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Low vitamin D and the risk of developing chronic widespread pain: Results from the European male ageing study

McCabe, PS and Pye, SR and Beth, JM and Lee, DM and Tajar, A and Bartfai, G and Boonen, S and Bouillon, R and Casanueva, F and Finn, JD and Forti, G and Giwercman, A and Huhtaniemi, IT and Kula, K and Pendleton, N and Punab, M and Vanderschueren, D and Wu, FC and O'Neill, TW (2016) Low vitamin D and the risk of developing chronic widespread pain: Results from the European male ageing study. BMC Musculoskeletal Disorders, 17 (1). ISSN 1471-2474

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Abstract

© 2016 McCabe et al. 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, particula rly obesity and depression.

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