title: Associations of metabolic factors and adipokines with pain in incipient upper extremity soft tissue disorders: a cross-sectional study.
abstract: OBJECTIVE
  Earlier studies have suggested associations between metabolic factors and musculoskeletal pain or disorders. We studied the associations of obesity, lipids, other features of the metabolic syndrome and adipokines (adiponectin, leptin, resistin, visfatin) with upper extremity pain in a clinical population with incipient upper extremity soft tissue disorders (UESTDs).
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  Primary healthcare (occupational health service) with further examinations at a research institute.
  
  
  METHODS
  Patients (N=163, 86% were women) seeking medical advice in the occupational health service due to incipient upper extremity symptoms with symptom duration of <1 month were referred for consultation to the Finnish Institute of Occupational Health from Spring 2006 to Fall 2008. We included all actively working subjects meeting diagnostic criteria based on physical examination. We excluded subjects meeting predetermined conditions.
  
  
  METHODS
  Pain intensity was assessed with visual analogue scale and dichotomised at the highest tertile (cut-point 60).
  
  
  RESULTS
  Obesity (adjusted OR for high waist circumference 2.9, 95% CI 1.1 to 7.3), high-density lipoprotein cholesterol (OR 3.9, 95% CI 1.4 to 10.1 for low level) and triglycerides (OR 2.6, 95% CI 1.0 to 6.8 for high level) were associated with pain intensity. Of four adipokines studied, only visfatin was associated with upper extremity pain (adjusted OR 1.4, 95% CI 1.0 to 2.1 for 1SD increase in level).
  
  
  CONCLUSIONS
  Abdominal obesity and lipids may have an impact on pain intensity in UESTDs. They may intensify pain through proinflammatory pain-modifying molecular pathways or by causing soft tissue pathology and dysfunction of their supplying arteries. Of four adipokines studied only one (visfatin) was associated with pain intensity. In the future, further studies are required to better understand the relationship between metabolic factors and UESTDs.
authors: Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Martti
authors: M
authors: Rechardt
authors: Rahman
authors: R
authors: Shiri
authors: Harri
authors: H
authors: Lindholm
authors: Jaro
authors: J
authors: Karppinen
authors: Eira
authors: E
authors: Viikari-Juntura
keywords: Musculoskeletal disorders < ORTHOPAEDIC & TRAUMA SURGERY; Occupational & Industrial Medicine
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