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Andersson, M. L. .., Thorén, E., Sylwander, C. & Bergman, S. (2023). Associations between chronic widespread pain, pressure pain thresholds, leptin, and metabolic factors in individuals with knee pain. BMC Musculoskeletal Disorders, 24(1), Article ID 639.
Open this publication in new window or tab >>Associations between chronic widespread pain, pressure pain thresholds, leptin, and metabolic factors in individuals with knee pain
2023 (English)In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 24, no 1, article id 639Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The aim was to study associations between chronic widespread pain, widespread pain sensitivity, leptin, and metabolic factors in individuals with knee pain. A secondary aim was to study these associations in a subgroup of individuals with normal BMI.

METHOD: This cross-sectional study included 265 individuals. The participants were categorised into three different pain groups: Chronic widespread pain (CWP), chronic regional pain (ChRP), or no chronic pain (NCP). The pressure pain thresholds (PPTs) were assessed using computerised pressure algometry. Low PPTs were defined as having PPTs in the lowest third of all tender points. Leptin and metabolic factors such as BMI, visceral fat area (VFA), lipids, and glucose were also assessed.

RESULT: Sixteen per cent reported CWP, 15% had low PPTs, and 4% fulfilled both criteria. Those who fulfilled the criteria for CWP were more often women, more obese, and had increased leptin levels. In logistic regression, adjusted for age and gender, leptin was associated with fulfilling criteria for CWP, OR 1.015 (95% CI 1.004-1.027, p = 0.008). In logistic regression, adjusted for age and gender, leptin was associated with low PPTs, OR 1.016 (95% CI 1.004-1.029, p = 0.012). Leptin was also associated with fulfilling both criteria, adjusted for age, sex, and visceral fat area (VFA), OR 1.030 (95% CI 1.001-1.060), p = 0.040.

CONCLUSION: Leptin was associated with fulfilling the combined criteria for chronic widespread pain and low PPTs, even after adjusting for the visceral fat area (VFA). Longitudinal studies are needed to study the causal relationships between leptin and the development of widespread pain.

Place, publisher, year, edition, pages
London: BioMed Central (BMC), 2023
Keywords
Chronic widespread pain, Leptin, Metabolic factors, Pressure pain thresholds
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:hh:diva-51567 (URN)10.1186/s12891-023-06773-4 (DOI)001044916800001 ()37559026 (PubMedID)2-s2.0-85167532783 (Scopus ID)
Funder
The Crafoord FoundationSwedish Rheumatism Association
Note

Funding text: Open access funding provided by Lund University. The study was funded by the Swedish Rheumatism Association, grant numbers R-531621, R-635431, R-939824, and R-967899; targeted investment from the Swedish Rheumatism Association – Osteoarthritis from 2014 to 2019, and the Crafoord Foundation. The funders have not influenced the study design, collection, analysis, or interpretation of data, nor the writing of the manuscript or the decision to submit the manuscript for publication.

Available from: 2023-09-04 Created: 2023-09-04 Last updated: 2024-01-17Bibliographically approved
Malmborg, J. S., Roswall, J., Almquist-Tangen, G., Dahlgren, J., Alm, B. & Bergman, S. (2023). Smärta och hälsa hos 10-åriga barn från en födelsekohort. In: : . Paper presented at Barnveckan 2023, Halmstad, Sverige, 22-25 maj, 2023.
Open this publication in new window or tab >>Smärta och hälsa hos 10-åriga barn från en födelsekohort
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2023 (Swedish)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-52011 (URN)
Conference
Barnveckan 2023, Halmstad, Sverige, 22-25 maj, 2023
Available from: 2023-11-15 Created: 2023-11-15 Last updated: 2023-12-01Bibliographically approved
Andersson, M. L. .., Thoren, E., Sylwander, C. & Bergman, S. (2022). Associations Between Chronic Widespread Pain, Pressure Pain Thresholds and Leptin in Individuals with Knee Pain. In: : . Paper presented at EULAR 2022, Copenhagen, Denmark, 1-4 June, 2022 (pp. 318-318). London: BMJ Publishing Group Ltd, 81, Article ID Suppl 1.
Open this publication in new window or tab >>Associations Between Chronic Widespread Pain, Pressure Pain Thresholds and Leptin in Individuals with Knee Pain
2022 (English)Conference paper, Poster (with or without abstract) (Other academic)
Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2022
Series
Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060 ; 81
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:hh:diva-48024 (URN)10.1136/annrheumdis-2022-eular.401 (DOI)000850279001114 ()
Conference
EULAR 2022, Copenhagen, Denmark, 1-4 June, 2022
Available from: 2022-09-08 Created: 2022-09-08 Last updated: 2023-12-14Bibliographically approved
Andersson, M. L. .., Haglund, E., Aili, K., Bremander, A. & Bergman, S. (2022). Associations between metabolic factors and radiographic knee osteoarthritis in early disease - a cross-sectional study of individuals with knee pain. BMC Musculoskeletal Disorders, 23(1), Article ID 938.
Open this publication in new window or tab >>Associations between metabolic factors and radiographic knee osteoarthritis in early disease - a cross-sectional study of individuals with knee pain
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2022 (English)In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 23, no 1, article id 938Article in journal (Refereed) Published
Abstract [en]

