Effects of chronic osteoarthritis pain on neuroendocrine function in men.
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.
Khoromi
Suzan
S
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
Muniyappa
Ranganath
R
Nackers
Lisa
L
Gray
Nora
N
Baldwin
Howard
H
Wong
Kelli Anne
KA
Matheny
Leigh Ann
LA
Moquin
Barbara
B
Rainer
Aliya
A
Hill
Suvimol
S
Remaley
Alan
A
Johnson
Laura Lee
LL
Max
Mitchell B
MB
Blackman
Marc R
MR
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
D013739:Testosterone; D000324:Adrenocorticotropic Hormone; D007986:Luteinizing Hormone; D004298:Dopamine; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine