title: Adolescent obesity, joint pain, and hypermobility.
abstract: BACKGROUND
  Obesity associated with joint pain of the lower extremities is likely due to excessive mechanical load on weight bearing joints. Additional mechanical factors may explain the association between obesity and joint pain.
  
  
  RESULTS
  We characterized the association between obesity and non-traumatic lower extremity (LE) joint pain in adolescents and examined the modifying effect of hypermobility on this association.We performed a cross-sectional analysis of data from subjects enrolled in a clinical trial examining the impact of weight loss on bone health in adolescents. Anthropometric data were collected and body mass index (BMI = kg/m2) was calculated. Subjects were categorized as obese or healthy weight controls based on CDC 2000 growth curves for age and gender. We assessed any musculoskeletal pain and LE pain by the PEDS™ Pediatric Pain Questionnaire™. Hypermobility was assessed with the modified Beighton scoring system. Multivariate logistic regression models adjusted for covariates were performed to examine the association between weight status and joint pain.Out of 142 subjects, 91 were obese and 51 were healthy weight. Obesity was not associated with any musculoskeletal pain (OR 0.86, CI 0.49-1.50), LE pain (OR 1.02, CI 0.49-2.15) or hypermobility (OR 1.23, CI 0.72-2.14, p = 0.3). There was no effect modification on the association between obesity and any musculoskeletal pain (OR 0.80, CI 0.45 -1.42) or LE pain (OR 0.98, CI 0.46 - 2.08) by hypermobility status.
  
  
  CONCLUSIONS
  We found no association between LE pain and obesity, and hypermobility did not modify this association.
authors.affiliation: Department of Pediatrics, Division of Rheumatology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, USA. sharon.bout-tabaku@nationwidechildrens.org.
authors.forename: Sharon
authors.initials: S
authors.lastname: Bout-Tabaku
authors.forename: Sarah B
authors.initials: SB
authors.lastname: Klieger
authors.forename: Brian H
authors.initials: BH
authors.lastname: Wrotniak
authors.forename: David D
authors.initials: DD
authors.lastname: Sherry
authors.forename: Babette S
authors.initials: BS
authors.lastname: Zemel
authors.forename: Nicolas
authors.initials: N
authors.lastname: Stettler
mesh_terms: D000293:Adolescent; D018771:Arthralgia / Q000209:etiology / Q000503:physiopathology; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D059352:Musculoskeletal Pain / Q000209:etiology / Q000503:physiopathology; D063766:Pediatric Obesity / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D013223:Statistics as Topic; D014481:United States / Q000453:epidemiology; D016474:Weight-Bearing / Q000502:physiology*