capturing the increase overweight-to-obese (BMI 27-34 overtime) were bidirectionally related to knee and multi-site pain. The lower obese pattern (BMI 33-38) was unidirectionally associated with lower limb pain. Women with BMI above 40 had an increased all-cause and cardiovascular mortality risk. ConclusionFor most postmenopausal women, the overweight WHO category was a transition. Two patterns capturing increase overweight-to-obese were mutually related to musculoskeletal pain, i.e., knee and multi-site pain contributed to becoming obese, and trajectories of becoming obese increased the odds of experiencing pain later.
Highlights
Obesity is a global problem related to numerous noncommunicable diseases and mortality
Between 1990-2010, back pain accounted for the most disability-adjusted life-years (DALYs), osteoarthritis (OA) had the most rapid increase in disease burden [3]
We found that women who reported back pain and knee pain at baseline had increased odds of having lower and upper overweight-to-obese and upper obese trajectories
Summary
Obesity is a global problem related to numerous noncommunicable diseases and mortality. According to the World Health Organization (WHO), in 2016, there were 1.9 billion (39%) overweight, and over 650 million (13%) obese adults in the world [1]. The global, European, and United Kingdom (UK) estimates showed that obesity was more prevalent in women [2]. Body mass index (BMI), used for defining overweight and obesity, has been associated with musculoskeletal disorders [1], which account for significant disability-adjusted life-years (DALYs) in noncommunicable diseases [3,4,5]. Between 1990-2010, back pain accounted for the most DALYs, osteoarthritis (OA) had the most rapid increase in disease burden [3]. Musculoskeletal pain is the primary determinant of patients’ impaired quality of life, and delivery of pharmacological or surgical treatments [7]
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