Objective: Metabolic factors have been shown to be associated to severe radiographic knee osteoarthritis (RKOA). However, more knowledge is needed in early clinical knee osteoarthritis (KOA). The aim was to study associations between metabolic factors and radiographic knee osteoarthritis (OA) in individuals with knee pain. A second aim was to study associations between metabolic factors and RKOA in those with normal BMI and in those overweight/obese, respectively. Method: This cross-sectional study included 282 individuals with knee pain (without cruciate ligament injury) and aged 30–67 years, and 70% women. Waist circumference, body mass index (BMI), proportion of fat and visceral fat area (VFA) were assessed. RKOA was defined as Ahlbäck grade 1 in at least one knee. Fasting blood samples were taken and triglycerides, cholesterol (total, low density lipoprotein (LDL) and high density lipoprotein (HDL)), C-reactive protein (CRP), glucose, HbA1C were analysed. Metabolic syndrome was defined in accordance with the International Diabetes Federation (IDF). Associations were analysed by logistic regression. Results: Individuals with RKOA were older, had higher BMI, higher VFA, larger waist circumference and had increased total cholesterol, triglycerides and LDL-cholesterol, but not fasting glucose. There was no difference between the group with RKOA vs. non-radiographic group regarding the presence of metabolic syndrome. In a subgroup analysis of individuals with normal BMI (n = 126), those with RKOA had higher VFA, more central obesity, higher levels of CRP and total cholesterol, compared with individuals without RKOA. In individuals with obesity, age was the only outcome associated to RKOA. Conclusion: There were clear associations between metabolic factors and RKOA in individuals with knee pain, also in those with normal BMI. In individuals with obesity age was the only variable associated to RKOA. Trial registration:: clinicalTrials.gov Identifier: NCT04928170. © 2022, The Author(s).

Place, publisher, year, edition, pages
London: BioMed Central (BMC), 2022
Keywords
Knee osteoarthritis, Knee pain, Metabolic factors
National Category
Orthopaedics
Identifiers
urn:nbn:se:hh:diva-48784 (URN)10.1186/s12891-022-05881-x (DOI)000876271800005 ()36307803 (PubMedID)2-s2.0-85141056952 (Scopus ID)
Funder
Swedish Rheumatism Association, R-531621, R-635431, R-939824, R-967899The Crafoord Foundation
Note

The study was funded by the Swedish Rheumatism Association, grant number R-531621, R-635431, R-939824, R-967899, Targeted investment from the Swedish Rheumatism Association – Osteoarthritis from 2014 to 2019, and the Crafoord Foundation. The funders have not influenced the study design, collection, analysis, or interpretation of data, nor the writing of the manuscript or the decision to submit the manuscript for publication. Open access funding provided by Lund University

Available from: 2022-12-09 Created: 2022-12-09 Last updated: 2024-01-17Bibliographically approved
Andersson, M. L., Haglund, E., Aili, K., Bremander, A. & Bergman, S. (2022). Cohort profile: the Halland osteoarthritis (HALLOA) cohort–from knee pain to osteoarthritis: a longitudinal observational study in Sweden. BMJ Open, 12(7), Article ID e057086.
Open this publication in new window or tab >>Cohort profile: the Halland osteoarthritis (HALLOA) cohort–from knee pain to osteoarthritis: a longitudinal observational study in Sweden
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2022 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 7, article id e057086Article in journal (Refereed) Published
Abstract [en]

Purpose: The overall objective in this study is to investigate the early development of radiographic knee osteoarthritis (OA) and its association with hand or/and knee OA, metabolic diseases, biomarkers, chronic pain, physical function and daily physical activity types.

