Chronic Pain and Inflammatory Biomarkers in Obese Women: Impact of Adipose Phenotypes and Lipedema
DOI:
https://doi.org/10.36557/2674-8169.2026v8n2p869-884Keywords:
Obesity, Lipedema, Inflammatory Biomarkers, Chronic PainAbstract
Background: Chronic pain in women with obesity may arise from interactions between fat distribution (android vs gynoid), systemic inflammation, and painful adipose-tissue phenotypes, including lipedema. Objective: To critically synthesize 2020–2025 evidence on the association between pain intensity and inflammatory biomarkers in women with obesity, contrasting android/gynoid phenotypes and incorporating lipedema as a confounder or distinct phenotype. Methods: Narrative review with a structured search in PubMed/MEDLINE and Google Scholar (2020–2025), combining terms for obesity, body fat distribution, chronic pain, inflammation, and lipedema; studies were selected for clinical/methodological relevance, and data were extracted on body composition phenotyping, pain outcomes, biomarker panels, and confounder control. Results: Findings are heterogeneous; variability in visceral vs subcutaneous adiposity measurement, biomarker selection, and adjustment strategies constrains cross-study comparability. Unrecognized lipedema may cluster pain within peripheral phenotypes and bias comparisons. Conclusions: Interpreting pain–inflammation relationships in women with obesity requires objective fat-distribution phenotyping and systematic lipedema screening to disentangle metabolic–inflammatory visceral mechanisms from subcutaneous painful-adipose mechanisms.
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ARONSSON, M. L.; et al. High leptin levels in blood are associated with chronic widespread pain in rheumatoid arthritis. Arthritis Research & Therapy, v. 26, n. 1, p. 228, 2024. DOI: https://doi.org/10.1186/s13075-024-03463-x
AS-SANIE, S.; et al. Chronic pelvic pain in women. JAMA, v. 334, n. 1, p. 64-78, 2025. DOI: https://doi.org/10.1001/jama.2025.2975
BARIS, E.; et al. Serum choline, leptin and interleukin-6 levels in fibromyalgia syndrome-induced pain: a case-control study. BMC Musculoskeletal Disorders, v. 26, n. 1, p. 97, 2025. DOI: https://doi.org/10.1186/s12891-025-08337-0
BULMER, C.; et al. The effect of dietary weight-loss interventions on the inflammatory markers interleukin-6 and TNF-alpha in adults with obesity: A systematic review and meta-analysis of randomized controlled clinical trials. Obesity Reviews, v. 26, n. 7, e13910, 2025. DOI: https://doi.org/10.1111/obr.13910
COTA, C. C.; et al. Analysis of the relationship between pain intensity and inflammatory biomarkers in women with obesity (android vs. gynoid) and chronic pain. Journal of Clinical Medicine, v. 14, n. 12, p. 4170, 2025. DOI: https://doi.org/10.3390/jcm14124170
GÜNAY, U. B.; et al. Health-related quality of life among lipedema patients: A systematic review and meta-analysis. Phlebology, eLocation 2683555251410009, 2025. DOI: https://doi.org/10.1177/02683555251410009
JI, J.; et al. The effect of a ketogenic diet on inflammation-related markers: a systematic review and meta-analysis of randomized controlled trials. Nutrition Reviews, v. 83, n. 1, p. 40-58, 2025. DOI: https://doi.org/10.1093/nutrit/nuad175
KLÖPPEL, M.; et al. Quality of life following liposuction for lipoedema: a prospective outcome study. Journal of Plastic, Reconstructive & Aesthetic Surgery, v. 91, p. 70-78, 2024. DOI: https://doi.org/10.1016/j.bjps.2024.02.048
LI, S.; et al. Association of visceral adiposity with pain but not structural osteoarthritis. Arthritis & Rheumatology, v. 72, n. 7, p. 1103-1110, 2020. DOI: https://doi.org/10.1002/art.41222
LIECHTI, E. K.; et al. Pain intensity and body composition in chronic non-specific low back pain in adults with overweight and obesity: a systematic review and meta-analysis. Obesity Reviews, v. 26, n. 4, e13875, 2025. DOI: https://doi.org/10.1111/obr.13875
LUNDANES, J.; et al. Effect of a low-carbohydrate diet on pain and quality of life in female patients with lipedema: a randomized controlled trial. Obesity (Silver Spring), v. 32, n. 6, p. 1071-1082, 2024. DOI: https://doi.org/10.1002/oby.24026
LUNDANES, J.; et al. The effect of a low-carbohydrate diet on subcutaneous adipose tissue in females with lipedema. Frontiers in Nutrition, v. 11, p. 1484612, 2024. DOI: https://doi.org/10.3389/fnut.2024.1484612
MCMASTERS, M.; et al. Addressing Meta-Inflammation in the Management of Chronic Pain: The Potential Role of Dietary Modification. Cureus, v. 17, n. 10, e94863, 2025. DOI: https://doi.org/10.7759/cureus.94863
MESSIER, S. P.; et al. Effect of diet and exercise on knee pain in adults with overweight or obesity and osteoarthritis: a randomized clinical trial. JAMA, v. 328, n. 22, p. 2242-2251, 2022. DOI: https://doi.org/10.1001/jama.2022.21893
MIRANDA, A.; et al. Adipose tissue-derived mediators of pain and inflammation. Neurobiology of Pain, v. 10, p. 100066, 2021. DOI: https://doi.org/10.1016/j.ynpai.2021.100066
NCD RISK FACTOR COLLABORATION (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. The Lancet, v. 403, n. 10431, p. 1027-1050, 2024. DOI: https://doi.org/10.1016/S0140-6736(23)02750-2
POUDEL, D. R.; et al. Obesity and immune-mediated inflammatory diseases: a systematic review. Current Rheumatology Reports, v. 22, n. 9, p. 56, 2020. DOI: https://doi.org/10.1007/s11926-020-00933-4
RABIEE, A. Lipedema and adipose tissue: current understanding, controversies, and future directions. Frontiers in Cell and Developmental Biology, v. 13, p. 1691161, 2025. DOI: https://doi.org/10.3389/fcell.2025.1691161
RUBINO, F.; et al. Definition and diagnostic criteria of clinical obesity. The Lancet Diabetes & Endocrinology, v. 13, n. 3, p. 221-262, 2025. DOI: https://doi.org/10.1016/S2213-8587(24)00316-4
SHAFRIR, A. L.; et al. Immunologic and inflammatory mechanisms in endometriosis. International Journal of Molecular Sciences, v. 26, n. 11, p. 5377, 2025. DOI: https://doi.org/10.3390/ijms26115377
STEFANOVA, D. I.; et al. Bariatric surgery and low back pain: a systematic review and meta-analysis. Obesity Surgery, v. 30, n. 8, p. 3201-3207, 2020. DOI: https://doi.org/10.1007/s11695-020-04713-y
TAN, L.; et al. The intensity of exercise and inflammation markers in women with overweight & obesity: a systematic review and network meta-analysis. International Journal of Obesity (London), v. 49, n. 7, p. 1229-1239, 2025. DOI: https://doi.org/10.1038/s41366-025-01777-7
VAN LA PARRA, R. F. D.; DECONINCK, C.; KRUG, B. Diagnostic imaging in lipedema: A systematic review. Obesity Reviews, v. 25, n. 1, e13648, 2024. DOI: https://doi.org/10.1111/obr.13648.
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Copyright (c) 2026 Paulo André Dias da Silva, Reginaldo Costa da Silva Junior, Tiago dos Santos Brito, Diórgenes Rodrigues Cardoso, Yasmin Santiago Paixão, Felipe de Castro dos Santos, Israel Dias Nonato, Igor Gomes de Oliveira, Gabriel Jersemi Rodrigues Costa, Manuel Dionizio Bentes Monteiro Neto, Carolyna Tereza Brasil Papaléo, Maria Eduarda de Lima Dacier Lobato, José Rodrigo Moraes Teles, Vitor Cayke Savedra Dias, Amanda Beatriz Pinheiro Macedo
This work is licensed under a Creative Commons Attribution 4.0 International License.
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