Association between waist-to-height ratio and chronic pain among American adults: A cross-sectional study of the National Health and Nutrition Examination Survey.

Chronic pain and obesity are prevalent conditions that substantially impair the quality of life and impose considerable socioeconomic burdens. We sought to investigate the relationship between the waist-to-height ratio (WHtR) and chronic pain in American adults. This cross-sectional analysis included adults who participated in the 1999 to 2004 National Health and Nutrition Examination Survey. Chronic pain referred to self-reported pain persisting for at least 3 months within the past year. The WHtR was derived by dividing the waist circumference in centimeters by the height in centimeters. Multivariable logistic regression and restricted cubic spline models were used to elucidate the relationship. Subgroup analyses were further used to assess the influence of potential confounding factors. A total of 11,591 adults were included, of whom 1690 (15.9%) had chronic pain. After full adjustment for potential confounders, a higher WHtR was significantly associated with an increased odd of chronic pain (OR = 3.16, 95% CI: 1.50-6.65, P = .004). Participants in the highest WHtR quintile (Q5) were more likely to experience chronic pain than those in the lowest quintile (Q1) (adjusted OR = 1.74, 95% CI: 1.47-2.08, P = .011). Restricted cubic spline analysis revealed a nonlinear association with an inflection point at approximately 0.53. No significant interactions were observed across the subgroups (all P for interaction > 0.05). WHtR, as a simple and reliable anthropometric measure of central obesity, was positively associated with the risk of chronic pain among U.S. adults. These findings highlight the importance of controlling central obesity in chronic pain prevention and public health interventions.