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Saija C, Bertuccio MP, Scoglio A, Macaione V, Cacciola F, Micalizzi G, Caccamo D, Muscoli C, Currò M. Role of Vitamin D Status and Alterations in Gut Microbiota Metabolism in Fibromyalgia-Associated Chronic Inflammatory Pain. Biomedicines 2025; 13:139. [PMID: 39857723 PMCID: PMC11760899 DOI: 10.3390/biomedicines13010139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2024] [Revised: 12/26/2024] [Accepted: 01/07/2025] [Indexed: 01/27/2025] Open
Abstract
Background/Objectives: Several studies suggest gut microbiota metabolites as important immuno-modulators in inflammatory pain. We aimed to investigate the relationship between vitamin D status and gut dysbiosis markers in fibromyalgia (FM)-associated chronic inflammation. Methods: Blood samples were collected from sixty-eight female FM patients (49.9 ± 12.35 years). Pain intensity was assessed by FIQ-R. The serum levels of the pro-inflammatory cytokines TNF-α, IL-1β, IL-6, IL-17, IFN-γ, as well as those of vitamin D (25(OH)D3) and the kynurenine/tryptophan ratio (Kyn/Trp) were determined by ELISA and HPLC, respectively. The plasma levels of the SCFAs acetate, butyrate, and propionate were detected by GC-MS. Results: A mean FIQ-R score indicated that the patients could be classified as having moderate FM. The mean levels of all cytokines, but IL-6 and IL-1β, were higher than the normal reference values. The highest concentrations of cytokines were observed in patients showing the highest FIQ-R scores and the lowest 25(OH)D3 levels. Deficient levels of acetate were found paralleled by an increase in Kyn/Trp. The highest acetate concentrations were detected in patients with the lowest FIQ-R scores and 25(OH)D3 levels. Significantly negative correlations were found between 25(OH)D3 concentrations and FIQ-R scores (p = 0.007) as well as IL-17 levels (p = 0.002) and between acetate and TNF-α (p = 0.040) as well as FIQ-R scores (p = 0.028), while significantly positive correlations were observed between Kyn/Trp and IL-17 (p = 0.027) as well as IFN-γ (p = 0.003). Conclusions: Our preliminary data suggest that the vitamin D status along with altered gut microbiota metabolism plays a major role in FM-related inflammatory pain. Replication of these findings in a larger cohort is required to provide additional insights.
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Affiliation(s)
- Caterina Saija
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy; (C.S.); (M.P.B.); (A.S.); (M.C.)
| | - Maria Paola Bertuccio
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy; (C.S.); (M.P.B.); (A.S.); (M.C.)
| | - Alberto Scoglio
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy; (C.S.); (M.P.B.); (A.S.); (M.C.)
| | - Vincenzo Macaione
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy;
| | - Francesco Cacciola
- Messina Institute of Technology, Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, Former Veterinary School, University of Messina, 98168 Messina, Italy; (F.C.); (G.M.)
| | - Giuseppe Micalizzi
- Messina Institute of Technology, Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, Former Veterinary School, University of Messina, 98168 Messina, Italy; (F.C.); (G.M.)
| | - Daniela Caccamo
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy; (C.S.); (M.P.B.); (A.S.); (M.C.)
| | - Carolina Muscoli
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy;
| | - Monica Currò
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy; (C.S.); (M.P.B.); (A.S.); (M.C.)
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Xie Y, Farrell SF, Armfield N, Sterling M. Serum Vitamin D and Chronic Musculoskeletal Pain: A Cross-Sectional Study of 349,221 Adults in the UK. THE JOURNAL OF PAIN 2024; 25:104557. [PMID: 38734042 DOI: 10.1016/j.jpain.2024.104557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/08/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024]
Abstract
Insufficient and deficient vitamin D may be associated with chronic musculoskeletal pain, but study findings are conflicting, and few account for important confounding factors. This cross-sectional study explored the association between serum vitamin D status and chronic musculoskeletal pain in various body sites, adjusting for a wide range and a number of potential confounding factors. Data collected at the baseline assessments of 349,221 UK Biobank participants between 2006 and 2010 were analyzed. Serum 25-hydroxyvitamin D was measured and categorized as <25.0 nmol/L (severe deficiency), 25.0 to 49.9 nmol/L (deficiency), 50.0 to 74.9 nmol/L (insufficiency), and ≥75.0 nmol/L (sufficiency). The outcome was self-reported chronic musculoskeletal pain at any site, neck/shoulder, back, hip, knee, or widespread pain that interfered with usual activities. Potential confounders were identified using directed acyclic graphs and included sociodemographic, lifestyle, psychological factors, and medical comorbidities. Simple models adjusted for age and sex showed significant associations between suboptimal vitamin D status and chronic pain across all sites (odds ratios [ORs] ranged 1.07-2.85). These associations were weakened or became insignificant after accounting for all confounding factors (ORs ≤ 1.01) for chronic regional musculoskeletal pain. Severe vitamin D deficiency remained a significant and positive association with chronic widespread pain after adjusting for all confounding factors (OR [95% confidence interval]: 1.26 [1.07, 1.49]). This study suggests that, while vitamin D status is not a key independent determinant of chronic regional musculoskeletal pain, severe vitamin D deficiency may be associated with chronic widespread pain. PERSPECTIVE: After accounting for various confounders, vitamin D deficiency was not associated with regional musculoskeletal pain. However, the relationship between chronic widespread pain severe vitamin D deficiency remained after confounder adjustment. Use of vitamin D supplements in individuals with chronic widespread pain and severe vitamin D deficiency warrants further exploration.
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Affiliation(s)
- Yanfei Xie
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Queensland, Australia; NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Brisbane, Queensland, Australia; STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, Queensland, Australia
| | - Scott F Farrell
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Queensland, Australia; NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Brisbane, Queensland, Australia; STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, Queensland, Australia
| | - Nigel Armfield
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Queensland, Australia; NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Brisbane, Queensland, Australia; STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, Queensland, Australia
| | - Michele Sterling
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Queensland, Australia; NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Brisbane, Queensland, Australia; STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, Queensland, Australia.
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3
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D’Amuri A, Greco S, Pagani M, Presciuttini B, Ciaffi J, Ursini F. Common Non-Rheumatic Medical Conditions Mimicking Fibromyalgia: A Simple Framework for Differential Diagnosis. Diagnostics (Basel) 2024; 14:1758. [PMID: 39202246 PMCID: PMC11354086 DOI: 10.3390/diagnostics14161758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 08/06/2024] [Accepted: 08/10/2024] [Indexed: 09/03/2024] Open
Abstract
Fibromyalgia (FM) is a chronic non-inflammatory disorder mainly characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and a constellation of other symptoms. For this reason, delineating a clear distinction between pure FM and FM-like picture attributable to other common diseases can be extremely challenging. Physicians must identify the most significant confounders in individual patients and implement an appropriate diagnostic workflow, carefully choosing a minimal (but sufficient) set of tests to be used for identifying the most plausible diseases in the specific case. This article discusses prevalent non-rheumatological conditions commonly observed in the general population that can manifest with clinical features similar to primary FM. Given their frequent inclusion in the differential diagnosis of FM patients, the focus will be on elucidating the distinctive clinical characteristics of each condition. Additionally, the most cost-effective and efficient diagnostic methodologies for accurately discerning these conditions will be examined.
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Affiliation(s)
- Andrea D’Amuri
- General Medicine Unit, Medical Department, ASST Mantova, Ospedale Carlo Poma, Str. Lago Paiolo 10, 46100 Mantova, Italy; (A.D.); (M.P.); (B.P.)
| | - Salvatore Greco
- Internal Medicine Unit, Medical Department, Ospedale del Delta, Via Valle Oppio 2, Lagosanto, 44023 Ferrara, Italy;
| | - Mauro Pagani
- General Medicine Unit, Medical Department, ASST Mantova, Ospedale Carlo Poma, Str. Lago Paiolo 10, 46100 Mantova, Italy; (A.D.); (M.P.); (B.P.)
| | - Barbara Presciuttini
- General Medicine Unit, Medical Department, ASST Mantova, Ospedale Carlo Poma, Str. Lago Paiolo 10, 46100 Mantova, Italy; (A.D.); (M.P.); (B.P.)
| | - Jacopo Ciaffi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy
| | - Francesco Ursini
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy
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Bassett E, Gjekmarkaj E, Mason AM, Zhao SS, Burgess S. Vitamin D, chronic pain, and depression: linear and non-linear Mendelian randomization analyses. Transl Psychiatry 2024; 14:274. [PMID: 38965219 PMCID: PMC11224391 DOI: 10.1038/s41398-024-02997-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/21/2024] [Accepted: 06/27/2024] [Indexed: 07/06/2024] Open
Abstract
Vitamin D deficiency has been linked to various chronic pain conditions. However, randomized trials of vitamin D supplementation have had mixed results. In contrast, systematic reviews of randomized trials indicate a protective effect of vitamin D supplementation on depression. We undertake a Mendelian randomization investigation in UK Biobank, a study of UK residents aged 40-65 at recruitment. We perform linear and non-linear Mendelian randomization analyses for four outcomes: fibromyalgia, clinical fatigue, chronic widespread pain, and probable lifetime major depression. We use genetic variants from four gene regions with known links to vitamin D biology as instruments. In linear analyses, genetically-predicted levels of 25-hydroxyvitamin D [25(OH)D], a clinical marker of vitamin D status, were not associated with fibromyalgia (odds ratio [OR] per 10 nmol/L higher 25(OH)D 1.02, 95% confidence interval [CI] 0.93, 1.12), clinical fatigue (OR 0.99, 95% CI 0.94, 1.05), chronic widespread pain (OR 0.95, 95% CI 0.89, 1.02), or probable lifetime major depression (OR 0.97, 95% CI 0.93, 1.01). In non-linear analyses, an association was observed between genetically-predicted 25(OH)D levels and depression in the quintile of the population with the lowest 25(OH)D levels (OR 0.75, 95% CI 0.59, 0.94); associations were null in other strata. Our findings suggest that population-wide vitamin D supplementation will not substantially reduce pain or depression; however, targeted supplementation of deficient individuals may reduce risk of depression.
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Affiliation(s)
- Emily Bassett
- MRC Biostatistics Unit, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Eva Gjekmarkaj
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, CB1 8RN, UK
| | - Amy M Mason
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB2 0BD, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Sizheng Steven Zhao
- Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Science, School of Biological Sciences, Faculty of Biological Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Stephen Burgess
- MRC Biostatistics Unit, University of Cambridge, Cambridge, CB2 0SR, UK.
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB2 0BD, UK.
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Presto P, Sehar U, Kopel J, Reddy PH. Mechanisms of pain in aging and age-related conditions: Focus on caregivers. Ageing Res Rev 2024; 95:102249. [PMID: 38417712 DOI: 10.1016/j.arr.2024.102249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 03/01/2024]
Abstract
Pain is a complex, subjective experience that can significantly impact quality of life, particularly in aging individuals, by adversely affecting physical and emotional well-being. Whereas acute pain usually serves a protective function, chronic pain is a persistent pathological condition that contributes to functional deficits, cognitive decline, and emotional disturbances in the elderly. Despite substantial progress that has been made in characterizing age-related changes in pain, complete mechanistic details of pain processing mechanisms in the aging patient remain unknown. Pain is particularly under-recognized and under-managed in the elderly, especially among patients with Alzheimer's disease (AD), Alzheimer's disease-related dementias (ADRD), and other age-related conditions. Furthermore, difficulties in assessing pain in patients with AD/ADRD and other age-related conditions may contribute to the familial caregiver burden. The purpose of this article is to discuss the mechanisms and risk factors for chronic pain development and persistence, with a particular focus on age-related changes. Our article also highlights the importance of caregivers working with aging chronic pain patients, and emphasizes the urgent need for increased legislative awareness and improved pain management in these populations to substantially alleviate caregiver burden.
