Association of Fat Mass and Adipokines With Foot Pain in a Community Cohort

Abstract

Objective. To determine, first, if fat mass index (FMI) or fat-free mass index (FFMI) and serum adipokines tumor necrosis factor (TNF) and interleukin-6 (IL-6) are associated with prevalent (stage 2) foot pain, and, second, if they are predictive of future (stage 3) foot pain. Methods. A subset of participants ages ‡50 years (n 5 1,462) from the North West Adelaide Health Study were used for this study. Participants from this community cohort were asked in stage 2 (2004)(2005)(2006) and stage 3 (2008-2010) if they had foot pain, aching, or stiffness. In stage 2, serum adipokines and anthropometry were measured, while body composition was analyzed with dual x-ray absorptiometry. These variables, along with comorbidities and social history, were used in logistic regression analyses to determine if FMI, FFMI, and serum adipokines were associated with foot pain. Results. Prevalent foot pain was present in 20.2% of participants, and future foot pain in 36.4%. Following multivariate modeling, the odds of having pain at stage 2 increased by 8% for each FMI unit (odds ratio [OR] 1.08, 95% confidence interval [95% CI] 1.04-1.12), while the odds of having pain at stage 3 increased by 6% for each FMI unit at stage 2 (OR 1.06, 95% CI 1.02-1.11). TNF level, IL-6 level, and FFMI were not associated with pain. Conclusion. Increased FMI, but not body mass index, FFMI, or TNF or IL-6 level, was associated with both prevalent and future foot pain. These results suggest that body fat may be more important than body weight with respect to foot pain. The role played by other adipokines requires further investigation.

Foot pain and inflammatory markers: a cross sectional study in older adults

“…Additional work has suggested that, given the relationship between fat mass and foot pain, differences in body composition and fat mass distribution between men and women may also contribute [16]. The present work examined whether inflammatory markers may be associated with foot pain and structural foot disorders in a cross-sectional setting.…”

Identification of Clusters of Foot Pain Location in a Community Sample

“…Previous work has identified cross‐sectional associations between BMI and foot pain , and this is likely due to biomechanical factors, with a high BMI resulting in increased pressure on the feet. However, more recently, fat mass and inflammatory markers have also been implicated as likely contributors to foot pain . In addition to the association between depression and foot pain highlighted above , there is also a relationship between obesity and depression , indicating that a complex interplay of factors is likely to exist, but certainly supporting the association between these factors and foot pain.…”

Is adiposity associated with back and lower limb pain? A systematic review

“…Of the included studies, 17 were cohort [ 85 – 101 ], ten were case-control [ 102 – 111 ] and 29 were cross-sectional [ 6 , 7 , 112 – 138 ] studies. Twenty one studies were conducted in Australia [ 6 , 7 , 85 , 89 , 90 , 92 – 94 , 97 – 99 , 101 , 102 , 105 , 106 , 117 , 119 , 122 , 126 , 129 , 134 ], seven in Japan [ 95 , 107 , 118 , 121 , 131 , 132 , 136 ], five in Finland [ 87 , 96 , 123 , 124 , 127 ], four in the USA [ 86 , 91 , 100 , 112 ], two in Brazil [ 128 , 130 ], Turkey [ 109 , 120 ], The Netherlands [ 113 , 115 ], India [ 114 , 135 ], Nigeria [ 116 , …”

“…Twenty one studies were conducted in Australia [ 6 , 7 , 85 , 89 , 90 , 92 – 94 , 97 – 99 , 101 , 102 , 105 , 106 , 117 , 119 , 122 , 126 , 129 , 134 ], seven in Japan [ 95 , 107 , 118 , 121 , 131 , 132 , 136 ], five in Finland [ 87 , 96 , 123 , 124 , 127 ], four in the USA [ 86 , 91 , 100 , 112 ], two in Brazil [ 128 , 130 ], Turkey [ 109 , 120 ], The Netherlands [ 113 , 115 ], India [ 114 , 135 ], Nigeria [ 116 , 133 ], and China [ 104 , 110 ], and one each in, Korea [ 125 ], Slovenia [ 103 ], Norway [ 88 ], United Kingdom [ 100 ], Sweden [ 111 ], Mexico [ …”

“…Adiposity was assessed using various methods; 16 studies used dual energy X-ray absorptiometry [ 6 , 7 , 85 , 89 , 90 , 94 , 97 – 100 , 106 , 107 , 119 , 125 , 126 , 129 ], 11 studies used bioelectric impedance analysis [ 92 , 93 , 105 , 114 , 118 , 120 – 122 , 128 , 131 , 137 ], 20 studies used a tape measure to determine waist and hip circumference [ 87 , 89 , 91 – 93 , 102 , 104 , 105 , 109 , 112 , 113 , 116 , 117 , 122 , 126 , 127 ], two studies used mathematical calculations [ 103 , 116 , 132 , 135 , 137 , 138 ], and five studies used skin fold callipers [ 95 , 108 , 109 , 111 , 115 ] ( Table 1 ). Twelve studies did not specify how adiposity was measured [ ...…”