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OP0337 Association between metabolic syndrome and trajectories of knee pain: a 10.7-year follow-up study
  1. F. Pan1,
  2. J. Tian1,
  3. F. Cicuttini2,
  4. C. Ding1,
  5. G. Jones1
  1. 1Menzies Institute for Medical Research, University of Tasmania, Hobart
  2. 2Department of Epidemiology and Preventive Medicine, Monash University Medical School, Melbourne, Australia


Background Metabolic syndrome (MetS) has been suggested as having a role in the pathogenesis of osteoarthritis (OA). However, no study has assessed whether MetS and its components are associated with knee pain and its change over time.

Objectives To identify distinct trajectories of MSP over 10.7 years in an older population, and to examine risk factors for identified trajectories.

Methods 1099 participants (mean age 63 years) from the population-based Tasmanian Older Adult Cohort study were recruited at baseline. 875, 768 and 563 participants attended years 2.6, 5.1 and 10.7 follow-up, respectively. Demographic, psychological, lifestyle and comorbidities data were obtained at baseline. Knee radiographic OA was assessed by X-ray at baseline. Group-based trajectory modelling was applied to identify distinct trajectories of MSP. Multi-nominal logistic regression was used for the analyses with adjustment for potential confounders.

Results 985 participants were included for the analyses, three pain trajectories were identified: ‘Mild pain’ (52%), ‘Moderate pain’ (33%) and ‘Severe pain’ (15%) with 32% of participants having Mets. MetS was significantly associated with increased risk of both ‘Moderate pain’ (relative risk [RR]: 1.47, 95% confidence interval [CI]: 1.10 to 1.96) and ‘Severe pain’ (2.22, 1.54 to 3.20) relative to ‘Mild pain’ in univariate analysis. After adjustment for age, sex, smoking, physical activity, emotional problems, comorbidities and radiographic OA, central obesity was associated with increased risk of both ‘Moderate pain’ (1.70, 1.17 to 2.49) and ‘Severe pain’ (3.28, 2.16 to 4.98), and MetS and its components (hypertriglyceridemia and low HDL) were only associated with increased risk of ‘Severe pain’ (p<0.05). However, these associations became weak and non-significant after further adjustment for body mass index (BMI), but hypertension became significantly protective with ‘Moderate pain’ (0.70, 0.50 to 0.99). Similar associations were found in those with knee OA (RR: 1.70 to 2.75, all p<0.05).

Conclusions The Mets is predominantly associated with knee pain trajectories through central obesity, and hypertriglyceridemia and low HDL can predict ‘Severe pain’ trajectory in those with Mets. An unexpected inverse association between hypertension and moderate pain trajectory needs a further investigation, which may reflect an interaction between blood pressure and pain sensitivity in ‘Moderate pain’ trajectory.

Disclosure of Interest None declared

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