Depressive Symptoms and Multi-joint Pain Partially Mediate the Relationship Between Obesity and Opioid Use in People with Knee Osteoarthritis

Lisa C Carlesso; S Reza Jafarzadeh; Andrew Stokes; David T Felson; Na Wang; Laura Frey-Law; Cora E Lewis; Michael Nevitt; Tuhina Neogi; Multicenter Osteoarthritis Study Group

doi:10.1016/j.joca.2022.06.002

Back

Depressive Symptoms and Multi-joint Pain Partially Mediate the Relationship Between Obesity and Opioid Use in People with Knee Osteoarthritis

Journal article

Open access

Peer reviewed

Depressive Symptoms and Multi-joint Pain Partially Mediate the Relationship Between Obesity and Opioid Use in People with Knee Osteoarthritis

Lisa C Carlesso, S Reza Jafarzadeh, Andrew Stokes, David T Felson, Na Wang, Laura Frey-Law, Cora E Lewis, Michael Nevitt, Tuhina Neogi and Multicenter Osteoarthritis Study Group

Osteoarthritis and cartilage, Vol.30(9), pp.1263-1269

06/11/2022

DOI: 10.1016/j.joca.2022.06.002

PMCID: PMC9419857

PMID: 35700904

Files and links (1)

url

https://doi.org/10.1016/j.joca.2022.06.002View

Published (Version of record) Open Access

Abstract

To assess the relation of obesity to opioid use in people with or at risk of knee osteoarthritis (OA), and the extent to which this association is mediated by number of painful joints or depressive symptoms. We used data from the Multicenter Osteoarthritis Study, a longitudinal cohort of older adults with or at risk of knee OA. Opioid use was identified by prescription medications and self-report. Obesity was defined as BMI≥30kg/m . Multi-joint pain was assessed using a standardized body homunculus, and depressive symptoms using the Center for Epidemiological Studies Depression scale. We quantified the direct and indirect effect of obesity on opioid use through the number of painful joints or depressive symptoms using causal mediation analysis by natural-effects models. We studied 2335 participants (mean age: 68; mean BMI 31 kg/m ; 60% women). Persons with obesity had ∼50% higher odds of opioid use than those without. Estimates of indirect (mediated) effect by the number of painful joints and depressive symptoms suggested an increased odds of opioid use by 34% (odds ratio [OR] = 1.34, 95% CI: 1.04, 1.70) and 35% (OR 1.35, 95% CI: 1.05, 1.71), respectively, in obese versus non-obese individuals. The total effect of obesity on opioid use was higher in women than in men. Multi-joint pain and depressive symptoms partially explained greater opioid use among obese persons with knee OA, demonstrating that the negative impact of obesity on knee OA extends beyond its influence on knee pain and structural progression.

Obesity

mediation analysis

depression

knee osteoarthritis

Details

Title: Subtitle: Depressive Symptoms and Multi-joint Pain Partially Mediate the Relationship Between Obesity and Opioid Use in People with Knee Osteoarthritis
Creators: Lisa C Carlesso - McMaster University
S Reza Jafarzadeh - Boston University School of Medicine
Andrew Stokes - Boston University
David T Felson - Boston University School of Medicine
Na Wang - Boston University
Laura Frey-Law - Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa city, Iowa, USA. Electronic address: laura-freylaw@uiowa.edu
Cora E Lewis - University of Alabama at Birmingham
Michael Nevitt - University of California, San Francisco
Tuhina Neogi - Boston University School of Medicine
Multicenter Osteoarthritis Study Group
Resource Type: Journal article
Publication Details: Osteoarthritis and cartilage, Vol.30(9), pp.1263-1269
DOI: 10.1016/j.joca.2022.06.002
PMID: 35700904
PMCID: PMC9419857
ISSN: 1063-4584
eISSN: 1522-9653
Grant note: DOI: 10.13039/100000002, name: National Institutes of Health, award: U01 AG19069, U01 AG18820, U01 AG18832, U01 AG18947
Language: English
Date published: 06/11/2022
Academic Unit: Nursing; Physical Therapy and Rehabilitation Science
Record Identifier: 9984294951102771

Metrics

6 Record Views

2 Times Cited - Web of Science

See more details