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Affiliation(s)
- Peyton Presto
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Jonathan Kopel
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Nutritional Sciences Department, College of Human Sciences, Texas Tech University, Lubbock, TX 79409, USA; Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Public Health, School of Population and Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Neurology, Departments of School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
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Siaton BC, Hogans BB, Frey-Law LA, Brown LM, Herndon CM, Buenaver LF. Pain, comorbidities, and clinical decision-making: conceptualization, development, and pilot testing of the Pain in Aging, Educational Assessment of Need instrument. FRONTIERS IN PAIN RESEARCH 2024; 5:1254792. [PMID: 38455875 PMCID: PMC10918012 DOI: 10.3389/fpain.2024.1254792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/26/2024] [Indexed: 03/09/2024] Open
Abstract
Introduction Pain is highly prevalent in older adults and often contextualized by multiple clinical conditions (pain comorbidities). Pain comorbidities increase with age and this makes clinical decisions more complex. To address gaps in clinical training and geriatric pain management, we established the Pain in Aging-Educational Assessment of Need (PAEAN) project to appraise the impacts of medical and mental health conditions on clinical decision-making regarding older adults with pain. We here report development and pilot testing of the PAEAN survey instrument to assess clinician perspectives. Methods Mixed-methods approaches were used. Scoping review methodology was applied to appraise both research literature and selected Medicare-based data. A geographically and professionally diverse interprofessional advisory panel of experts in pain research, medical education, and geriatrics was formed to advise development of the list of pain comorbidities potentially impacting healthcare professional clinical decision-making. A survey instrument was developed, and pilot tested by diverse licensed healthcare practitioners from 2 institutions. Respondents were asked to rate agreement regarding clinical decision-making impact using a 5-point Likert scale. Items were scored for percent agreement. Results Scoping reviews indicated that pain conditions and comorbidities are prevalent in older adults but not universally recognized. We found no research literature directly guiding pain educators in designing pain education modules that mirror older adult clinical complexity. The interprofessional advisory panel identified 26 common clinical conditions for inclusion in the pilot PAEAN instrument. Conditions fell into three main categories: "major medical", i.e., cardio-vascular-pulmonary; metabolic; and neuropsychiatric/age-related. The instrument was pilot tested by surveying clinically active healthcare providers, e.g., physicians, nurse practitioners, who all responded completely. Median survey completion time was less than 3 min. Conclusion This study, developing and pilot testing our "Pain in Aging-Educational Assessment of Need" (PAEAN) instrument, suggests that 1) many clinical conditions impact pain clinical decision-making, and 2) surveying healthcare practitioners about the impact of pain comorbidities on clinical decision-making for older adults is highly feasible. Given the challenges intrinsic to safe and effective clinical care of older adults with pain, and attendant risks, together with the paucity of existing relevant work, much more education and research are needed.
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Affiliation(s)
- Bernadette C. Siaton
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
- Geriatric Research Education and Clinical Center, VA Maryland Health Care System, Baltimore, MD, United States
| | - Beth B. Hogans
- Geriatric Research Education and Clinical Center, VA Maryland Health Care System, Baltimore, MD, United States
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Laura A. Frey-Law
- Department of Physical Therapy and Rehabilitative Science, University of Iowa Carver College of Medicine, Iowa City, IA, United States
| | - Lana M. Brown
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
| | - Christopher M. Herndon
- Department of Pharmacy Practice, Southern Illinois University Edwardsville School of Pharmacy, Edwardsville, IL, United States
- Department of Family and Community Medicine, St. Louis University School of Medicine, St. Louis, MO, United States
| | - Luis F. Buenaver
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
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Ye AL, Sudek EW, Magdaleno D, Roldan CJ. Diagnostic and therapeutic value of intracellular biomarker testing in chronic pain. Pain Manag 2024; 14:21-27. [PMID: 38193288 DOI: 10.2217/pmt-2023-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Abstract
Aim: Micronutrient and metabolic compound supplementation as a method of treating chronic pain is not well understood. Case: A 58 year-old woman presented with refractory painful neuropathy. She did not respond to conservative treatment and was seeking spinal cord stimulator implantation. She underwent a biomarker panel that revealed low intracellular levels of multiple compounds. As she supplemented her deficiencies, her symptoms fully resolved, and the implant was no longer indicated. Discussion: Micronutrient and metabolic compound testing could potentially expand non-invasive treatment options for patients with refractory chronic pain. Caution should be exercised given limited regulatory oversight in the supplement industry and actively ongoing nutritional research. Conclusion: Biomarker testing panels may be a useful adjunct in the management of refractory neuropathic pain.
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Affiliation(s)
- Alice L Ye
- Department of Pain Medicine, The University of Texas MD Anderson Texas Center, Houston, TX 77030, USA
| | - Emily W Sudek
- Department of Pain Medicine, The University of Texas MD Anderson Texas Center, Houston, TX 77030, USA
| | - Daniela Magdaleno
- Department of Pain Medicine, The University of Texas MD Anderson Texas Center, Houston, TX 77030, USA
| | - Carlos J Roldan
- Department of Pain Medicine, The University of Texas MD Anderson Texas Center, Houston, TX 77030, USA
- McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA
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Trivedi MK, Mondal S, Gangwar M, Jana S. Effects of Cannabidiol Interactions with CYP2R1, CYP27B1, CYP24A1, and Vitamin D 3 Receptors on Spatial Memory, Pain, Inflammation, and Aging in Vitamin D 3 Deficiency Diet-Induced Rats. Cannabis Cannabinoid Res 2023; 8:1019-1029. [PMID: 35443806 DOI: 10.1089/can.2021.0240] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction: The study was planned to investigate memory-enhancing, anti-inflammatory, and antiaging potential of cannabidiol (CBD) on vitamin D3 deficient diet (VDD)-induced rats. Materials and Methods: Cytochrome P-450 enzymes were analyzed by RT-PCR method and others biomarkers by enzyme-linked immunosorbent assay. Results: CYP2R1 and CYP27B1-mRNA were significantly increased by 39.29 and 38.37%, respectively, while; CYP24A1-mRNA was significantly reduced by 21.39% compared to VDD. Vitamin D3 receptor protein expression was significantly increased by 148.3%, 60.48%, and 142.03% in liver, kidney, and brain, respectively, compared to VDD group. Vitamin D3 metabolites and serotonin were significantly increased more than 60% and 100%, respectively, compared to VDD. Spatial memory (in terms of total distance, escape latency) and pain score were improved compared to VDD. Cytokines were significantly reduced than VDD. Besides, levels of superoxide dismutase (49.61%), glutathione peroxidase (178.87%), acetylcholine (25.40%), and klotho (145.57%) were significantly increased than VDD. Conclusions: Study findings supported that CBD interacts with CYP2R1, CYP27B1, CYP24A1, and vitamin D receptors, resulting in increased vitamin D3 metabolites, which improved memory, pain tolerance, reduced inflammation, and aging through modulating antioxidative enzymes, cytokines, and neurotransmitters in VDD-induced rats.
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Affiliation(s)
| | - Sambhu Mondal
- Trivedi Science Research Laboratory Pvt. Ltd., Thane, India
| | - Mayank Gangwar
- Trivedi Science Research Laboratory Pvt. Ltd., Thane, India
| | - Snehasis Jana
- Trivedi Science Research Laboratory Pvt. Ltd., Thane, India
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Channarong P, Phongamwong C. Prevalence and risk factors of vitamin D deficiency among patients with chronic myofascial pain syndrome: a cross-sectional study. BMC Nutr 2023; 9:129. [PMID: 37964354 PMCID: PMC10647172 DOI: 10.1186/s40795-023-00792-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/10/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Myofascial pain syndrome (MPS) is a common muscle condition characterized by painful trigger points. Vitamin D deficiency has been recognized as a precipitating factor of MPS. The present study aimed to determine the prevalence and risk factors of vitamin D deficiency in patients with chronic MPS. METHODS A cross-sectional study was conducted, using a structured face-to-face interview to collect demographic information, clinical characteristics, pain duration and location, as well as the bodily pain subscale of SF36 and EQ-5D-5 L. The Elecsys vitamin D total II assay was used to measure serum total 25-hydroxyvitamin D level. RESULTS Of 120 participants, vitamin D insufficiency (20 to 29.9 ng/ml) and deficiency (< 20 ng/ml) were 47.5% (95% CI: 38.3-56.8%) and 34.2% (95% CI: 25.8-43.4%), respectively. The adjusted odds ratios for vitamin D deficiency of participants aged < 45 years and who reported having ≤ 15 min sunlight exposure per day were 3.5 (95% CI: 1.54 to 7.98) and 2.38 (95% CI: 1.05 to 5.26), respectively. The bodily pain score (r = - 0.02, P = 0.86) and EQ-5D-5 L utility (r = 0.04, P = 0.66) did not significantly correlate with vitamin D levels. CONCLUSION Approximately one third of patients with chronic MPS had vitamin D deficiency. Age < 45 years and sunlight exposure ≤ 15 min/day were identified as potential risk factors for vitamin D deficiency in MPS patients.
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Affiliation(s)
- Pimpitcha Channarong
- Department of Rehabilitation Medicine, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Chanwit Phongamwong
- Department of Rehabilitation Medicine, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand.
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Khater WA, Alfarkh MA, Allnoubani A. The Association Between Vitamin D Level and Chest Pain, Anxiety, and Fatigue in Patients With Coronary Artery Disease. Clin Nurs Res 2023; 32:639-647. [PMID: 36205377 DOI: 10.1177/10547738221126325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study sought to assess the association between vitamin D deficiency (VDD) and chest pain, anxiety, and fatigue in patients with coronary artery disease (CAD). A cross-sectional study was conducted to collect data from a sample of 90 participants with CAD. Serum 25OHD3 was measured using a radioimmunoassay procedure. Chest pain was assessed using the Numeric Pain Rating Scale, anxiety using the Anxiety Subscale, and fatigue by the General Fatigue subscale. The majority of participants (80%) had VDD. Results showed that the level of vitamin D was significantly negatively associated with chest pain (r = -.43, p = .00); anxiety (r = -.466, p = .00); and fatigue (r = -.25, p = .018). Findings suggest the role of VDD in heightened central sensitivity in cardiac-related symptoms such as chest pain, anxiety, and fatigue. Patients with CAD should be monitored for VDD so that the condition can be corrected.
