<b>Central Obesity Rather Than BMI Is Associated with Chronic Pain:</b><b>A Cross-Sectional Analysis of NHANES 1999–2004</b>

Central obesity, a phenotype characterized by abdominal fat accumulation, has emerged as a more relevant predictor of chronic disease risk than general obesity. Chronic pain, a widespread and debilitating condition, has complex etiologies that are increasingly understood to include metabolic and inflammatory factors. This study reveals that central obesity, as measured by A Body Shape Index (ABSI), is significantly associated with increased odds of chronic pain, even after adjusting for a comprehensive set of covariates, including body mass index (BMI). In contrast, BMI, waist circumference (WC), and body roundness index (BRI) show no significant association with chronic pain after adjustment. The findings emphasize that ABSI may serve as a more sensitive anthropometric marker in pain-related health risk assessments, and support incorporating central obesity indicators into public health strategies for pain prevention and management.以腹部脂肪堆积为特征的中心性肥胖（Central obesity），已被证明是优于全身性肥胖（general obesity）的慢性病风险预测因子。慢性疼痛（Chronic pain）作为一种广泛流行且致残性的疾患，其复杂病因近年来已被证实包含代谢与炎症相关因素。本研究显示，通过体形体指数（A Body Shape Index，ABSI）衡量的中心性肥胖，即便在校正了包括身体质量指数（Body Mass Index，BMI）在内的一系列全面协变量后，仍与慢性疼痛的患病风险显著升高存在关联。与之形成对比的是，在校正协变量后，身体质量指数（BMI）、腰围（Waist Circumference，WC）以及体圆度指数（Body Roundness Index，BRI）均未表现出与慢性疼痛的显著关联。本研究结果提示，ABSI或可作为疼痛相关健康风险评估中更为灵敏的人体测量学标志物，并支持将中心性肥胖相关指标纳入疼痛预防与管理的公共卫生策略体系。