Relationships between body mass index, fat mass, muscle mass, and musculoskeletal pain in community residents.

OBJECTIVE To evaluate the relationships between fat mass, muscle mass, fat:muscle mass ratio, metabolic syndrome, and musculoskeletal pain in community residents. METHODS In the Korean Health and Genome Study, 1,530 participants (mean ± SD age 60.8 ± 8.60 years) completed pain questionnaires and underwent dual x-ray absorptiometry to calculate body composition. Pain was categorized according to the number of pain regions, such that widespread pain, defined as pain above the waist, below the waist, on both sides of the body, and in the axial region, represented the most severe pain. Metabolic syndrome was defined using the International Diabetes Federation 2005 recommendations, and the association between metabolic syndrome and pain was evaluated by dividing the population into 4 groups, according to the presence/absence of metabolic syndrome and of high body mass index (BMI). RESULTS Total fat mass and fat:muscle mass ratio were significantly and positively associated with musculoskeletal pain among female subjects only. Compared to the lowest quartile of fat:muscle mass ratio, the odds ratios for widespread pain among subjects in other quartiles were significantly increased after adjustment for confounders. Widespread pain was more prevalent among subjects with metabolic syndrome whether their BMI was high or normal, especially among female subjects. CONCLUSION Increased fat mass and fat:muscle mass ratio were significantly associated with musculoskeletal pain among women. Widespread pain was significantly associated with a high fat:muscle mass ratio after adjustment for confounders. Understanding the relationship between fat mass and pain may provide insights into preventative measures and therapeutic strategies for musculoskeletal pain.