title: Investigating the Burden of Chronic Pain: An Inflammatory and Metabolic Composite.
abstract: Background. Chronic pain is associated with increased morbidity and mortality, predominated by cardiovascular disease and cancer. Investigating related risk factor measures may elucidate the biological burden of chronic pain. Objectives. We hypothesized that chronic pain severity would be positively associated with the risk factor composite. Methods. Data from 12,982 participants in the 6th Tromsø study were analyzed. Questionnaires included demographics, health behaviors, medical comorbidities, and chronic pain symptoms. The risk factor composite was comprised of body mass index, fibrinogen, C-reactive protein, and triglycerides. Chronic pain severity was characterized by frequency, intensity, time/duration, and total number of pain sites. Results. Individuals with chronic pain had a greater risk factor composite than individuals without chronic pain controlling for covariates and after excluding inflammation-related health conditions (p < 0.001). A significant "dose-response" relationship was demonstrated with pain severity (p < 0.001). In individuals with chronic pain, the risk factor composite varied by health behavior, exercise, lower levels and smoking, and higher levels. Discussion. The risk factor composite was higher in individuals with chronic pain, greater with increasing pain severity, and influenced by health behaviors. Conclusions. Identification of a biological composite sensitive to pain severity and adaptive/maladaptive behaviors would have significant clinical and research utility.
authors.affiliation: Department of Aging & Geriatric Research, University of Florida, Gainesville, FL 32610, USA; Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32610, USA.
authors.forename: Kimberly T
authors.initials: KT
authors.lastname: Sibille
authors.affiliation: Department of Ageing and Health, Norwegian Institute of Public Health, 0403 Oslo, Norway.
authors.forename: Ólöf A
authors.initials: ÓA
authors.lastname: Steingrímsdóttir
authors.affiliation: Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32610, USA.
authors.forename: Roger B
authors.initials: RB
authors.lastname: Fillingim
authors.affiliation: Department of Pain Management and Research, Oslo University Hospital, 0424 Oslo, Norway; Faculty of Medicine, University of Oslo, 0316 Oslo, Norway.
authors.forename: Audun
authors.initials: A
authors.lastname: Stubhaug
authors.affiliation: Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University, 9038 Tromsø, Norway; Department of Cardiology, University Hospital North Norway, 9038 Tromsø, Norway.
authors.forename: Henrik
authors.initials: H
authors.lastname: Schirmer
authors.affiliation: Department of Biostatistics, University of Florida, Gainesville, FL 32610, USA.
authors.forename: Huaihou
authors.initials: H
authors.lastname: Chen
authors.affiliation: Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, New York, NY 10065, USA.
authors.forename: Bruce S
authors.initials: BS
authors.lastname: McEwen
authors.affiliation: Department of Ageing and Health, Norwegian Institute of Public Health, 0403 Oslo, Norway; Department of Pain Management and Research, Oslo University Hospital, 0424 Oslo, Norway.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Nielsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000886:Anthropometry; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D059350:Chronic Pain / Q000150:complications* / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D015438:Health Behavior; D006801:Humans; D007249:Inflammation / Q000453:epidemiology*; D008297:Male; D008603:Mental Health; D008659:Metabolic Diseases / Q000453:epidemiology*; D008875:Middle Aged; D009664:Norway; D010147:Pain Measurement; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000378:metabolism
chemical_list: D014280:Triglycerides; D005340:Fibrinogen; D002097:C-Reactive Protein