| Title: | 24-h movement behaviors and the association of chronic pain with venous thromboembolism risk |
| Journal: | Journal of Clinical Anesthesia |
| Published: | 5 May 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42091023/ |
| DOI: | https://doi.org/10.1016/j.jclinane.2026.112227 |
Publication 20168
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Abstract
STUDY OBJECTIVE: Chronic pain (CP) has been linked to multiple health complications, but its association with venous thromboembolism (VTE) remains unclear. We aimed to investigate the associations between CP and VTE risk, and the potential mediating role of 24-h movement behaviors.</p>
DESIGN: A prospective cohort study.</p>
SETTING: Population-based study using data from the UK Biobank.</p>
INTERVENTIONS: Not applicable; this was an observational study analyzing exposure to CP.</p>
MEASUREMENTS: CP was assessed as the main exposure, and incident VTE as the primary outcome. Exploratory analyses were conducted to examine the role of 24-h movement behaviors, including sedentary behavior (SB), light-intensity physical activity (LIPA), moderate-to-vigorous physical activity (MVPA), and sleep, in relation to CP and VTE. Multivariate-adjusted Cox proportional hazards regression, compositional mediation analysis, and isotemporal substitution Cox regression were applied to evaluate these associations.</p>
PARTICIPANTS: A total of 453,289 individuals were included in the analytic cohort, with 88,675 participants in the accelerometer sub-cohort for analyses of movement behaviors.</p>
MAIN RESULTS: Compared to the pain-free group, participants with limited chronic pain (LCP, HR: 1.13, 95% CI: 1.08-1.19, P < 0.001) and multisite chronic pain (MCP, HR: 1.32, 95% CI: 1.24-1.41, P < 0.001) showed increased VTE risk in the total cohort. In exploratory analyses within the accelerometer sub-cohort, 24-h movement behaviors showed a contribution to the MCP-VTE association (indirect effect HR = 1.03 [1.01-1.05]; total effect HR = 1.25 [1.02-1.48]; 12.8% mediated). Among MCP participants, hypothetical reallocation models suggested that reallocating one hour/day from sleep to LIPA (HR = 0.87, 95% CI: 0.76-0.99) or MVPA (HR = 0.59, 95% CI: 0.35-0.98) was associated with lower VTE risk.</p>
CONCLUSIONS: CP was associated with an increased risk of VTE. In participants with MCP, 24-h movement behaviors showed a potential association that may contribute to this relationship. However, these findings are exploratory and do not support causal or prescriptive interpretation.</p>
10 Authors
- Xiao Huang
- Darui Gao
- Mengmeng Ji
- Yanyu Zhang
- Yiwen Dai
- Yang Pan
- Yuling Liu
- Anshi Wu
- Fanfan Zheng
- Wuxiang Xie
1 Application
| Application ID | Title |
|---|---|
| 90492 | Identification of risk factors for major chronic diseases among older adults |
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