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

McCabe, PS, Pye, SR, Beth, JM, Lee, DM, Tajar, A, Bartfai, G, Boonen, S, Bouillon, R, Casanueva, F, Finn, JD, Forti, G, Giwercman, A, Huhtaniemi, IT, Kula, K, Pendleton, N, Punab, M, Vanderschueren, D, 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.