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Incident liver disease was defined as new-onset physician-diagnosed liver disease during follow-up. Pain at 15 body sites was assessed dichotomously. Generalized estimating equations identified risk factors for pain symptoms post-diagnosis, adjusting for demographics, health status, lifestyle, and comorbidities. Time interactions, subgroup analysis by gender and residence, and sensitivity analysis including multiple imputation and different model specifications were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among participants, 1150 (7.1%) developed incident liver disease over 9\u00a0years. At baseline, future incident cases showed significantly higher pain prevalence across all sites compared to those remaining disease-free (waist pain: 28.7% vs 17.9%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001; leg pain: 20.7% vs 13.9%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001; headache: 20.6% vs 12.4%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Post-diagnosis pain prevalence increased substantially, with waist pain rising from 28.1% to 45.3%. Arthritis emerged as the strongest risk factor (OR range: 1.42\u20134.99), particularly for musculoskeletal pain. Depression (CESD-10) was consistently associated with increased pain risk (OR: 1.03\u20131.08, all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05), while self-rated health showed protective effects (OR: 0.72\u20130.82). Significant interactions revealed stronger depression-pain associations in males and urban residents. Kidney disease effects on back pain intensified over time (interaction OR\u2009=\u20091.47,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pain symptoms precede liver disease diagnosis and progressively worsen thereafter, with arthritis and depression as key modifiable risk factors requiring targeted management strategies in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40001-026-04003-w","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T17:55:47Z","timestamp":1770659747000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Longitudinal analysis of pain symptoms and risk factors in patients with incident liver disease: a nationwide cohort study"],"prefix":"10.1186","volume":"31","author":[{"given":"Ke","family":"Pu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaodi","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"issue":"10464","key":"4003_CR1","doi-asserted-by":"publisher","first-page":"1761","DOI":"10.1016\/S0140-6736(24)01811-7","volume":"404","author":"M Israelsen","year":"2024","unstructured":"Israelsen M, Francque S, Tsochatzis EA, et al. 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