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Low vitamin D and the risk of developing chronic widespread pain: results from the European male ageing study

PainSci » bibliography » McCabe et al 2016
updated
Tags: chronic pain, vitamin D, fibromyalgia, aging, pain problems, nutrition, self-treatment, treatment

Two articles on PainSci cite McCabe 2016: 1. The Complete Guide to Trigger Points & Myofascial Pain 2. Vitamin D for Pain 

PainSci commentary on McCabe 2016: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

This study measured vitamin D levels in more than 2300 older European men in good health and then checked up on them a few years later. If they had low vitamin D at the beginning, they were more likely to have chronic widespread pain later. However, that connection got much weaker when they eliminated obese and depressed patients from consideration. Obesity and depression are known, confirmed risk factors for chronic pain. The study concluded: “Low vitamin D is linked with the new occurrence of chronic widespread pain, although this may be explained by underlying adverse health factors, particularly obesity and depression.”

This study is one of about a dozen others investigating a link between chronic pain and vitamin D deficiency, reviewed by Hsiao et al. Notably, in most studies the link is clear even after adjusting for other factors.

~ Paul Ingraham

original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

BACKGROUND: The association between low levels of vitamin D and the occurrence of chronic widespread pain (CWP) remains unclear. The aim of our analysis was to determine the relationship between low vitamin D levels and the risk of developing CWP in a population sample of middle age and elderly men.

METHODS: Three thousand three hundred sixty nine men aged 40-79 were recruited from 8 European centres for a longitudinal study of male ageing, the European Male Ageing Study. At baseline participants underwent assessment of lifestyle, health factors, physical characteristics and gave a fasting blood sample. The occurrence of pain was assessed at baseline and follow up (a mean of 4.3 years later) by shading painful sites on a body manikin. The presence of CWP was determined using the ACR criteria for fibromyalgia. Serum 25-hydroxyvitamin D (25-(OH) D) was assessed by radioimmunoassay. Logistic regression was used to determine the relationship between baseline vitamin D levels and the new occurrence of CWP.

RESULTS: Two thousand three hundred thirteen men, mean age 58.8 years (SD = 10.6), had complete pain and vitamin data available and contributed to this analysis. 151 (6.5%) developed new CWP at follow up and 577 (24.9%) were pain free at both time points, the comparator group. After adjustment for age and centre, physical performance and number of comorbidities, compared to those in upper quintile of 25-(OH) D ( ≥36.3 ng/mL), those in the lowest quintile (<15.6 ng/mL) were more likely to develop CWP (Odds Ratio [OR] = 1.93; 95% CI = 1.0-3.6). Further adjustment for BMI (OR = 1.67; 95% CI = 0.93-3.02) or depression (OR = 1.77; 95% CI = 0.98-3.21), however rendered the association non-significant.

CONCLUSIONS: Low vitamin D is linked with the new occurrence of chronic widespread pain, although this may be explained by underlying adverse health factors, particularly obesity and depression.

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