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Omega-6: Omega-3 PUFA Ratio, Pain, Functioning, and Distress in Adults with Knee Pain.

Sibille, Kimberly T. MA, PhD; King, Christopher; Garrett, Timothy J.; Glover, Toni L.; Zhang, Hang; Chen, Huaihou; Reddy, Divya; Goodin, Burel R.; Sotolongo, Adriana; Petrov, Megan E.; Cruz-Almeida, Yenisel; Herbert, Matthew; Bartley, Emily J.; Edberg, Jeffrey C.; Staud, Roland; Redden, David T.; Bradley, Laurence A.; Fillingim, Roger B.
Clinical Journal of Pain: Post Acceptance: May 24, 2017
doi: 10.1097/AJP.0000000000000517
Original Article: PDF Only

Objectives: Osteoarthritis (OA) is associated with inflammation, chronic pain, functional limitations, and psychosocial distress. High Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) are associated with lower levels of inflammatory mediators, anti-nociception, and adaptive cognitive/emotional functioning. High Omega-6 (n-6) PUFAs are associated with inflammation, nociception, and psychological distress. While findings related to n-3 supplementation in knee OA are mixed, consideration of the n-6:n-3 ratio and additional outcome measures may provide improved understanding of the potential relevance of these fatty acids in OA. Based on recommended and typical ranges of the n-6:n-3 ratio, we hypothesized that in adults with knee pain, those with a high n-6:n-3 ratio would have greater pain/functional limitations, experimental pain sensitivity, and psychosocial distress compared to those with a low n-6:n-3 ratio.

Methods: A cross-sectional investigation of clinical and experimental pain and physical and psychosocial functioning was completed in 167 adults ages 45-85 meeting knee OA screening criteria. Blood samples were collected and the plasma n-6:n-3 PUFA ratio determined. Quartile splits were computed and low (n=42) and high (n=41) ratio groups were compared.

Results: The high ratio group reported greater pain and functional limitations, (all P's<0.04), mechanical temporal summation (hand and knee, P<0.05), and perceived stress (P=0.008) but not depressive symptoms.

Discussion: In adults with knee pain, a high n-6:n-3 ratio is associated with greater clinical pain/functional limitations, experimental pain sensitivity, and psychosocial distress compared to a low ratio group. Findings support consideration of the n-6:n-3 PUFA ratio and additional clinical endpoints in future research efforts.

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