Participants: The Halland osteoarthritis (HALLOA) cohort is a longitudinal cohort study that includes individuals with knee pain in the southwest of Sweden. Enrolment took place from 2017 to 2019. The inclusion criteria were current knee pain, with no former known radiographic knee OA and no cruciate ligament rupture or rheumatological disorder. The participants were recruited: (1) when seeking care for knee pain in primary healthcare or (2) by advertisements in local newspapers. There are 306 individuals included in the study, mean age (SD) 51.7 (8.7) years and 69% are women. The baseline and follow-ups include clinical tests, radiographical examinations, blood samples, metabolic measures, pain pressure thresholds, tests of physical functions, daily physical activity types and patient-reported outcomes.

Findings to date: There were associations between metabolic factors and radiographic knee OA, even in those with normal body mass index at baseline. In addition, clinical hand OA was positively associated with fasting plasma glucose. We also found that modifiable factors as increased visceral fat and total body fat were associated with increased pain sensitivity among individuals with knee pain.

Future plans: By studying possible pathophysiological mechanisms of OA over time, we aim to provide new insights on OA progression, identify usable preventive measures helping the clinicians in the management of the disease and improve health for the patients. It is also important to study the development of chronic pain in OA, to get tools to identify individuals at risk and to be able to offer them treatment.

 © Author(s) (or their employer(s)) 2022. 

Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2022
Keywords
Internal Medicine, Knee, Musculoskeletal disorders, Rheumatology
National Category
Rheumatology and Autoimmunity Health Sciences
Identifiers
urn:nbn:se:hh:diva-48969 (URN)10.1136/bmjopen-2021-057086 (DOI)000826598000010 ()35835523 (PubMedID)2-s2.0-85134137962 (Scopus ID)
Funder
Swedish Rheumatism Association, R-531621Swedish Rheumatism Association, R-635431Swedish Rheumatism Association, R-939824Swedish Rheumatism Association, R-967899The Crafoord Foundation
Note

Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Available from: 2022-12-20 Created: 2022-12-20 Last updated: 2023-08-28Bibliographically approved
Lindholm, A., Almqvist-Tangen, G., Alm, B., Bremander, A., Dahlgren, J., Roswall, J., . . . Bergman, S. (2022). Early rapid weight gain, parental body mass index and the association with an increased waist-to-height ratio at 5 years of age. PLOS ONE, 17(9), Article ID e0273442.
Open this publication in new window or tab >>Early rapid weight gain, parental body mass index and the association with an increased waist-to-height ratio at 5 years of age
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2022 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 17, no 9, article id e0273442Article in journal (Refereed) Published
Abstract [en]

Background/Objectives: Obesity-related adverse health consequences are closely associated with abdominal obesity. Risk factors for overweight and obesity have been studied but there is a lack of information regarding risk factors for abdominal obesity, especially in the preschool population. The aim of the present study was to examine early life risk factors for an increased waist-to-height ratio (WHtR) in children at five years of age and, in addition, to investigate if these risk factors also were associated with overweight or obesity. 

Subjects/Methods: The study population comprised 1,540 children from a population-based longitudinal birth cohort study that included 2,666 Swedish children. The children were included if they had complete growth data for the analyses used in this study. Children were classified as having WHtR standard deviation scores (SDS) ≥ 1 or < 1 at five years of age, according to Swedish reference values, and as having body mass index standard deviation scores (BMISDS) for overweight/obesity, or normal weight/underweight according to the International Obesity Task Force criteria. Associations between child-related, socioeconomic status-related, parental health-related and nutrition- and feeding practice-related factors during the first two years and a WHtRSDS ≥ 1 or a BMISDS for overweight/obesity at five years were investigated with logistic regression analyses. 

Results: At five years of age, 15% of the children had WHtRSDS ≥ 1 and 11% had overweight or obesity. In multivariable analyses, rapid weight gain (RWG) during 0-6 months (OR: 1.90, 95% CI: 1.23–2.95, p=0.004), maternal pre-pregnancy BMI (1.06, 1.01–1.11, p=0.019) and paternal BMI (1.11, 1.01–1.21, p=0.028) were associated with WHtRSDS ≥ 1. RWG during 0-6 months (2.53, 1.53–4.20, p<0.001), 6-12 months (2.82, 1.37–5.79, p=0.005), and maternal pre-pregnancy BMI (1.11, 1.06–1.17, p<0.001) were associated with overweight or obesity.

Conclusions: Early risk factors, including rapid weight gain, are associated with increased WHtRSDS and overweight or obesity at 5 years of age. Preventive interventions should target early RWG and parental overweight and obesity. 

