title: Low vitamin D and the risk of developing chronic widespread pain: results from the European male ageing study.
abstract: 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 CWP, although this may be explained by underlying adverse health factors, particularly obesity and depression.
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Stopford Building, Oxford Road, M13 9PT, Manchester, UK. paul.mccabe@manchester.ac.uk.
authors.forename: Paul S
authors.initials: PS
authors.lastname: McCabe
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Stopford Building, Oxford Road, M13 9PT, Manchester, UK.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Pye
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Stopford Building, Oxford Road, M13 9PT, Manchester, UK.|Arthritis Research Primary Care Centre, Primary Care Sciences, Keele University, Keele, UK.
authors.forename: John Mc
authors.initials: JM
authors.lastname: Beth
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Stopford Building, Oxford Road, M13 9PT, Manchester, UK.
authors.forename: David M
authors.initials: DM
authors.lastname: Lee
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Stopford Building, Oxford Road, M13 9PT, Manchester, UK.
authors.forename: Abdelouahid
authors.initials: A
authors.lastname: Tajar
authors.affiliation: Department of Obstetrics, Gynaecology and Andrology, Albert Szent-Gyorgy Medical University, Szeged, Hungary.
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Bartfai
authors.affiliation: University Division of Geriatric Medicine, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Boonen
authors.affiliation: Department of Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Roger
authors.initials: R
authors.lastname: Bouillon
authors.affiliation: Department of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, ; Santiago de Compostela, Spain.
authors.forename: Felipe
authors.initials: F
authors.lastname: Casanueva
authors.affiliation: Andrology Research Unit, Centre for Endocrinology and Diabetes, University of Manchester, Manchester, UK.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Finn
authors.affiliation: Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Forti
authors.affiliation: Scanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Lund, Sweden.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Giwercman
authors.affiliation: Department of Reproductive Biology, Imperial College London, London, UK.
authors.forename: Ilpo T
authors.initials: IT
authors.lastname: Huhtaniemi
authors.affiliation: Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kula
authors.affiliation: Clinical Gerontology, University of Manchester, Salford Royal Hospital, Salford, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Pendleton
authors.affiliation: Andrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia.
authors.forename: Margus
authors.initials: M
authors.lastname: Punab
authors.affiliation: Department of Andrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Vanderschueren
authors.affiliation: Andrology Research Unit, Centre for Endocrinology and Diabetes, University of Manchester, Manchester, UK.
authors.forename: Frederick C
authors.initials: FC
authors.lastname: Wu
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Stopford Building, Oxford Road, M13 9PT, Manchester, UK.|NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK.
authors.forename: Terence W
authors.initials: TW
authors.lastname: O'Neill
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000097:blood* / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D059350:Chronic Pain / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods / Q000639:trends*; D012307:Risk Factors; D014807:Vitamin D / Q000097:blood*
chemical_list: D015415:Biomarkers; D014807:Vitamin D