The Association of Chronic Pain, Painkiller Use, and Potential Mediators with Liver Fat Content

Excessive accumulation of liver fat content (LFC) is a pathological manifestation of steatotic liver diseases. This study aims to investigate the relationship between chronic pain and LFC development. In the UK Biobank, chronic pain sites were collected via questionnaire, while LFC was measured by magnetic resonance imaging and quantified by Proton Density Fat Fraction (PDFF). During the median follow-up of 10.5 (4.0-17.8) years, in 39,437 individuals, neck/shoulder, back, stomach/abdominal, knee, and general pain achieved significant arithmetic means difference of 0.02, 0.02, 0.04, 0.02, and 0.15 in PDFF (P < 0.05) using multivariable linear regression models. There was a significant dose-effect for number of pain sites and PDFF (P < 0.001). Additionally, the link between pain sites and PDFF was much stronger in aspirin users than non-users, while steroids had the reverse effect (P for interaction < 0.05). C-reactive protein, sleep, diet, and depression were proved to mediated 8.41%, 13.3%, 6.6%, and 23.0% of the relationship, respectively. In conclusion, there were quantified differences in the relationship between chronic pain and LFC. For chronic pain patients with potential liver health issues, aspirin may be prioritized as an analgesic option due to its potential protective benefits, whereas steroid medications should be avoided.