Clinical features of chronic pain and premorbid factors in patients with various phenotypes of metabolic syndrome

Zh Nevrol Psikhiatr Im S S Korsakova. 2026;126(5):95-100. doi: 10.17116/jnevro202612605195.

ABSTRACT

OBJECTIVE: To identify the clinical features associated with chronic pain and the premorbid factors in patients with metabolic syndrome of various phenotypes.

MATERIALS AND METHODS: In this prospective comparative cohort study involving 118 patients with chronic pain, participants were divided into four groups based on the predominant phenotype of their metabolic syndrome: lipocentric (n=41), hypertensive (n=22), mixed (n=18), and control (n=37). We assessed clinical pain characteristics, anthropometric parameters, comorbidities, and behavioral and psychosocial premorbid factors.

RESULTS: Patients exhibiting a mixed phenotype of metabolic syndrome demonstrated higher pain intensity (7.5 [6; 8] points on the NRS scale, p=0.003), more pain sites (4 [3; 6], p=0.029), and experienced more frequent (p=0.004) and prolonged exacerbations (p=0.002) compared to the control group. Notably, severe fatigue (FAS scores ³22, p=0.007) was a specific premorbid feature in this group. Additionally, both the hypertensive and mixed phenotypes exhibited a higher prevalence of pain in the lower back and lower extremities.

CONCLUSIONS: The chronic pain experienced by patients with metabolic syndrome displays phenotype-dependent variations, with the mixed phenotype exhibiting the most unfavorable pain profile. Recognizing the phenotype of metabolic syndrome is essential for personalized evaluation and management of chronic pain in outpatient settings.

PMID:42246532 | DOI:10.17116/jnevro202612605195