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Fialho MFP, Brum ES, Oliveira SM. Could the fibromyalgia syndrome be triggered or enhanced by COVID-19? Inflammopharmacology 2023; 31:633-651. [PMID: 36849853 PMCID: PMC9970139 DOI: 10.1007/s10787-023-01160-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/08/2023] [Indexed: 03/01/2023]
Abstract
Fibromyalgia (FM) is a complex disease with an uncertain aetiology and intricate pathophysiology. Although its genesis is not fully explained, potential environmental factors, such as viral infections might trigger FM or worsen patients' clinical outcomes. The SARS-CoV-2 virus may affect central and peripheral nervous systems, leading to musculoskeletal, neurological, and psychological disturbances. These symptoms might persist at least 12 months beyond the recovery, often referred to as post-COVID syndrome, which resembles FM syndrome. In this sense, we argued the potential consequences of COVID-19 exclusively on FM syndrome. First, we have described post-COVID syndrome and its painful symptoms. Afterwards, we argued whether FM syndrome could be triggered or enhanced by COVID-19 infection or by numerous and persistent stressors imposed daily by the pandemic setting (isolation, uncertainty, depression, mental stress, generalized anxiety, and fear of the virus). In addition, we have demonstrated similarities between pathophysiological mechanisms and cardinal symptoms of FM and COVID-19, speculating that SARS-CoV-2 might represent a critical mediator of FM or an exacerbator of its symptoms once both syndromes share similar mechanisms and complaints. Therefore, pharmacologic and non-pharmacological approaches commonly used to treat FM could serve as strategic therapies to attenuate painful and neurological manifestations of post-COVID syndrome. Although it is still theoretical, clinicians and researchers should be alert of patients who develop symptoms similar to FM or those who had their FM symptoms increased post-COVID to manage them better.
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Affiliation(s)
- Maria Fernanda Pessano Fialho
- Graduate Program in Biological Sciences: Biochemistry Toxicology, Centre of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Evelyne Silva Brum
- Graduate Program in Biological Sciences: Biochemistry Toxicology, Centre of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Sara Marchesan Oliveira
- Graduate Program in Biological Sciences: Biochemistry Toxicology, Centre of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil.
- Department of Biochemistry and Molecular Biology, Centre of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil.
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12
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Jin G, Nie Y, Fan J, Yang Y, Chen D, Li Y, Ju L. Association between urinary phthalate levels and chronic pain in US adults, 1999-2004: A nationally representative survey. Front Neurol 2023; 14:940378. [PMID: 36816553 PMCID: PMC9932803 DOI: 10.3389/fneur.2023.940378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 01/11/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Chronic pain is a public health concern throughout the world. Ascertaining and managing its risk factors helps develop well-directed treatment plans and prevention strategies. Phthalates (PAEs) exposure leads to various health problems. The present study aims to explore the potential correlation between urinary PAEs metabolites and chronic pain in adults. Methods The study population data were extracted from the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2004 in the United States. Seven urinary PAEs metabolites were used to assess long-term PAEs exposure. The assessment of chronic pain was determined by a self-report questionnaire. Weighted analyses were conducted to consider the complex sampling design. Models were adjusted by demographic data and lifestyle factors. Urinary PAEs metabolites were assessed as both continuous and categorical variables. Tertile 1 was considered as the reference. Stratified analyses were performed by gender and pain site. All data analyses were conducted with STATA, version 15.1. P < 0.05 was considered with statistical significance. Results A total of 4,196 participants were considered in our final analysis. Chronic pain prevalence reached 52.19% (n = 2,138) among the participants, with women accounting for a large proportion (57.75% vs. 42.25%). After multivariable logistic regression analysis, a higher prevalence of chronic pain was observed among participants in the third tertile of mono-(2-ethyl)-hexyl phthalate (MEHP) (OR = 1.23, 95% CI = 1.02-1.48, P = 0.034) and mono-benzyl phthalate (MBzP) (OR = 1.28, 95% CI = 1.04-1.58, P = 0.022) in our adjusted model. The logtransformed concentration of MBzP also showed a significant association with chronic pain prevalence (OR = 1.09, 95% CI = 1.01-1.18, P = 0.036) in the adjusted model. In further analysis, the positive correlations of urinary phthalate metabolites with chronic pain remained robust when stratified by gender and chronic pain site. Conclusions Our findings presented a positive correlation between urinary PAEs metabolites and chronic pain among adult participants, and more causal research should be conducted to ascertain the interactions between the two and to expound their underlying mechanisms.
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Affiliation(s)
- Guoping Jin
- Department of Orthopaedics, Ningbo No. 9 Hospital, Ningbo, Zhejiang, China
| | - Yaoyao Nie
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Jiayao Fan
- School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ye Yang
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Dingwan Chen
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Yingjun Li
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Li Ju
- Department of Occupational and Environmental Health, School of Public Health, Hangzhou Medical College, Hangzhou, China,*Correspondence: Li Ju ✉
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Miniksar ÖH, Yüksek A, Göçmen AY, Katar MK, Kılıç M, Honca M. Serum vitamin D le Serum vitamin D levels are associated with acute post e associated with acute postoperative pain and opioid analgesic consumption after laparoscopic cholecystect cholecystectomy: a str omy: a strobe compliant pr obe compliant prospectiv ospective obser e observational ational study. Turk J Med Sci 2023; 53:171-182. [PMID: 36945925 PMCID: PMC10387885 DOI: 10.55730/1300-0144.5570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 11/20/2022] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND In this prospective observational study, we aimed to evaluate the relationship between serum levels of vitamin D and acute postoperative pain scores, as well as opioid analgesic consumption in patients undergoing laparoscopic cholecystectomy. METHODS : The study was performed in the Medical Faculty Hospital, from April 2020 to April 2021. Postoperative visual analog scale (VAS) pain scores, total tramadol consumption, number of requests on patient-controlled analgesia (PCA) were compared between the vitamin D deficient (≤20 ng/mL; n = 25) and vitamin D nondeficient (>20 ng/mL; n = 55) groups at five time points (T0: in the recovery room, T1: 1st hour in the ward, T2: 6th hour, T3: 12th hour, and T4: 24th hour). RESULTS Postoperative VAS pain scores were similar in the vitamin D deficient group at all time points (T0-4), but differed significantly only at the T-0 time point (p = 0.020). The mean cumulative tramadol consumption was significantly higher in the vitamin D deficiency group than in the nondeficiency group (p = 0.005). Vitamin D levels were lower in patients with VAS ≥ 4 at the postoperative T-0 time point (p = 0.009). In the multivariate linear regression analysis, 15.7% of cumulative tramadol consumption was due to vitamin D deficiency (β = -0.188). DISCUSSION : Our study shows that preoperative low vitamin D level was associated with an increase in acute postoperative pain scores and consumption of opioid analgesics in patients undergoing laparoscopic cholecystectomy. Our findings may be useful for postoperative pain management in patients with vitamin D deficiency.
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Affiliation(s)
- Ökkeş Hakan Miniksar
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Ahmet Yüksek
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Ayşe Yeşim Göçmen
- Department of Biochemistry, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Mehmet Kağan Katar
- Department of General Surgery, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Mahmut Kılıç
- Department of Public Health, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turke
| | - Mehtap Honca
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
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14
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Yu G, Lin Y, Dai H, Xu J, Liu J. Association between serum 25-hydroxyvitamin D and osteoarthritis: A national population-based analysis of NHANES 2001-2018. Front Nutr 2023; 10:1016809. [PMID: 36925955 PMCID: PMC10011108 DOI: 10.3389/fnut.2023.1016809] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Background Previous studies have not provided a consensus on the effect of serum 25-hydroxyvitamin D [25(OH)D] on osteoarthritis (OA). We aimed to evaluate the association using a large, nationally representative sample. Methods The cross-sectional data were obtained from the 2001 to 2018 National Health and Nutrition Examination Survey (NHANES). Individuals aged ≥40 years who had information of serum 25(OH)D, self-report OA, and related covariates were included. Multivariable logistic regression analysis was employed to assess the association between serum 25(OH)D and osteoarthritis. Results Among the 21,334 participants included (weighted mean age, 56.9 years; 48.5% men), the proportion of participants with high serum 25(OH)D concentrations (≥100 nmol/L) increased significantly from 4.2% in 2001-2006 to 18.8% in 2013-2018. Higher serum 25(OH)D levels were associated with more osteoarthritis prevalence in fully adjusted model (odd ratio [OR] 1.25 [95% CI: 1.10, 1.43] for the 50-75 nmol/L group; OR 1.62 [95% CI: 1.42, 1.85] for the 75-100 nmol/L group; OR 1.91 [95% CI: 1.59, 2.30] for the ≥100 nmol/L group; with <50 nmol/L group as the reference) (p < 0.001 for trend). The association was consistent across several sensitivity analyses, including propensity score methods and excluding participants who had received vitamin D supplement. In subgroup analysis, the OR for the association increased significantly with body mass index (BMI) (BMI < 25 kg/m2, 1.01 [95% CI: 1.04, 1.08]; BMI 25-30 kg/m2, 1.05 [95% CI: 1.01, 1.08]; BMI ≥ 30 kg/m2, 1.10 [95% CI: 1.06, 1.13]; p = 0.004 for interaction). Conclusion There was a positive correlation between serum 25(OH)D and osteoarthritis with a possible modification by BMI. Our finding raises concerns about the potential adverse effects of high serum 25(OH)D on osteoarthritis, particularly among obese individuals. More well-designed studies are still needed to validate our findings in future.
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Affiliation(s)
- Guoyu Yu
- Clinical College of Orthopedics, Tianjin Medical University, Tianjin, China.,Department of Orthopedics, Fujian Provincial Hospital, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Yuan Lin
- Department of Orthopedics, Fujian Provincial Hospital, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Hanhao Dai
- Department of Orthopedics, Fujian Provincial Hospital, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Jie Xu
- Department of Orthopedics, Fujian Provincial Hospital, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Jun Liu
- Clinical College of Orthopedics, Tianjin Medical University, Tianjin, China.,Department of Joints, Tianjin Hospital, Tianjin University, Tianjin, China
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15
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Abukhalil AD, Falana H, Hamayel R, Yasser F, Nasser A, Naseef H, Al-Shami N, Rabba A. Vitamin D Deficiency Association with Comorbid Diseases in Palestine: "A Cross-Sectional Observation Study". Int J Gen Med 2022; 15:8033-8042. [PMID: 36348976 PMCID: PMC9637367 DOI: 10.2147/ijgm.s389190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/27/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Vitamin D deficiency (VDD) is a global health concern. This study aimed to determine the prevalence of vitamin D deficiency and its associated comorbidities in Palestine, such as diabetes mellitus, hypertension, hyperlipidemia, and cardiovascular and autoimmune diseases. METHODS A retrospective, descriptive study retrieved medical data from the Nat Health insurance processor database from 2014 to 2020. Patient information included age, sex, vitamin D laboratory order, symptoms, and comorbidities. This study included patients prescribed vitamin D at a dose of 50000IU for vitamin D deficiency confirmed by a serum vitamin D laboratory test. The collected data were analyzed using IBM SPSS. In addition, a chi-square test was conducted to assess the association between vitamin D deficiency, symptoms, and comorbidities. RESULTS Data of 3011 patients were collected; 639 patients were diagnosed with osteoporosis, and 39 patients prescribed vitamin D without a laboratory test were excluded. Approximately, 1837 (78%) participants had vitamin D deficiency. A total of 1330 women (81.3%) were significantly more likely to have vitamin D deficiency than males, 507 (72.7%; P < 0.001). Joint pain, back pain, and cervicalgia were significantly associated with vitamin D deficiency (P < 0.001). Asymptomatic participants (2.1%) were significantly less likely to have vitamin D deficiency than symptomatic participants (9.5%, p < 0.001). Hypothyroidism is significantly associated with vitamin D deficiency (p = 0.048). CONCLUSION In this retrospective study, the prevalence of vitamin D was high and alarming. There was a significant association between VDD, patients who presented with back pain, arthritis, and cervicalgia symptoms, and patients diagnosed with hypothyroidism. Therefore, health initiative programs are warranted to increase awareness regarding screening, prevention, and treatment. Further studies are needed to confirm the relationship between vitamin D supplementation and the reduced risk of comorbid diseases.
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Affiliation(s)
- Abdallah Damin Abukhalil
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| | - Hiba Falana
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| | - Rawan Hamayel
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| | - Fatima Yasser
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| | - Aleen Nasser
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| | - Hani Naseef
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| | - Ni’meh Al-Shami
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| | - Abdullah Rabba
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
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16
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Zeng X, Chen X, Li C, Shi H. Preoperative Vitamin D Level is Associated with Acute Pain After Video-Assisted Thoracoscopic Surgery: A Retrospective Cohort Study. J Pain Res 2022; 15:3189-3196. [PMID: 36258760 PMCID: PMC9572550 DOI: 10.2147/jpr.s382407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022] Open
Abstract
Purpose Low vitamin D levels have been associated with musculoskeletal pain, cancer pain, chronic postoperative pain, and post-traumatic pain. However, their association with postoperative pain after video-assisted thoracoscopic surgery has not been explored. The aim of this study was to examine the association between vitamin D levels and postoperative pain after video-assisted thoracoscopic surgery. Patients and Methods This study enrolled 194 adult patients who underwent elective non-cardiac thoracic surgery in Shanghai Pulmonary Hospital from February 2021 to June 2021. Following application of the exclusion criteria, 135 patients who underwent video-assisted thoracoscopic surgery were included in the final analysis. The primary outcome was the incidence of acute postoperative moderate-severe pain. Secondary outcomes included C-reactive protein (CRP), interleukin (IL)-1, IL-6, and tumor necrosis factor-α levels in the immediate postoperative (48 hours) period, as well as pain scores at 3 months after surgery. A multivariable logistic regression model was used to analyze the association between vitamin D levels and acute postoperative moderate-severe pain. Results Among 135 patients, 54.1% were categorized as having a low vitamin D level (<30 nmol/L). On multivariable analysis, patients with a low 25-hydroxy-vitamin D (25[OH]D) level had a higher risk of postoperative moderate-severe pain (odds ratio, 2.44; 95% confidence interval, 1.181-5.041; P = 0.016) when compared to patients with a sufficient 25(OH)D level. Static and dynamic pain scores at 3 months after surgery, as well as serum levels of CRP, IL-1, IL-6, and tumor necrosis factor-α were not significantly different between patients with low and sufficient 25(OH)D levels. Conclusion Patients with low vitamin D levels are at a higher risk of acute moderate-severe pain after video-assisted thoracoscopic surgery. Trial Registration http://www.chictr.org.cn, ChiCTR2100052380.
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Affiliation(s)
- Xiaoping Zeng
- Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, People’s Republic of China
| | - Xue Chen
- Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, People’s Republic of China
| | - Caixia Li
- Department of Anesthesiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, People’s Republic of China,Correspondence: Caixia Li, Department of Anesthesiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, People’s Republic of China, Tel +86-21-65161782-3235, Email
| | - Hong Shi
- Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, People’s Republic of China,Hong Shi, Department of Anesthesiology, Shanghai Pulmonary Hospital, school of Medicine, Tongji University, Shanghai, 200433, People’s Republic of China, Tel +86-21-65115006-2060, Email
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17
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Tu L, Zheng S, Cicuttini F, Jin X, Han W, Zhu Z, Antony B, Winzenberg T, Jones G, Gu J, Wluka AE, Ding C. Effects of Vitamin D Supplementation on Disabling Foot Pain in Patients With Symptomatic Knee Osteoarthritis. Arthritis Care Res (Hoboken) 2021; 73:781-787. [PMID: 32623812 DOI: 10.1002/acr.24371] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 06/30/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The present study was undertaken to determine whether vitamin D supplementation or maintaining sufficient vitamin D level reduces foot pain over 2 years in patients with symptomatic knee osteoarthritis (OA). METHODS A post hoc study was conducted from a randomized, double-blind, placebo-controlled trial named the Vitamin D Effect on Osteoarthritis (VIDEO) study. Symptomatic knee OA patients with serum 25-hydroxyvitamin D levels between 12.5 nmoles/liter and 60 nmoles/liter were included and randomly allocated to either monthly vitamin D3 or placebo treatment (1:1) for 2 years. Manchester Foot Pain and Disability Index (MFPDI) was used to evaluate foot pain and disabling foot pain was defined as at least 1 of the 10 functional limitation items (items 1-9 and 11) being documented as on "most/every day(s)" in the last month. A repeated-measures, mixed-effects model was used to analyze the change of MFPDI scores between groups adjusting for potential confounders. RESULTS A total of 413 patients with a mean age of 63.2 years (49.7% males) were enrolled and 340 completed the study. The mean MFPDI score was 22.8 ± 7.3, with 23.7% of participants having disabling foot pain at baseline. There were significant differences in MFPDI scores change between groups over 2 years, with more improvements in the vitamin D group than in the placebo group (-0.03 versus 1.30; P = 0.013) and more improvement in those maintaining sufficient vitamin D levels (n = 226) than those who did not (n = 114) (-0.09 versus 2.19; P = 0.001). CONCLUSION Vitamin D supplementation and maintenance of sufficient vitamin D levels may improve foot pain in those with knee OA.
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Affiliation(s)
- Liudan Tu
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China, and University of Tasmania, Hobart, Tasmania, Australia
| | - Shuang Zheng
- University of Tasmania, Hobart, Tasmania, Australia
| | | | - Xingzhong Jin
- University of Tasmania, Hobart, Tasmania, and the University of Sydney, New South Wales, Australia
| | - Weiyu Han
- University of Tasmania, Hobart, Tasmania, Australia, and Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhaohua Zhu
- University of Tasmania, Hobart, Tasmania, Australia, and Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Benny Antony
- University of Tasmania, Hobart, Tasmania, Australia
| | | | - Graeme Jones
- University of Tasmania, Hobart, Tasmania, Australia
| | - Jieruo Gu
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | | | - Changhai Ding
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China, University of Tasmania, Hobart, Tasmania, Australia, Monash University, Melbourne, Victoria, Australia, and Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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18
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Food for Special Medical Purposes and Nutraceuticals for Pain: A Narrative Review. Pain Ther 2021; 10:225-242. [PMID: 33594594 PMCID: PMC8119521 DOI: 10.1007/s40122-021-00239-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/30/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction The present paper focuses on the possible contribution of food compounds to alleviate symptomatic pains. Chronic pain can more easily be linked to anticipatory signals such as thirst and hunger than it is to sensory perceptions as its chronicity makes it fall under the behavioural category rather than it does senses. In fact, pain often negatively affects one’s normal feeding behavioural patterns, both directly and indirectly, as it is associated with pain or because of its prostrating effects. Nutritional Compounds for Pain Several nutraceuticals and Foods for Special Medical Purposes (FSMPs) are reported to have significant pain relief efficacy with multiple antioxidant and anti-inflammatory properties. Apart from the aforementioned properties, amino acids, fatty acids, trace elements and vitamins may have a role in the modulation of pain signals to and within the nervous system. Conclusion In our opinion, this review could be of great interest to clinicians, as it offers a complementary perspective in the management of pain. Trials with well-defined patient and symptoms selection and a robust pharmacological design are pivotal points to let these promising compounds become better accepted by the medical community.
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Kim Y, Zhang F, Su K, LaRochelle M, Callahan M, Fisher D, Wharam JF, Asgari MM. Perioperative Serum 25-Hydroxyvitamin D Levels as a Predictor of Postoperative Opioid Use and Opioid Use Disorder: a Cohort Study. J Gen Intern Med 2020; 35:2545-2552. [PMID: 32583342 PMCID: PMC7459073 DOI: 10.1007/s11606-020-06001-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 06/17/2020] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Vitamin D deficiency is associated with chronic pain syndromes and higher opioid use among cancer patients, but its association with opioid use among opioid-naïve subjects following a major surgical procedure with acute pain has not been explored. OBJECTIVE To determine the association between serum 25-hydroxyvitamin D (25(OH)D) levels, opioid use, and opioid use disorder. METHODS We identified commercially insured subjects aged 18-64 years with available perioperative serum 25-hydroxyvitamin D (25D) levels who underwent one of nine major surgical procedures in 2000-2014. Primary outcomes were dose and duration of opioid use measured using pharmacy claims. Secondary outcome was opioid use disorder captured using diagnosis codes. Multivariable negative binomial models with generalized estimating equations were performed examining the association between 25D levels and postoperative opioid use measures, adjusting for age, sex, race/ethnicity, Charlson score, education, income, latitude, and season of blood draw. Adjusted Cox regression was used to examine the association with opioid use disorder. RESULTS Among 5446 subjects, serum 25(OH)D was sufficient (≥ 20 ng/mL) among 4349 (79.9%) subjects, whereas 837 (15.4%) had insufficient (12 to < 20 ng/mL) and 260 (4.8%) had deficient (< 12 ng/mL) levels. On multivariable analysis, as compared with subjects with sufficient 25(OH)D levels, subjects with deficient 25(OH)D levels had 1.7 more days (95% CI 0.76, 2.58) of opioid use per year and had 98.7 higher morphine milligram equivalent dose (95% CI 55.7, 141.8) per year. Among 11,713 study cohort, subjects with deficient 25(OH)D levels were more likely to be diagnosed with opioid use disorders (HR 2.41; 95% CI 1.05, 5.52). CONCLUSION Patients undergoing common surgical procedures with deficient 25D levels are more likely to have higher opioid use and an increased risk of opioid use disorder compared to those with sufficient levels. Serum 25D levels may serve as a biomarker to identify subjects at increased risk of opioid misuse.
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Affiliation(s)
- Yuhree Kim
- Department of Population Medicine, Harvard Medical School, , 401 Park Drive #401, Boston, MA, 02215, USA.,Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, , 50 Staniford Street, Boston, MA, USA
| | - Fang Zhang
- Department of Population Medicine, Harvard Medical School, , 401 Park Drive #401, Boston, MA, 02215, USA
| | - Katherine Su
- Department of Population Medicine, Harvard Medical School, , 401 Park Drive #401, Boston, MA, 02215, USA.,Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, , 50 Staniford Street, Boston, MA, USA
| | - Marc LaRochelle
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, , Boston, MA, USA
| | - Matthew Callahan
- Department of Population Medicine, Harvard Medical School, , 401 Park Drive #401, Boston, MA, 02215, USA
| | - David Fisher
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, , 50 Staniford Street, Boston, MA, USA
| | - J Frank Wharam
- Department of Population Medicine, Harvard Medical School, , 401 Park Drive #401, Boston, MA, 02215, USA
| | - Maryam M Asgari
- Department of Population Medicine, Harvard Medical School, , 401 Park Drive #401, Boston, MA, 02215, USA. .,Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, , 50 Staniford Street, Boston, MA, USA.
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20
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Abdul-Razzak KK, Kofahi RM. Carpel tunnel syndrome: A link with vitamin D and calcium. Biomed Rep 2020; 13:15. [PMID: 32765854 DOI: 10.3892/br.2020.1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 05/20/2020] [Indexed: 11/06/2022] Open
Abstract
Carpal tunnel syndrome (CTS) and vitamin D deficiency are two conditions that cause chronic pain and are thus associated with psychological issues as well. The aim of the present study was to evaluate vitamin D levels, daily calcium intake, musculoskeletal pain and psychological symptoms in patients with CTS. The study included 48 patients with CTS and age-sex matched controls. Serum vitamin D levels were measured, and psychological symptoms were assessed using a Hospital Anxiety and Depression Scale. A Pain DETECT questionnaire was used to assess musculoskeletal pain (MSP) sites and severity. The results showed that vitamin D deficiency was considerably more prevalent in patients with CTS (95.8%) compared with controls (22.9%). Clinical anxiety (35.4 vs. 6.3%) and clinical depression (29.2 vs. 4.2%) were also more common in patients with CTS compared with controls. All the patients with CTS exhibited MSP, whereas none of the controls reported any MSP. Anxiety was significantly and inversely associated with vitamin D levels (r2=-0.482; P<0.01), total daily calcium intake (r2=-0.294: P<0.05), and positively associated with body mass index (BMI; r2=0.200; P≤0.05) and depression (r2=0.587; P<0.01). Depression was significantly and inversely associated with vitamin D levels (r2=-0.269; P<0.01) and total daily calcium intake (r2=-0.236; P<0.05). Logistic regression analysis showed that with every unit increase in serum vitamin D levels, the odds of CTS were decreased 1.22x. While a one-unit increase in anxiety total score was associated with a 14% increase in the odds of having CTS after adjusting for different confounders. In conclusion, vitamin D deficiency, MSP and psychological symptoms are common in patients with CTS. Serum vitamin D levels and anxiety were significant independent predictors of CTS. Based on the results of the present study, it was shown that housewives had an equivalent chance of suffering from CTS morbidity as other high-risk professions. Further studies are required to confirm if vitamin D supplementation could prevent the onset of CTS.
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Affiliation(s)
- Khalid Khaleel Abdul-Razzak
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Raid Mohammed Kofahi
- Department of Neuroscience, Faculty of Medicine, Jordan University of Science and Technology, Irbid-22110, Jordan
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21
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Sanabria-Mazo JP, Forero CG, Cristobal-Narváez P, Suso-Ribera C, García-Palacios A, Colomer-Carbonell A, Pérez-Aranda A, Andrés-Rodríguez L, McCracken LM, D'Amico F, Estivill-Rodríguez P, Carreras-Marcos B, Montes-Pérez A, Comps-Vicente O, Esteve M, Grasa M, Rosa A, Cuesta-Vargas AI, Maes M, Borràs X, Edo S, Sanz A, Feliu-Soler A, Castaño-Asins JR, Luciano JV. Efficacy, cost-utility and physiological effects of Acceptance and Commitment Therapy (ACT) and Behavioural Activation Treatment for Depression (BATD) in patients with chronic low back pain and depression: study protocol of a randomised, controlled trial including mobile-technology-based ecological momentary assessment (IMPACT study). BMJ Open 2020; 10:e038107. [PMID: 32709656 PMCID: PMC7380881 DOI: 10.1136/bmjopen-2020-038107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The IMPACT study focuses on chronic low back pain (CLBP) and depression symptoms, a prevalent and complex problem that represents a challenge for health professionals. Acceptance and Commitment Therapy (ACT) and Brief Behavioural Activation Treatment for Depression (BATD) are effective treatments for patients with persistent pain and depression, respectively. The objectives of this 12 month, multicentre, randomised, controlled trial (RCT) are (i) to examine the efficacy and cost-utility of adding a group-based form of ACT or BATD to treatment-as-usual (TAU) for patients with CLBP and moderate to severe levels of depressive symptoms; (ii) identify pre-post differences in levels of some physiological variables and (iii) analyse the role of polymorphisms in the FKBP5 gene, psychological process measures and physiological variables as mediators or moderators of long-term clinical changes. METHODS AND ANALYSIS Participants will be 225 patients with CLBP and moderate to severe depression symptoms recruited at Parc Sanitari Sant Joan de Déu (St. Boi de Llobregat, Spain) and Hospital del Mar (Barcelona, Spain), randomly allocated to one of the three study arms: TAU vs TAU+ACT versus TAU+BATD. A comprehensive assessment to collect clinical variables and costs will be conducted pretreatment, post-treatment and at 12 months follow-up, being pain interference the primary outcome measure. The following physiological variables will be considered at pretreatment and post-treatment assessments in 50% of the sample: immune-inflammatory markers, hair cortisol and cortisone, serum cortisol, corticosteroid-binding globulin and vitamin D. Polymorphisms in the FKBP5 gene (rs3800373, rs9296158, rs1360780, rs9470080 and rs4713916) will be analysed at baseline assessment. Moreover, we will include mobile-technology-based ecological momentary assessment, through the Pain Monitor app, to track ongoing clinical status during ACT and BATD treatments. Linear mixed-effects models using restricted maximum likelihood, and a full economic evaluation applying bootstrapping techniques, acceptability curves and sensitivity analyses will be computed. ETHICS AND DISSEMINATION This study has been approved by the Ethics Committee of the Fundació Sant Joan de Déu and Hospital del Mar. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media and various community engagement activities. TRIAL REGISTRATION NUMBER NCT04140838.
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Affiliation(s)
- Juan P Sanabria-Mazo
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain
- Department of Medicine, International University of Catalunya, Barcelona, Spain
- Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Catalunya, Spain
| | - Carlos G Forero
- Department of Medicine, International University of Catalunya, Barcelona, Spain
| | - Paula Cristobal-Narváez
- Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Catalunya, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
- Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
- Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain
| | - Ariadna Colomer-Carbonell
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain
- Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Catalunya, Spain
| | - Adrián Pérez-Aranda
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain
- Consorci Parc de Salut MAR de Barcelona, Barcelona, Catalunya, Spain
| | - Laura Andrés-Rodríguez
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain
| | | | - Francesco D'Amico
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | | | | | | | | | - Montserrat Esteve
- Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Barcelona, Spain
- Institute of Biomedicine (IBUB), University of Barcelona, Barcelona, Spain
| | - Mar Grasa
- Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain
- Department of Biochemistry and Molecular Biomedicine, University of Barcelona, Barcelona, Spain
- Institute of Biomedicine (IBUB), University of Barcelona, Barcelona, Spain
| | - Araceli Rosa
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
- Department of Evolutionary Biology, Ecology and Environmental Sciences, University of Barcelona, Barcelona, Spain
| | - Antonio I Cuesta-Vargas
- Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Department of Physiotherapy, University of Malaga & Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain
| | - Michael Maes
- Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand
| | - Xavier Borràs
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain
| | - Silvia Edo
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain
| | - Antoni Sanz
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain
| | - Albert Feliu-Soler
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain
- Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Catalunya, Spain
| | | | - Juan V Luciano
- Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Catalunya, Spain
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22
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Maloney SR, Goolkasian P. Low Vitamin D States Observed in U.S. Marines and Navy Sailors with Early Multi-Symptom Illness. Biomolecules 2020; 10:biom10071032. [PMID: 32664492 PMCID: PMC7407997 DOI: 10.3390/biom10071032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/28/2020] [Accepted: 07/08/2020] [Indexed: 12/21/2022] Open
Abstract
Research has implicated immune system inflammation as an underlying etiology of multi-symptom illnesses, and vitamin D has been shown to have a significant role in immune system function. In this retrospective review performed on the medical charts of service members who presented with signs and symptoms of multi-symptom illnesses, we focused on serum 25(OH)D3 levels and looked for associations of vitamin D status (deficient, insufficient, and normal) with age (20–31 years versus 31–56 years) and deployment status (war zones versus other). Two groups (U.S. Marines and Navy Sailors) were sampled and both showed high incidences of below normal vitamin D levels. However, with the Marines, age-related differences in serum levels (p = 0.009) were found only among those who deployed to Iraq/Afghanistan in comparison to those in non-combat locations. The comparison within the Navy sample showed that mobilized sailors had lower 25(OH)D3 levels than the group that did not deploy (p = 0.04). In addition, 100% of the sailors who deployed had below normal levels versus only 33% in the cadre group. The data suggest that personnel returning from a war zone with signs of early multi-symptom illness should be checked for low vitamin D status.
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Affiliation(s)
- Sean R. Maloney
- Navy Mobilization Processing Site, Deployment Processing Command-East, W.G. (Bill) Hefner VA Medical Center, Salisbury, NC 28144, USA
- Correspondence: (S.R.M.); (P.G.); Tel.: +1-336-406-6626 (S.R.M); +1-704-895-0927 (P.G.)
| | - Paula Goolkasian
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA
- Correspondence: (S.R.M.); (P.G.); Tel.: +1-336-406-6626 (S.R.M); +1-704-895-0927 (P.G.)
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23
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Urits I, Pham C, Swanson D, Berardino K, Bandi P, Amgalan A, Kaye RJ, Jung JW, Kaye AD, Paladini A, Varrassi G, Kaye AM, Manchikanti L, Viswanath O. The utilization of buprenorphine in chronic pain. Best Pract Res Clin Anaesthesiol 2020; 34:355-368. [PMID: 33004153 DOI: 10.1016/j.bpa.2020.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 12/18/2022]
Abstract
Reclassification of chronic pain as a disease may be helpful because patients with chronic pain require significant treatment and rehabilitation with a clear diagnosis. This can help address critical factors including suffering, quality of life, participation, and with family and social life, which continue to become more important in evaluating the quality of the health care we give our patients today. During the past decade of the opioid epidemic, methadone was the primary treatment for opioid addiction until buprenorphine was approved. Buprenorphine's high-affinity partial agonist properties make it a good alternative to methadone due to lower abuse potential and safer adverse effect profile while maintaining significant efficacy. Expanded out-patient prescribing options have allowed physician and physician extenders such as physician assistants and nurse practitioners to treat these patients that otherwise would have been required to utilize methadone. With unique pharmacological properties, buprenorphine is a safe and effective analgesic for chronic pain. The literature for buprenorphine shows great potential for its utilization in the treatment of chronic pain.
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Affiliation(s)
- Ivan Urits
- Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, USA.
| | - Cynthia Pham
- Georgetown University School of Medicine, Washington, DC, USA
| | - Daniel Swanson
- Georgetown University School of Medicine, Washington, DC, USA
| | - Kevin Berardino
- Georgetown University School of Medicine, Washington, DC, USA
| | - Prudhvi Bandi
- University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, AZ, USA
| | | | - Rachel J Kaye
- Medical University of South Carolina, Charleston, SC, USA
| | - Jai Won Jung
- Georgetown University School of Medicine, Washington, DC, USA
| | - Alan D Kaye
- Louisiana State University Health Shreveport, Department of Anesthesiology, Shreveport, LA, USA
| | | | | | - Adam M Kaye
- University of the Pacific, Department of Pharmacy Practice, Stockton, CA, USA
| | | | - Omar Viswanath
- University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, AZ, USA; Louisiana State University Health Shreveport, Department of Anesthesiology, Shreveport, LA, USA; Valley Pain Consultants, Envision Physician Services, Phoenix, AZ, USA; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, USA
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24
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Duan BL, Mao YR, Xue LQ, Yu QY, Liu MY. Determination of vitamin D and analysis of risk factors for osteoporosis in patients with chronic pain. World J Clin Cases 2020; 8:2150-2161. [PMID: 32548145 PMCID: PMC7281063 DOI: 10.12998/wjcc.v8.i11.2150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/10/2020] [Accepted: 04/30/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Vitamin D deficiency is common in patients with chronic pain and healthy people, but the difference between the two has not been reported; thus, whether there is a relationship between vitamin D deficiency and chronic pain remains to be confirmed. Osteoporosis is a common disease in chronic pain disorders. Understanding the relationship between vitamin D and osteoporosis will provide a basis for the rational supplementation of vitamin D to prevent osteoporosis, and to understand the risk factors of bone mass change to provide a new treatment plan for early prevention of osteoporosis.
AIM To determine 25 hydroxy vitamin D (25OHD) level in patients with chronic pain to clarify its clinical significance. The relationship between vitamin D and bone mineral density (BMD) and the risk factors for bone mass change were also evaluated.
METHODS In this study, 184 patients with chronic pain were included in the study group, and 104 healthy individuals who underwent routine health checkups during the same period were included in the control group. 25OHD level was detected in both groups by enzyme-linked immunosorbent assay. According to the BMD test results, the patients in the study group were further classified into three subgroups: Normal BMD group, reduced BMD group, and osteoporosis group. Age, sex, ethnicity, living altitude, body mass index, 25OHD level, parathyroid hormone (PTH), calcium (Ca) and phosphorus levels were analyzed statistically in both groups.
RESULTS The vitamin D level in the study group was lower than that in the control group at 53.8% vs 57.7%, with no significant difference between the two groups. The proportion of patients with severe vitamin D deficiency in the study group was higher than that in the control group. The mean age was greater in the osteoporosis subgroup, and the youngest in the normal BMD subgroup. Vitamin D level in the osteoporosis subgroup was lower than that in the other two subgroups, and was not specific for the diagnosis of bone mass reduction and osteoporosis. The above results were analyzed statistically and showed significant differences (P < 0.05). There was a positive correlation between age and BMD in patients with chronic pain (R = 0.567, P < 0.001). Age, PTH and Ca were risk factors for bone mass reduction, while age, ethnicity and altitude were risk factors for osteoporosis.
CONCLUSION Vitamin D deficiency is a common phenomenon in patients with chronic pain, and severe vitamin D deficiency is not uncommon. Vitamin D level is not a risk factor for bone mass reduction and osteoporosis. Bone mass reduction is correlated with age, PTH and Ca, while osteoporosis is correlated with age, ethnicity and altitude.
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Affiliation(s)
- Bao-Lin Duan
- Department of Pain, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
| | - Yuan-Rong Mao
- Department of Pain, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
| | - Li-Qi Xue
- Department of Pain, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
| | - Qing-Yuan Yu
- Department of Pain, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
| | - Mei-Yi Liu
- Department of Pain, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
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25
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Garrido C, Bardón-Cancho EJ, Fajardo-Sánchez VDLÁ, Cascón-Pérez-Teijón ME, García-Morín M, Cela E. Evaluation of the effectiveness of prophylactic oral vitamin D (cholecalciferol) in children with sickle cell disease. Bone 2020; 133:115228. [PMID: 31972313 DOI: 10.1016/j.bone.2020.115228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/23/2019] [Accepted: 01/08/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Vitamin D (25(OH)D) deficiency has become an emerging public health problem due to its influence on skeletal and extraskeletal diseases. Bone health in patients with sickle cell disease (SCD) is especially compromised and they are more likely to have 25(OH)D deficiency than the general population. Despite this, there is little information on the efficacy of vitamin D3 (vitD3) prophylaxis and its role in improving bone mineral density (BMD) in this population. PROCEDURES A prospective, longitudinal, single-center study was conducted with 136 children with SCD monitored at a tertiary referral hospital for SCD. Demographic, clinical and management data, 25(OH)D levels and bone densitometries (DXA) were collected. RESULTS Eighty patients were included. There are significant differences between the means of each of 25(OH)D levels as a function of whether the patient started prophylactic treatment as an infant or not (35.71 vs. 27.89 ng/ml, respectively [p = .014]). In multivariate analysis, 800 IU daily dose was shown as a protective factor (p = .044) to reach optimal blood levels (≥30 ng/ml). According to Kaplan-Meier curves, patients younger than 10 years reached optimal levels earlier than older (p = .002), as well as those who were not being treated with hydroxyurea (p = .039). CONCLUSIONS VitD3 prophylaxis is a safe practice in SCD. It is important to start this prophylactic treatment when the child is an infant. The daily regimen with 800 IU could be more effective for reaching levels ≥30 ng/ml, and, especially in preadolescent and adolescent patients, we should raise awareness about the importance of good bone health.
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Affiliation(s)
- Carmen Garrido
- Pediatric Hematology Unit, "Hospital General Universitario Gregorio Marañón", Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Instituto Nacional de Investigación Biomédica en Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.
| | - Eduardo J Bardón-Cancho
- Pediatric Hematology Unit, "Hospital General Universitario Gregorio Marañón", Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | | | - María Elena Cascón-Pérez-Teijón
- Musculoskeletal Section, Radiodiagnosis Department, "Hospital General Universitario Gregorio Marañón", Profesora asociada Facultad de Medicina, Universidad Complutense de Madrid, Spain.
| | - Marina García-Morín
- Pediatric Hematology Unit, "Hospital General Universitario Gregorio Marañón", Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Elena Cela
- Pediatric Hematology Unit, "Hospital General Universitario Gregorio Marañón", Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Instituto Nacional de Investigación Biomédica en Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.
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26
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Guida F, Boccella S, Belardo C, Iannotta M, Piscitelli F, De Filippis F, Paino S, Ricciardi F, Siniscalco D, Marabese I, Luongo L, Ercolini D, Di Marzo V, Maione S. Altered gut microbiota and endocannabinoid system tone in vitamin D deficiency-mediated chronic pain. Brain Behav Immun 2020; 85:128-141. [PMID: 30953765 DOI: 10.1016/j.bbi.2019.04.006] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/18/2019] [Accepted: 04/02/2019] [Indexed: 12/14/2022] Open
Abstract
Recent evidence points to the gut microbiota as a regulator of brain and behavior, although it remains to be determined if gut bacteria play a role in chronic pain. The endocannabinoid system is implicated in inflammation and chronic pain processing at both the gut and central nervous system (CNS) levels. In the present study, we used low Vitamin D dietary intake in mice and evaluated possible changes in gut microbiota, pain processing and endocannabinoid system signaling. Vitamin D deficiency induced a lower microbial diversity characterized by an increase in Firmicutes and a decrease in Verrucomicrobia and Bacteroidetes. Concurrently, vitamin D deficient mice showed tactile allodynia associated with neuronal hyperexcitability and alterations of endocannabinoid system members (endogenous mediators and their receptors) at the spinal cord level. Changes in endocannabinoid (anandamide and 2-arachidonoylglycerol) levels were also observed in the duodenum and colon. Remarkably, the anti-inflammatory anandamide congener, palmitoylethanolamide, counteracted both the pain behaviour and spinal biochemical changes in vitamin D deficient mice, whilst increasing the levels of Akkermansia, Eubacterium and Enterobacteriaceae, as compared with vehicle-treated mice. Finally, induction of spared nerve injury in normal or vitamin D deficient mice was not accompanied by changes in gut microbiota composition. Our data suggest the existence of a link between Vitamin D deficiency - with related changes in gut bacterial composition - and altered nociception, possibly via molecular mechanisms involving the endocannabinoid and related mediator signaling systems.
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Affiliation(s)
- Francesca Guida
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Serena Boccella
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Carmela Belardo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Monica Iannotta
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fabiana Piscitelli
- Institute of Biomolecular Chemistry, Consiglio Nazionale delle Ricerche, Pozzuoli, Italy
| | - Francesca De Filippis
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy; Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy
| | - Salvatore Paino
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Flavia Ricciardi
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Dario Siniscalco
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ida Marabese
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Livio Luongo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Danilo Ercolini
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy; Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy
| | - Vincenzo Di Marzo
- Institute of Biomolecular Chemistry, Consiglio Nazionale delle Ricerche, Pozzuoli, Italy; Canada Excellence Research Chair on the Microbiome-Endocannabinoidome Axis in Metabolic Health, Quèbec Heart and Lung Institute and Institute for Nutrition and Functional Foods, Université Laval, 2325 Rue de l'Université, Québec, QC G1V 0A6, Canada.
| | - Sabatino Maione
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
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Zhang X, Liu Z, Xia L, Gao J, Xu F, Chen H, Du Y, Wang W. Clinical features of vitamin D deficiency in children: A retrospective analysis. J Steroid Biochem Mol Biol 2020; 196:105491. [PMID: 31586638 DOI: 10.1016/j.jsbmb.2019.105491] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/04/2019] [Accepted: 10/01/2019] [Indexed: 01/25/2023]
Abstract
Vitamin D is very important for children's health. Previous studies have shown that vitamin D deficiency leads to a series of diseases in adults. However, pediatricians are mostly aware of rickets caused by vitamin D deficiency in children and poorly aware of other symptoms. This study aimed to retrospectively analyze the different clinical features of vitamin D deficiency to enhance identification by pediatricians, thus minimizing misdiagnosis. In this study, we retrospectively analyzed the clinical features of vitamin D deficiency in 268 children aged 0-14 years from June 2016 to May 2018 in the Third Affiliated Hospital of Zhengzhou University. Serum 25-hydroxy vitamin D [25(OH)D] levels were determined using the chemiluminescence method. Of the 268 cases, 101 cases showed movement disorder (37.7%) and 167 nervous system abnormalities (62.3%). Among all cases, 6 were misdiagnosed as febrile seizures (2.23%), 5 as epilepsy (1.86%), 2 as Tourette syndrome (0.74%), and 2 as developmental retardation (0.74%). There were significant differences in patients with clinical characteristics of movement disorder and nervous system abnormalities partly between Pre-and post-vitamin D treatment. This analysis revealed that vitamin D deficiency occurs not only in children but also in adolescents, with diverse clinical features. Therefore, pediatricians should pay more attention to clinical different signs and symptoms, and future studies should be conducted to confirm the mechanisms of these processes.
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Affiliation(s)
- Xiangmin Zhang
- The Third Affiliated Hospital of Zhengzhou University, China.
| | - Zongyuan Liu
- The Third Affiliated Hospital of Zhengzhou University, China.
| | - Lei Xia
- The Third Affiliated Hospital of Zhengzhou University, China.
| | - Junjun Gao
- The Third Affiliated Hospital of Zhengzhou University, China.
| | - Falin Xu
- The Third Affiliated Hospital of Zhengzhou University, China.
| | - Hao Chen
- The Third Affiliated Hospital of Zhengzhou University, China.
| | - Yanhua Du
- The Third Affiliated Hospital of Zhengzhou University, China.
| | - Weiwei Wang
- The Third Affiliated Hospital of Zhengzhou University, China.
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Deng S, He Y, Nian X, Sun E, Li L. Relationship between Vitamin D levels and pain and disease activity in patients with newly diagnosed axial spondyloarthritis. Int J Nurs Sci 2020; 7:54-59. [PMID: 32099860 PMCID: PMC7031124 DOI: 10.1016/j.ijnss.2019.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 10/30/2019] [Accepted: 12/11/2019] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES To explore the relationship between Vitamin D levels and pain and disease activity in patients with newly diagnosed axial spondyloarthritis (axSpA). METHODS A convenience sample of 131 newly diagnosed axSpA patients and 60 healthy controls was recruited from July 2016 to December 2018. Serum 25-hydroxyvitamin D [25(OH)D] was measured to assess vitamin D levels. Disease activity was assessed by objective indicators [Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), the Bath Ankylosing Spondylitis Metrology Index (BASMI)], patient-reported questionnaires [the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the Bath Ankylosing Spondylitis Functional Index (BASFI)]. Pain intensity and interference were also assessed. RESULTS Vitamin D insufficiency [serum 25(OH) D levels<50 nmol/L]was found in 46 (35.1%) and 25 (43.3%) of the axSpA patients and the healthy controls, respectively. Female patients had higher risk (OR:4.928; 95% CI: 1.921-12.642) for vitamin D insufficiency than male patients. Vitamin D was positively correlated with CRP, ESR level, the BASFI, and the BASMI. Logistic regression showed that vitamin D levels were not associated with pain, or disease activity in the newly diagnosed axSpA patients. Gender was the only predictive variable for vitamin D levels. CONCLUSIONS Vitamin D insufficiency was prevalent in both newly diagnosed axSpA patients and healthy controls. There was no association between vitamin D and pain and disease activity in the newly diagnosed axSpA patients. Monitoring vitamin D levels is important and early intervention for vitamin D insufficiency is needed, especially in female patients.
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Affiliation(s)
- Sisi Deng
- Department of Nursing, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yi He
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Xinying Nian
- Department of Nursing, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Erwei Sun
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Li Li
- Department of Nursing, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Khamar P, Nair AP, Shetty R, Vaidya T, Subramani M, Ponnalagu M, Dhamodaran K, D'souza S, Ghosh A, Pahuja N, Deshmukh R, Ahuja P, Sainani K, Nuijts RMMA, Das D, Ghosh A, Sethu S. Dysregulated Tear Fluid Nociception-Associated Factors, Corneal Dendritic Cell Density, and Vitamin D Levels in Evaporative Dry Eye. Invest Ophthalmol Vis Sci 2019; 60:2532-2542. [PMID: 31195410 DOI: 10.1167/iovs.19-26914] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to study the status and association among tear-soluble factors, corneal dendritic cell density, vitamin D, and signs and symptoms in dry eye disease (DED). Methods A total of 33 control subjects and 47 evaporative dry eye patients were included in the study. DED diagnosis and classification was based on the 2017 Report of the Tear Film & Ocular Surface Society International Dry Eye Workshop (TFOS DEWS II). DED workup, including tear film break-up time (TBUT), Schirmer's test I (STI), corneal and conjunctival staining, ocular surface disease index (OSDI) scoring, and in vivo confocal microscopy (to assess corneal dendritic cell density [cDCD] and subbasal nerve plexus [SBNP] features) was performed in the study subjects. Tear fluid using Schirmer's strip and serum were collected from the subjects. Multiplex ELISA or single analyte ELISA was performed to measure 34 tear-soluble factors levels including vitamin D. Results Significantly higher OSDI discomfort score, lower TBUT, and lower STI were observed in DED patients. cDCD was significantly higher in DED patients. No significant difference was observed in SBNP features. Tear fluid IL-1β, IL-17A, MMP9, MMP10, MMP9/TIMP ratio, and VEGF-B were significantly higher in DED patients. Significantly lower tear fluid IL-2, IP-10, NPY, VEGF-A, and vitamin D was observed in DED patients. These dysregulated tear factors showed significant associations with DED signs and symptoms. Conclusions Altered tear fluid soluble factors with potential to modulate nociception exhibited a distinct association with ocular surface discomfort status, TBUT, STI, and cDCD. This implies a functional relationship between the various tear-soluble factors and dry eye pathogenesis, indicating new molecular targets for designing targeted therapies.
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Affiliation(s)
- Pooja Khamar
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Archana Padmanabhan Nair
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India.,Manipal Academy of Higher Education, Manipal, India
| | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Tanuja Vaidya
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India.,Manipal Academy of Higher Education, Manipal, India
| | - Murali Subramani
- Stem Cell Lab, GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India
| | - Murugeswari Ponnalagu
- Stem Cell Lab, GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India
| | - Kamesh Dhamodaran
- Stem Cell Lab, GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India
| | - Sharon D'souza
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Anuprita Ghosh
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India
| | - Natasha Pahuja
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Rashmi Deshmukh
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Prerna Ahuja
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Kanchan Sainani
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Rudy M M A Nuijts
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Debashish Das
- Stem Cell Lab, GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India
| | - Arkasubhra Ghosh
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India.,Singapore Eye Research Institute, Singapore
| | - Swaminathan Sethu
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India
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30
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Pellesi L, Bellei E, Guerzoni S, Cainazzo MM, Baraldi C, Monari E, Pini LA. Exploration of candidate serum biomarkers potentially related to the chronic pain condition in Medication-overuse headache. BMC Neurol 2019; 19:239. [PMID: 31623575 PMCID: PMC6798334 DOI: 10.1186/s12883-019-1469-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 09/20/2019] [Indexed: 01/03/2023] Open
Abstract
Background Medication Overuse Headache (MOH) is a prevalent and disabling disorder resulting from the overuse of analgesic drugs, triptans or other acute headache medications. In previous proteomic studies, several proteins have been found at high concentrations in the urine of MOH patients and in the serum of rats with neuropathic pain. The aim of this study was to compare the serum levels of lipocalin-type Prostaglandin D2 synthase (L-PGDS), Vitamin D-binding protein (VDBP), apolipoprotein E (APOE) and apolipoprotein A1 (APOA1) in MOH patients and healthy individuals, further exploring their relationship with cutaneous pain thresholds (CPTs) in the territories innervated by the trigeminal nerve. Methods Sixty-nine MOH patients and 42 age- and sex-matched healthy volunteers were enrolled in the study. Von Frey-like filaments were applied to the skin territories innervated by the trigeminal nerve, to determine the CPTs. L-PGDS, VDBP, APOE and APOA1 were quantified in the serum by Enzyme-linked Immunosorbent Assay (ELISA). Clinical and laboratory data were collected. Comparisons between MOH patients and healthy individuals were performed using independent t test or χ2 test. To correlate serum proteins with CPTs, Pearson correlation coefficient or Spearman’s rank correlation coefficient were used. Results CPTs were lower among MOH patients. L-PGDS, VDBP and APOE had significantly different serum concentrations between groups (p < 0.01), but no correlation was found with CPTs. APOA1 serum concentrations did not differ between patients and healthy individuals. Conclusions L-PGDS, VDBP and APOE had abnormal serum levels in MOH patients, confirming their alteration in some conditions of chronic headache and neuropathic pain. However, they had no relationship with CPTs. The in-depth study of serum proteins represents a promising approach for a better understanding of MOH, as well as the detection of candidate biomarkers for chronic headache or the risks associated with overuse medications.
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Affiliation(s)
- Lanfranco Pellesi
- Medical Toxicology, Headache and Drug Abuse Centre, University of Modena and Reggio Emilia, Modena, Italy.
| | - Elisa Bellei
- Department of Diagnostic Medicine, Clinic and Public Health, Proteomic Lab, University of Modena and Reggio Emilia, Modena, Italy
| | - Simona Guerzoni
- Medical Toxicology, Headache and Drug Abuse Centre, University of Modena and Reggio Emilia, Modena, Italy
| | - Maria Michela Cainazzo
- Medical Toxicology, Headache and Drug Abuse Centre, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlo Baraldi
- Medical Toxicology, Headache and Drug Abuse Centre, University of Modena and Reggio Emilia, Modena, Italy
| | - Emanuela Monari
- Department of Diagnostic Medicine, Clinic and Public Health, Proteomic Lab, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Alberto Pini
- Medical Toxicology, Headache and Drug Abuse Centre, University of Modena and Reggio Emilia, Modena, Italy.,Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
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31
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Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth 2019; 123:e273-e283. [PMID: 31079836 PMCID: PMC6676152 DOI: 10.1016/j.bja.2019.03.023] [Citation(s) in RCA: 863] [Impact Index Per Article: 143.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 03/22/2019] [Indexed: 12/18/2022] Open
Abstract
Chronic pain is a common, complex, and distressing problem that has a profound impact on individuals and society. It frequently presents as a result of a disease or an injury; however, it is not merely an accompanying symptom, but rather a separate condition in its own right, with its own medical definition and taxonomy. Studying the distribution and determinants of chronic pain allows us to understand and manage the problem at the individual and population levels. Targeted and appropriate prevention and management strategies need to take into account the biological, psychological, socio-demographic, and lifestyle determinants and outcomes of pain. We present a narrative review of the current understanding of these factors.
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Affiliation(s)
- Sarah E E Mills
- Population Health and Genomics Division, University of Dundee School of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK.
| | - Karen P Nicolson
- Population Health and Genomics Division, University of Dundee School of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK
| | - Blair H Smith
- Population Health and Genomics Division, University of Dundee School of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK
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32
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Kılıç B, Kılıç M. Evaluation of Vitamin D Levels and Response to Therapy of Childhood Migraine. ACTA ACUST UNITED AC 2019; 55:medicina55070321. [PMID: 31261815 PMCID: PMC6681503 DOI: 10.3390/medicina55070321] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/24/2019] [Accepted: 06/25/2019] [Indexed: 12/19/2022]
Abstract
Background and Objectives: Vitamin D deficiency and insufficiency are related with many neurological diseases such as migraine. The aim of this study was to investigate whether pediatric migraine is associated with vitamin D deficiency and the effect of vitamin D therapy on the frequency, duration, severity of migraine attacks, and Pediatric Migraine Disability Assessment (PedMIDAS). Materials and Methods: We retrospectively examined the patients’ levels of calcium, phosphorus, parathyroid hormone, alkaline phosphatase, and 25-OH vitamin D of 92 pediatric migraine patients. The patients were divided into two groups: Group 1, which had low vitamin D levels and received vitamin D therapy, and group 2, which had normal vitamin D levels and did not receive vitamin D therapy. Migraine severity measured by the visual analog scale (VAS), migraine frequency, and duration as well as scores on the PedMIDAS questionnaire were compared with regard to the 25-OH vitamin D levels. In addition, pre- and posttreatment pedMIDAS scores, VAS, migraine frequency, and duration were compared with baseline values. Results: A total of 34.7% patients had vitamin D insufficiency (vitamin D levels between 10 and 20 ng/mL), whereas 10.8% had vitamin D deficiency (vitamin D levels < 10 ng/mL). Migraine frequency, migraine duration, and PedMIDAS scores were significantly higher in the group 1 than group 2 (p = 0.004, p = 0.008, and p = 0.001). After vitamin D therapy at sixth months of supplementation, migraine duration was reported statistically significant shorter (p < 0.001) and the migraine frequency, VAS scores, and pedMIDAS scores were statistically significant lower compared with baseline values in group 1 (p < 0.001). Conclusion: We found a marked correlation between pediatric migraine and vitamin D levels. Vitamin D therapy was beneficial in migraine pediatric patients.
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Affiliation(s)
- Betül Kılıç
- Department of Child Neurology, University of Health Sciences, Derince Training and Research Hospital, 41900 Kocaeli, Turkey.
| | - Mustafa Kılıç
- Department of Neurosurgery, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, 34371 Istanbul, Turkey.
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33
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Philpot U, Johnson MI. Diet therapy in the management of chronic pain: better diet less pain? Pain Manag 2019; 9:335-338. [PMID: 31215321 DOI: 10.2217/pmt-2019-0014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Ursula Philpot
- Centre for Pain Research, School of Clinical & Applied Sciences, Leeds Beckett University, Leeds, UK
| | - Mark I Johnson
- Centre for Pain Research, School of Clinical & Applied Sciences, Leeds Beckett University, Leeds, UK
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34
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Goischke HK. Comorbidities in multiple sclerosis-a plea for interdisciplinary collaboration to improve the quality of life of MS patients. Degener Neurol Neuromuscul Dis 2019; 9:39-53. [PMID: 31354380 PMCID: PMC6584285 DOI: 10.2147/dnnd.s204555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 04/15/2019] [Indexed: 12/21/2022] Open
Abstract
The negative influence of comorbidities on the quality of life of people with multiple sclerosis is evident and the problem is increasingly acknowledged by numerous international studies in long-term care. One therapeutic option would be an add-on therapy with vitamin D (VD), with the aim of achieving a therapeutically effective dose. The individually required VD dose must be tested, since the response to a certain dose is subject to variations between individuals. A possible toxicity with increased 1.25(OH)D3 (active VD metabolite) is largely prevented by increased activity of 24-hydroxylase (CYP24A1). Monitoring of serum VD levels as well as serum calcium and phosphate levels (optional Ca excretion in 24-hour urine, Ca creatinine ratio in urine) provides safety and is necessary because possible mutations on the (catabolic) CYP24A1 gene can lead to a partial or total loss of 24-hydroxylase activity and provoke hypercalcemia/hyperphosphatemia. The main therapeutic objective is to maintain functional and social independence by using drugs with a high safety profile. The prevention and optimal management of comorbidities can influence the quality of life of patients with MS (PwMS) when included in patient care. Adequate measures can reduce the burden of MS only if the risk of comorbidity is reduced through targeted monitoring, early detection and diagnosis. Such a strategy will contribute to influencing the premature mortality of patients with MS. If VD is recognized as a "multipurpose steroid hormone", it could also be used to maintain cognitive function and prevent premature possible dementia, especially as there is evidence that VD deficiency correlates with brain atrophy (hippocampus). At present, MS therapy is still a balancing act between therapeutically efficient action and the management of unexpected side effects, with VD add-on therapy being almost unproblematic and most likely to be accepted by PwMS.
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35
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Arab A, Golpour-Hamedani S, Rafie N. The Association Between Vitamin D and Premenstrual Syndrome: A Systematic Review and Meta-Analysis of Current Literature. J Am Coll Nutr 2019; 38:648-656. [PMID: 31074708 DOI: 10.1080/07315724.2019.1566036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A number of studies have assessed the association between vitamin D and premenstrual syndrome (PMS) in different populations, but the findings have been inconclusive. Herein, we systematically reviewed available observational and interventional evidence to elucidate the overall relationship between vitamin D and PMS. PubMed, Cochrane Library, ScienceDirect, Scopus, Google Scholar, and ISI Web of Science databases were searched for all available articles until September 2018. The Newcastle-Ottawa quality assessment scale and Jadad scale were used to assess the quality of the observational and interventional studies, respectively. A total of 16 studies out of 196 met our inclusion criteria and were included in the final analysis. Although no significant association between serum 25(OH)D and PMS (weighted mean difference (WMD) = 3.35; 95% confidence interval, -7.80 to 1.11; p = 0.14) was indicated in observational studies, vitamin D supplementation was effective in ameliorating PMS symptoms based upon findings from interventional studies. These results add to the existing literature supporting the fact that nutrition, especially vitamin D, plays an important role in women's health. Additional well-designed clinical trials should be considered in future research to develop firm conclusions on the efficacy of vitamin D on PMS. KEY TEACHING POINTS 5-8% of women experience severe PMS. Nutrition especially vitamin D plays an important role in the women's health. Vitamin D could exert significant clinical effects on PMS symptoms. This is a systematic review and meta-analysis in this regard.
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Affiliation(s)
- Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences , Isfahan , Iran
| | - Sahar Golpour-Hamedani
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences , Isfahan , Iran
| | - Nahid Rafie
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences , Isfahan , Iran
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36
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Cholecalciferol (Vitamin D 3) Reduces Rat Neuropathic Pain by Modulating Opioid Signaling. Mol Neurobiol 2019; 56:7208-7221. [PMID: 31001801 DOI: 10.1007/s12035-019-1582-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/21/2019] [Indexed: 01/13/2023]
Abstract
The impact of vitamin D on sensory function, including pain processing, has been receiving increasing attention. Indeed, vitamin D deficiency is associated with various chronic pain conditions, and several lines of evidence indicate that vitamin D supplementation may trigger pain relief. However, the underlying mechanisms of action remain poorly understood. We used inflammatory and non-inflammatory rat models of chronic pain to evaluate the benefits of vitamin D3 (cholecalciferol) on pain symptoms. We found that cholecalciferol supplementation improved mechanical nociceptive thresholds in monoarthritic animals and reduced mechanical hyperalgesia and cold allodynia in a model of mononeuropathy. Transcriptomic analysis of cerebrum, dorsal root ganglia, and spinal cord tissues indicate that cholecalciferol supplementation induces a massive gene dysregulation which, in the cerebrum, is associated with opioid signaling (23 genes), nociception (14), and allodynia (8), and, in the dorsal root ganglia, with axonal guidance (37 genes) and nociception (17). Among the identified cerebral dysregulated nociception-, allodynia-, and opioid-associated genes, 21 can be associated with vitamin D metabolism. However, it appears that their expression is modulated by intermediate regulators such as diverse protein kinases and not, as expected, by the vitamin D receptor. Overall, several genes-Oxt, Pdyn, Penk, Pomc, Pth, Tac1, and Tgfb1-encoding for peptides/hormones stand out as top candidates to explain the therapeutic benefit of vitamin D3 supplementation. Further studies are now warranted to detail the precise mechanisms of action but also the most favorable doses and time windows for pain relief.
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37
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Wu Z, Camargo CA, Sluyter JD, Khaw KT, Malihi Z, Waayer D, Toop L, Lawes CMM, Scragg R. Association between serum 25-hydroxyvitamin D levels and self-reported chronic pain in older adults: A cross-sectional analysis from the ViDA study. J Steroid Biochem Mol Biol 2019; 188:17-22. [PMID: 30508645 DOI: 10.1016/j.jsbmb.2018.11.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/23/2018] [Accepted: 11/29/2018] [Indexed: 02/07/2023]
Abstract
Chronic pain is a major contributor to the global burden of disability. Prior studies on the association between serum 25-hydroxyvitamin D (25(OH)D) levels and chronic pain have yielded mixed results. The Vitamin D Assessment study, a large randomized controlled trial from New Zealand, offered the opportunity to examine this association in data collected at baseline in all participants, and among those with arthritis or depression. A total of 5110 participants aged 50-84 years were recruited from community general practices. Chronic pain (lasting ≥6 months) and other baseline characteristics were collected at baseline interview. Serum 25(OH)D concentration was measured by liquid chromatography-tandem mass spectrometry. Associations between 25(OH)D levels and chronic pain were explored using multivariable log-binomial regression to estimate relative risks (RRs). Out of 5049 participants with complete data, 871 (17%) reported having this clinical outcome, and 1254 (25%) had a 25(OH)D concentration <50 nmol/L. There was no significant association between 25(OH)D and chronic pain, with vitamin D status categorized in four groups: <25.0, 25.0-49.9, 50.0-74.9, and ≥75.0 nmol/L (the highest group as reference). The unadjusted RRs were 1.09, 1.10, and 1.08, respectively (Ptrend = 0.24). Adjustment for demographics, lifestyle, BMI, medical history, prescription of analgesics and vitamin D supplements did not change this finding. Similar non-significant results were observed in participants with arthritis (n = 1732) or depression (n = 528). In this multi-ethnic, community-selected sample of older adults in New Zealand, serum 25(OH)D levels were not associated with chronic pain. These results do not support a role for low vitamin D status in the prevalence of chronic pain in older adults.
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Affiliation(s)
- Zhenqiang Wu
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - John D Sluyter
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Kay-Tee Khaw
- Department of Public Health, University of Cambridge, Cambridge, England, United Kingdom
| | - Zarintaj Malihi
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Debbie Waayer
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Les Toop
- Department of Public Health & General Practice, The University of Otago, Christchurch, New Zealand
| | - Carlene M M Lawes
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Robert Scragg
- School of Population Health, The University of Auckland, Auckland, New Zealand.
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Abdul‐Razzak KK, Alshogran OY, Altawalbeh SM, Al‐Ghalayini IF, Al‐Ghazo MA, Alazab RS, Halalsheh OM, Sahawneh FE. Overactive bladder and associated psychological symptoms: A possible link to vitamin D and calcium. Neurourol Urodyn 2019; 38:1160-1167. [DOI: 10.1002/nau.23975] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/11/2019] [Accepted: 02/26/2019] [Indexed: 01/23/2023]
Affiliation(s)
- Khalid K. Abdul‐Razzak
- Department of Clinical PharmacyFaculty of PharmacyJordan University of Science and TechnologyIrbid Jordan
| | - Osama Y. Alshogran
- Department of Clinical PharmacyFaculty of PharmacyJordan University of Science and TechnologyIrbid Jordan
| | - Shoroq M. Altawalbeh
- Department of Clinical PharmacyFaculty of PharmacyJordan University of Science and TechnologyIrbid Jordan
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Drummond J. Functional Nutrition Treatment of Vulvodynia, Irritable Bowel Syndrome, and Depression: A Case Report. Integr Med (Encinitas) 2018; 17:44-51. [PMID: 30962795 PMCID: PMC6396768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A 34-y-old pregnant woman previously diagnosed with vulvodynia, irritable bowel syndrome (IBS), and depression used an elimination diet and nutritional supplementation-from 15 wk pregnant to 22 wk postpartum-to resolve her vulvodynia and IBS, and to reduce her use of antidepressant medication. This case demonstrates the potential usefulness of incorporating a customized functional nutritional approach to evaluate potential proinflammatory foods and nutritional insufficiencies in perinatal patients and postnatal patients.
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Affiliation(s)
- Jessica Drummond
- Corresponding author: Jessica Drummond, DCN, CNS, PT E-mail address:
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40
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Han J, Zhang X, Saraf SL, Gowhari M, Molokie RE, Hassan J, Jain S, Shah BN, Abbasi T, Machado RF, Gordeuk VR. Risk factors for vitamin D deficiency in sickle cell disease. Br J Haematol 2018; 181:828-835. [PMID: 29767851 DOI: 10.1111/bjh.15270] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/23/2018] [Indexed: 12/22/2022]
Abstract
Vitamin D deficiency (VDD), 25-OHD levels <20 ng/ml, is prevalent among patients with sickle cell disease (SCD) and is linked to acute and chronic pain and bone fracture in this population. There is limited literature regarding VDD-associated risk factors for SCD. We examined potential clinical and genomic parameters associated with VDD in 335 adults with SCD in a cross-sectional study. VDD was present in 65% of adult SCD patients, and 25-OHD levels independently and positively correlated with older age (P < 0·001) and vitamin D supplementation (P < 0·001). 25-OHD levels were higher in SCD patients over 40 years of age compared to the general African-American population. Both lower 25-OHD levels and increased pain frequency were associated with increased expression of SLC6A5 encoding glycine transporter-2 (GlyT2), a protein involved in neuronal pain pathways. Lower 25-OHD levels were also associated with increased expression of CYP3A4, and with decreased expression of GC (also termed DBP) and VDR, three genes involved in vitamin D metabolism. We conclude that vitamin D supplementation should be an almost universal feature of the care of young adults with SCD, and that further research is warranted into genomic factors that regulate vitamin D metabolism in SCD.
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Affiliation(s)
- Jin Han
- Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, USA.,Department of Medicine, Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA.,Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Xu Zhang
- Department of Medicine, Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA
| | - Santosh L Saraf
- Department of Medicine, Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA
| | - Michel Gowhari
- Department of Medicine, Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA
| | - Robert E Molokie
- Department of Medicine, Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA.,Jesse Brown VA Medical Center, Chicago, IL, USA
| | - Johara Hassan
- Department of Medicine, Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA
| | - Shivi Jain
- Department of Medicine, Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA
| | - Binal N Shah
- Department of Medicine, Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA
| | - Taimur Abbasi
- Department of Medicine, Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA
| | - Roberto F Machado
- Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Indiana University Department of Medicine, Indianapolis, IN, USA
| | - