{"doi":"10.1002/art.42056","title":"Associations of Body Mass Index With Pain and the Mediating Role of Inflammatory Biomarkers in People With Hand Osteoarthritis","abstract":"OBJECTIVE: To examine the association of body mass index (BMI) with pain in people with hand osteoarthritis (OA), and explore whether this association, if causal, is mediated by systemic inflammatory biomarkers. METHODS: In 281 Nor-Hand study participants, we estimated associations between BMI and hand pain, as measured by the Australian/Canadian Osteoarthritis Hand Index (AUSCAN; range 0-20) and Numerical Rating Scale (NRS; range 0-10); foot pain, as measured by NRS (range 0-10); knee/hip pain, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC; range 0-20); painful total body joint count; and pain sensitization. We fit natural-effects models to estimate natural direct and natural indirect effects of BMI on pain through inflammatory biomarkers. RESULTS: Each 5-unit increase in BMI was associated with more severe hand pain (on average increased AUSCAN by 0.64 [95% confidence interval (95% CI) 0.23, 1.08]), foot pain (on average increased NRS by 0.65 [95% CI 0.36, 0.92]), knee/hip pain (on average increased WOMAC by 1.31 [95% CI 0.87, 1.73]), generalized pain, and pain sensitization. Mediation analyses suggested that the effects of BMI on hand pain and painful total body joint count were partially mediated by leptin and high-sensitivity C-reactive protein (hsCRP), respectively. Effect sizes for mediation by leptin were larger for the hands than for the lower extremities, and were statistically significant for the hands only. CONCLUSION: In people with hand OA, higher BMI is associated with greater pain severity in the hands, feet, and knees/hips. Systemic effects of obesity, measured by leptin, may play a larger mediating role for pain in the hands than in the lower extremities. Low-grade inflammation, measured by hsCRP, may contribute to generalized pain in overweight/obese individuals.","journal":"Arthritis & Rheumatology","year":2022,"id":236193,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":71,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9117,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":394981,"name":"Pernille Steen Pettersen","orcid":"0000-0003-0312-4255","position":1,"is_corresponding":false},{"id":55625,"name":"Tuhina Neogi","orcid":"0000-0002-9515-1711","position":2,"is_corresponding":false},{"id":267435,"name":"S. Reza Jafarzadeh","orcid":"0000-0002-1099-9175","position":3,"is_corresponding":false},{"id":133298,"name":"Maria Vistnes","orcid":"0000-0002-6243-0626","position":4,"is_corresponding":false},{"id":856036,"name":"Christian S. Thudium","orcid":"0000-0002-0202-1417","position":5,"is_corresponding":false},{"id":64784,"name":"Anne‐Christine Bay‐Jensen","orcid":"0000-0001-7952-9297","position":6,"is_corresponding":false},{"id":578497,"name":"Joe Sexton","orcid":"0000-0003-4717-9637","position":7,"is_corresponding":false},{"id":394985,"name":"Tore K Kvien","orcid":"0000-0002-8441-3093","position":8,"is_corresponding":false},{"id":394983,"name":"Hilde Berner Hammer","orcid":"0000-0001-7317-8991","position":9,"is_corresponding":false},{"id":394986,"name":"I.K. Haugen","orcid":"0000-0001-7810-2216","position":10,"is_corresponding":false},{"id":856035,"name":"Marthe Gløersen","orcid":"0000-0003-2233-4370","position":0,"is_corresponding":true}],"reference_count":52,"raw_metadata":null,"created_at":"2026-07-19T00:21:58.728756Z","pmid":"35137553","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}