 

Place, publisher, year, edition, pages
San Francisco, CA: Public Library of Science, 2022
Keywords
Abdominal obesity, Body mass index, Parental body mass index, Pediatric obesity, Pediatric overweight, Rapid weight gain, Waist-to-height ratio
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:hh:diva-48018 (URN)10.1371/journal.pone.0273442 (DOI)000986598300001 ()36070291 (PubMedID)2-s2.0-85137736227 (Scopus ID)
Projects
Halland health and Growth study
Funder
Halmstad UniversityH.R.H. Crown Princess Lovisa's Association for Child Care
Available from: 2022-09-07 Created: 2022-09-07 Last updated: 2023-08-21Bibliographically approved
Malmborg, J. S., Bremander, A., Bergman, S., Haglund, E. & Olsson, M. C. (2022). Musculoskeletal pain and its association with health status, maturity, and sports performance in adolescent sport school students: a 2-year follow-up. BMC Sports Science, Medicine and Rehabilitation, 14(1), Article ID 43.
Open this publication in new window or tab >>Musculoskeletal pain and its association with health status, maturity, and sports performance in adolescent sport school students: a 2-year follow-up
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2022 (English)In: BMC Sports Science, Medicine and Rehabilitation, E-ISSN 2052-1847 , Vol. 14, no 1, article id 43Article in journal (Refereed) Published
Abstract [en]

Background: Musculoskeletal pain and its risk factors are rarely assessed in studies on adolescent athletes. The aim was to identify risk factors at baseline that were associated with the persistence or development of musculoskeletal pain at a two-year follow-up in adolescent sport school students, and to study cross-sectional associations at follow-up between musculoskeletal pain and sports performance.

Methods: Sport school students (79 boys and 52 girls, aged 14 years at baseline) were divided into infrequent (never–monthly) or frequent (weekly–almost daily) pain groups, based on frequency of pain using a pain mannequin. Logistic regression analyses were performed to study longitudinal associations between frequent pain at follow-up and baseline variables: pain group, number of regions with frequent pain, health status by EQ-5D, maturity offset (pre, average, or post peak height velocity), and sports (contact or non-contact). Linear regression analyses were used to study cross-sectional associations between pain groups and 20-m sprint, agility T-test, counter-movement jump, and grip strength at follow-up. Results were stratified by sex.

Results: A higher percentage of girls than boys reported frequent pain at follow-up (62% vs. 37%; p = 0.005). In boys, frequent pain at follow-up was associated with being pre peak height velocity at baseline (OR 3.884, CI 1.146–13.171; p = 0.029) and participating in non-contact sports (OR 3.429, CI 1.001–11.748; p = 0.050). In girls, frequent pain at follow-up was associated with having frequent pain in two or more body regions at baseline (OR 3.600, CI 1.033–12.542; p = 0.044), having a worse health status at baseline (OR 3.571, CI 1.026–12.434; p = 0.045), and participating in non-contact sports (OR 8.282, CI 2.011–34.116; p = 0.003). In boys, frequent pain was associated with worse performances in 20-m sprint and counter-movement jump, but not in agility T-test and grip strength.

Conclusions: Baseline risk factors for having frequent pain at follow-up were late maturation in boys, frequent pain and worse health status in girls, and participation in non-contact sports in both sexes. Boys with pain performed worse in sports tests. Coaches and school health-care services should pay attention to the risk factors and work towards preventing pain from becoming persistent. © 2022, The Author(s).

Place, publisher, year, edition, pages
London: BioMed Central (BMC), 2022
Keywords
Epidemiology, Exercise physiology, Health status, Maturity, Sports performance
National Category
Public Health, Global Health, Social Medicine and Epidemiology Other Health Sciences
Identifiers
urn:nbn:se:hh:diva-43031 (URN)10.1186/s13102-022-00437-x (DOI)000771455100001 ()35313966 (PubMedID)2-s2.0-85126734264 (Scopus ID)
Funder
Region Halland, HALLAND-639101Region Halland, HALLAND-469111Halmstad University
Note

Funding: Open access funding provided by Halmstad University. The study was supported financially by Halmstad University; Spenshult Research and Development Center, Halmstad; Region Halland (Grant Numbers HALLAND-469111, HALLAND-639101, and HALLAND-749041); and the Mayflower Charity Foundation, Sweden. The sources of funding had no involvement in the study design, data collection, analysis of data, interpretation of data, writing of the manuscript, or submission for publication.

