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. 2025 Jun 30;14(13):4634.
doi: 10.3390/jcm14134634.

Do Diabetes and Genetic Polymorphisms in the COMT and OPRM1 Genes Modulate the Postoperative Opioid Demand and Pain Perception in Osteoarthritis Patients After Total Knee and Hip Arthroplasty?

Alina Jurewicz  1 , Agata Gasiorowska  2 , Katarzyna Leźnicka  3   4 , Agnieszka Maciejewska-Skrendo  3   4 , Maciej Pawlak  5 , Anna Machoy-Mokrzyńska  6 , Andrzej Bohatyrewicz  7 , Maciej Tarnowski  4   8
Affiliations

Do Diabetes and Genetic Polymorphisms in the COMT and OPRM1 Genes Modulate the Postoperative Opioid Demand and Pain Perception in Osteoarthritis Patients After Total Knee and Hip Arthroplasty?

Alina Jurewicz et al. J Clin Med. .

Abstract

Background: Osteoarthritis (OA) of the hip and knee is a common age-related degenerative disease characterized by joint pain, stiffness, and gait disturbances. This study investigated the influence of genetic polymorphisms in the OPRM1 (rs1799971) and COMT (rs4633, rs4680, rs4818, and rs6269) genes on the postoperative analgesic requirements in 195 diabetic and non-diabetic patients undergoing total hip or knee arthroplasty. Methods: The prospective study included all patients who were admitted between January and September 2020 and agreed to participate. Postoperative pain management was assessed based on acetaminophen, ketoprofen, and morphine consumption on the first and second postoperative day. Results: Multilevel regression analyses revealed a significant three-way interaction between diabetes, type of analgesic, and OPRM1rs1799971 polymorphism, indicating different analgesic dosing patterns in diabetic and non-diabetic patients. Two-way interactions between diabetes and COMT polymorphisms rs4633, rs4680, and rs6269 further influenced the analgesic requirements. No significant associations were found for COMT rs4818. The results show that diabetes and genetic factors significantly influence opioid requirements and pain perception. Conclusions: Given the complexity of pain management in diabetic patients, personalized analgesic strategies tailored to genetic and metabolic profiles could be useful in postoperative pain management and reducing opioid consumption.

Keywords: COMT; OPRM1; diabetes; opioids; pain; polymorphism; postoperative treatment.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Dose of the analgesics received by patients with and without diabetes as a factor of the type of substance and OPRM1rs1799971 polymorphisms.
Figure 2
Figure 2
Dose of the analgesics received by patients as a factor of their diabetes and COMT rs4633 polymorphisms.
Figure 3
Figure 3
Dose of the analgesics received by patients as a factor of their diabetes and COMT rs4680 polymorphisms.
Figure 4
Figure 4
Dose of the analgesics received by patients as a factor of their diabetes and COMT rs6269 polymorphisms.
See this image and copyright information in PMC

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