title: Active vitamin D (1,25 dihydroxyvitamin D) is associated with chronic pain in older Australian men: the Concord Health and Ageing in Men Project.
abstract: BACKGROUND
  Although there is a conflicting evidence for an association between low serum 25-hydroxyvitamin D (25D) levels and pain, the relationship between pain and the active vitamin D metabolite, 1,25-hydroxyvitamin D (1,25D), has not been investigated. The aim of this study was to examine the associations between serum vitamin D metabolites: 25D and 1,25D with intrusive or chronic pain in community-living men aged ≥70 years.
  
  
  METHODS
  Population-based, cross-sectional analysis of the baseline phase of the Concord Health and Ageing in Men Project, a large epidemiological study conducted in Sydney between January 2005 and May 2007. Participants included 1,659 community dwelling men aged ≥70 years, taking part in Concord Health and Ageing in Men Project. Main outcome measurements were symptoms of chronic or intrusive pain. Covariates included 25D and 1,25D, parathyroid hormone, estimated glomerular filtration rate as well as age, country of birth, season of blood collection, body mass index, health conditions, and medication, including nonsteroidal anti-inflammatory drugs and statins.
  
  
  RESULTS
  The prevalence of intrusive pain was 22.9% and of chronic pain was 29.7%. Low serum 25D concentrations were associated with intrusive and chronic pain in unadjusted analysis, but after adjustment, the associations were no longer significant. Low 1,25D levels (<62.0 pmol/L) remained independently associated with chronic pain (odds ratio: 1.53 [1.05, 2.21, p = .02]), even after adjustment for a wide range of potential confounders and covariates of clinical significance.
  
  
  CONCLUSIONS
  Low serum 1,25D concentrations are associated with chronic pain in older men. This raises the question whether vitamin D metabolites may influence pain states, mediated through different biological mechanisms and pathways.
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital, School of Public Health, ARC Centre of Excellence in Population Ageing Research, vasant.hirani@sydney.edu.au.
authors.forename: Vasant
authors.initials: V
authors.lastname: Hirani
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Blyth
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital.
authors.forename: Vasi
authors.initials: V
authors.lastname: Naganathan
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital, School of Public Health, ARC Centre of Excellence in Population Ageing Research.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
authors.affiliation: ANZAC Research Institute and Charles Perkins Centre.
authors.forename: David G
authors.initials: DG
authors.lastname: Le Couteur
authors.affiliation: Department of Andrology, Concord Hospital and ANZAC Research Institute, and.
authors.forename: David J
authors.initials: DJ
authors.lastname: Handelsman
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital.
authors.forename: Louise M
authors.initials: LM
authors.lastname: Waite
authors.affiliation: Bone Research Program, ANZAC Research Institute, and Department of Endocrinology & Metabolism, Concord Hospital, University of Sydney, New South Wales, Australia.
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Seibel
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D015992:Body Mass Index; D059350:Chronic Pain / Q000097:blood* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005919:Glomerular Filtration Rate; D006304:Health Status; D006801:Humans; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D; C104450:25-hydroxyvitamin D
keywords: Calcitriol; Older men; Pain; Population study.; Vitamin D