Hand osteoarthritis (OA) pain is characterized as heterogeneous and multifactorial. Differences in pain may be explained by underlying phenotypes, which have not been previously explored Latent class analysis determined classes of participants with hand OA from the Nor-Hand study baseline examination (2016–17) based on a biopsychosocial framework. Outcomes were hand and overall bodily pain intensity (Numeric Rating Scale, 0–10) at baseline and follow-up (2019–21), The relations of the classes to pain outcomes at baseline, follow-up, and change over time were analysed in separate models by linear regression, using the overall healthiest class as reference. Five classes differing in radiographic hand OA burden and OA burden in the lower extremities by ultrasound, demographic factors, psychosocial burden and pain sensitization was identified. Persons with the least severe OA but higher burden of biopsychosocial factors reported the most hand pain (beta 3.65, 95% CI 2.53, 4.75). Pain was less pronounced in persons with the most severe hand OA but low burden of biopsychosocial factors (beta 1.03, 95% CI 0.41, 1.65). Results were similar for overall bodily pain and at follow-up. Changes in pain were small, but the association between a separate class defined by higher levels of biopsychosocial burden and pain changes was significant. The five hand OA phenotypes were associated with pain at baseline and 3.5 years later. The phenotype with the least OA severity, but higher burden of biopsychosocial factors reported more pain than the phenotype with the most severe OA, reflecting the symptom-structure discordance of the hand OA pain experience.

中文翻译：

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基于生物心理社会方法的手部骨关节炎表型及其与横断面和纵向疼痛的关联


手部骨关节炎 (OA) 疼痛的特点是异质性和多因素性。疼痛的差异可能是通过潜在的表型来解释的，这些表型之前尚未被探索过。潜在类别分析根据生物心理社会框架，根据 Nor-Hand 研究基线检查 (2016-17) 确定了手部 OA 参与者的类别。结果是基线和随访 (2019-21) 时的手部和整体身体疼痛强度（数字评定量表，0-10），分析了基线、随访和随时间变化的类别与疼痛结果的关系通过线性回归在单独的模型中，使用整体最健康的类别作为参考。根据超声、人口因素、心理社会负担和疼痛敏感性，确定了手部 OA 负担和下肢 OA 负担不同的五个类别。骨关节炎最轻但生物心理社会因素负担较高的人手部疼痛最严重（β 3.65，95% CI 2.53，4.75）。手部 OA 最严重但生物心理社会因素负担较低的患者疼痛不太明显（β 1.03，95% CI 0.41，1.65）。整体身体疼痛和随访结果相似。疼痛的变化很小，但由较高水平的生物心理社会负担定义的单独类别与疼痛变化之间的关联是显着的。五种手部 OA 表型与基线时和 3.5 年后的疼痛相关。 OA 严重程度最轻但生物心理社会因素负担较高的表型比 OA 最严重的表型报告的疼痛更多，反映了手部 OA 疼痛体验的症状结构不一致。