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181, respectively). After adjustment, a significantly increased severe pain odds was observed in the highest tertile of DII score in comparison with the lowest tertile (OR tertile = 1.55, 95% CI 1.04-2.31; P = 0.04). Linear regression analysis showed that the DII was significantly associated with VAS (p = 0.040; β = 0.151), and physical function (p = 0.039; β = - 0.184), emotional wellbeing (p = 0.048; β = - 0.158) and pain (p = 0.020; β = 0.161) scales and physical health (p = 0.047; β = 0.11 subscale of QOL after adjusting for age,
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