Available from: 2020-09-02 Created: 2020-09-02 Last updated: 2023-01-02Bibliographically approved
Malmborg, J., Roswall, J., Almquist-Tangen, G., Dahlgren, J., Alm, B. & Bergman, S. (2022). Pain and its association with health-related quality of life, sleep, physical activity, and sedentary behavior in 10-year-old children from a Swedish birth cohort. Paper presented at Annual European Congress of Rheumatology EULAR, Copenhagen, Denmark, 1-4 June, 2022. Annals of the Rheumatic Diseases, 81(Suppl. 1), 988-988
Open this publication in new window or tab >>Pain and its association with health-related quality of life, sleep, physical activity, and sedentary behavior in 10-year-old children from a Swedish birth cohort
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2022 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 81, no Suppl. 1, p. 988-988Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2022
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-46970 (URN)10.1136/annrheumdis-2022-eular.1006 (DOI)
Conference
Annual European Congress of Rheumatology EULAR, Copenhagen, Denmark, 1-4 June, 2022
Available from: 2022-06-09 Created: 2022-06-09 Last updated: 2022-06-09Bibliographically approved
Aili, K., Campbell, P., Michaleff, Z. A., Strauss, V. Y., Jordan, K. P., Bremander, A., . . . Bergman, S. (2021). Long-term trajectories of chronic musculoskeletal pain: a 21-year prospective cohort latent class analysis. Pain, 162(5), 1511-1520
Open this publication in new window or tab >>Long-term trajectories of chronic musculoskeletal pain: a 21-year prospective cohort latent class analysis
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2021 (English)In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 162, no 5, p. 1511-1520Article in journal (Refereed) Published
Abstract [en]

ABSTRACT: Our knowledge of the prevalence, impact, and outcomes of chronic pain in the general population is predominantly based on studies over relatively short periods of time. The aim of this study was to identify and describe trajectories of the chronic pain status over a period of 21 years. Self-reported population data (n = 1858) from 5 timepoints were analyzed. Pain was categorized by: no chronic pain (NCP), chronic regional pain (CRP), and chronic widespread pain (CWP). Latent class growth analysis was performed for identification of trajectories and logistic regression analysis for identification of predictors for pain prognosis. Five trajectories were identified: (1) persistent NCP (57%), (2) migrating from NCP to CRP or CWP (5%), (3) persistent CRP or migration between CRP and NCP (22%), (4) migration from CRP to CWP (10%), and (5) persistent CWP (6%). Age, sleeping problems, poor vitality, and physical function at baseline were associated with pain progression from NCP. Female gender, seeking care for pain, lack of social support, poor physical function, vitality, and mental health predicted poor pain prognosis among those with CRP. In conclusion, chronic pain was common in the population including 6% reporting persistent CWP, although the majority persistently reported NCP. Most people had stable pain status, but some had ongoing change in pain status over time including people who improved from chronic pain. It was possible to identify clinically relevant factors, characterizing trajectories of chronic pain development, that can be useful for identifying individuals at risk and potential targets for intervention. Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain.

Place, publisher, year, edition, pages
Philadelphia, PA: Lippincott Williams & Wilkins, 2021
Keywords
Chronic pain, Chronic widespread pain, CWP, Musculoskeletal pain, Trajectory
National Category
Medical and Health Sciences Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:hh:diva-44194 (URN)10.1097/j.pain.0000000000002137 (DOI)000658839100022 ()33230006 (PubMedID)2-s2.0-85104900221 (Scopus ID)
Funder
AFA Insurance
Available from: 2021-04-22 Created: 2021-04-22 Last updated: 2021-10-25Bibliographically approved
Malmborg, J., Bremander, A., Bergman, S., Haglund, E. & Olsson, M. C. (2021). Musculoskeletal pain in adolescent sportschool students – a two-year follow-up. In: : . Paper presented at Fysioterapi 2021, digital konferens, 19-20 oktober, 2021.
Open this publication in new window or tab >>Musculoskeletal pain in adolescent sportschool students – a two-year follow-up
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2021 (English)Conference paper, Poster (with or without abstract) (Refereed)
Keywords
Pain and pain rehabilitation, Children and adolescents, Physical activity, Sustainable health, Exercise medicine
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-46969 (URN)
Conference
Fysioterapi 2021, digital konferens, 19-20 oktober, 2021
Available from: 2022-06-09 Created: 2022-06-09 Last updated: 2022-06-10Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6294-538X

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