title: Effects of chronic osteoarthritis pain on neuroendocrine function in men.
abstract: BACKGROUND
  Chronic pain has been associated with elevated cortisol, reduced LH and testosterone (T), and/or augmented circulating or excreted catecholamines. Most endocrine studies have been conducted in patients in whom the potentially confounding effects of depression, inflammatory disease, or coexistent medication use have not been controlled.
  
  
  OBJECTIVE
  The objective of the study was to test the hypothesis that chronic pain activates ACTH-cortisol and suppresses LH-T.
  
  
  METHODS
  This was a case control study conducted at a clinical research center.
  
  
  METHODS
  Participants included 16 opioid-naive men with chronic osteoarthritis pain, aged 35-65 yr with body mass index 20-30 kg/m2, and 12 healthy, opioid- and pain-free men of similar ages and body mass indexes.
  
  
  METHODS
  We compared circulating concentrations of ACTH, cortisol, LH, and T derived from every 20-min blood sampling (2000-0800 h), and 24-h urinary excretion of cortisol, epinephrine, norepinephrine, and dopamine.
  
  
  RESULTS
  There were no significant differences in mean or integrated concentrations of ACTH, cortisol, LH, or T, or in the corresponding approximate entropy scores in osteoarthritis patients, compared with control subjects. The 0800-h serum LH concentrations were elevated in patients vs. controls (6.42 +/- 1.65 vs. 3.99 +/- 1.54 IU/liter, mean +/- sd, P = 0.02), whereas there were no significant group differences in total or free T, SHBG, cortisol binding globulin, dehydroepiandrosterone sulfate, or urinary cortisol and catecholamines.
  
  
  CONCLUSIONS
  These data suggest that neuroendocrine function is not significantly altered in otherwise healthy men with chronic musculoskeletal pain and that prior reports of such hormonal abnormalities may have resulted from the confounding effects of coexistent illness or medication use.
authors.affiliation: Laboratory of Clinical Investigation, Division of Intramural Research, National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, Maryland 20892-1302, USA. khoromisu@mail.nih.gov
authors.forename: Suzan
authors.initials: S
authors.lastname: Khoromi
authors.forename: Ranganath
authors.initials: R
authors.lastname: Muniyappa
authors.forename: Lisa
authors.initials: L
authors.lastname: Nackers
authors.forename: Nora
authors.initials: N
authors.lastname: Gray
authors.forename: Howard
authors.initials: H
authors.lastname: Baldwin
authors.forename: Kelli Anne
authors.initials: KA
authors.lastname: Wong
authors.forename: Leigh Ann
authors.initials: LA
authors.lastname: Matheny
authors.forename: Barbara
authors.initials: B
authors.lastname: Moquin
authors.forename: Aliya
authors.initials: A
authors.lastname: Rainer
authors.forename: Suvimol
authors.initials: S
authors.lastname: Hill
authors.forename: Alan
authors.initials: A
authors.lastname: Remaley
authors.forename: Laura Lee
authors.initials: LL
authors.lastname: Johnson
authors.forename: Mitchell B
authors.initials: MB
authors.lastname: Max
authors.forename: Marc R
authors.initials: MR
authors.lastname: Blackman
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000368:Aged; D001800:Blood Specimen Collection / Q000379:methods; D016022:Case-Control Studies; D002908:Chronic Disease; D004298:Dopamine / Q000652:urine; D004837:Epinephrine / Q000652:urine; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D009490:Neurosecretory Systems / Q000502:physiology*; D009638:Norepinephrine / Q000652:urine; D010003:Osteoarthritis / Q000150:complications*; D010146:Pain / Q000150:complications*; D013739:Testosterone / Q000097:blood
chemical_list: D013739:Testosterone; D000324:Adrenocorticotropic Hormone; D007986:Luteinizing Hormone; D004298:Dopamine; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine