TY - JOUR
T1 - Fat mass, but not fat-free mass, predicts increased foot pain with obesity, independent of bariatric surgery
AU - Walsh, Tom P.
AU - Quinn, Stephen J.
AU - Evans, Angela M.
AU - Yaxley, Alison
AU - Chisholm, Jacob A.
AU - Kow, Lilian
AU - Shanahan, E. Michael
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Background: Foot pain is a common manifestation of obesity. Objective: To determine if bariatric surgery is associated with a reduction in foot pain and if body mass index (BMI) or body composition predict a change in foot pain. Setting: University hospital. Methods: Participants with foot pain awaiting bariatric surgery were recruited for this prospective study. Multivariable linear regression was used to determine predictors of change in foot pain between baseline and 6-month follow-up using body composition (fat mass index and fat-free mass index) or BMI, adjusting for, depression, age, sex, and group (surgery versus control). Results: Forty-five participants (38 female), mean ± standard deviation age of 45.7 ± 9.4 years, were recruited for this study. Twenty-nine participants mean ± standard deviation BMI of 44.8 ± 7.0 kg underwent bariatric surgery, while 16 participants mean ± standard deviation BMI of 47.9 ± 5.2 kg were on the waiting list (control). One participant was lost to follow-up. The treatment group lost a mean of 24.3 kg (95% confidence interval [CI] 21.1–27.5), while the control group gained 1.2 kg (95% CI −2.5 to 4.9), respectively. In multivariable analysis, bariatric surgery was significantly associated with reduced foot pain at 6-month follow-up −32.6 points (95% CI −43.8 to −21.4, P <.001), while fat mass index was significantly associated with increased pain at follow-up 1.5 points (95% CI.2 to 2.8, P =.027), after controlling for fat-free mass index, age, sex, and depression. Conclusions: Bariatric surgery was significantly associated with reduced foot pain. Higher baseline fat mass index, but not fat-free mass index or BMI, was predictive of increased foot pain at follow-up. Foot pain may be mediated by metabolic, rather than mechanical, factors in bariatric surgery candidates.
AB - Background: Foot pain is a common manifestation of obesity. Objective: To determine if bariatric surgery is associated with a reduction in foot pain and if body mass index (BMI) or body composition predict a change in foot pain. Setting: University hospital. Methods: Participants with foot pain awaiting bariatric surgery were recruited for this prospective study. Multivariable linear regression was used to determine predictors of change in foot pain between baseline and 6-month follow-up using body composition (fat mass index and fat-free mass index) or BMI, adjusting for, depression, age, sex, and group (surgery versus control). Results: Forty-five participants (38 female), mean ± standard deviation age of 45.7 ± 9.4 years, were recruited for this study. Twenty-nine participants mean ± standard deviation BMI of 44.8 ± 7.0 kg underwent bariatric surgery, while 16 participants mean ± standard deviation BMI of 47.9 ± 5.2 kg were on the waiting list (control). One participant was lost to follow-up. The treatment group lost a mean of 24.3 kg (95% confidence interval [CI] 21.1–27.5), while the control group gained 1.2 kg (95% CI −2.5 to 4.9), respectively. In multivariable analysis, bariatric surgery was significantly associated with reduced foot pain at 6-month follow-up −32.6 points (95% CI −43.8 to −21.4, P <.001), while fat mass index was significantly associated with increased pain at follow-up 1.5 points (95% CI.2 to 2.8, P =.027), after controlling for fat-free mass index, age, sex, and depression. Conclusions: Bariatric surgery was significantly associated with reduced foot pain. Higher baseline fat mass index, but not fat-free mass index or BMI, was predictive of increased foot pain at follow-up. Foot pain may be mediated by metabolic, rather than mechanical, factors in bariatric surgery candidates.
KW - Bariatric surgery
KW - Foot
KW - Obesity
KW - Pain
UR - http://www.scopus.com/inward/record.url?scp=85050383585&partnerID=8YFLogxK
U2 - 10.1016/j.soard.2018.06.015
DO - 10.1016/j.soard.2018.06.015
M3 - Article
C2 - 30057094
AN - SCOPUS:85050383585
SN - 1550-7289
VL - 14
SP - 1389
EP - 1395
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
IS - 9
ER -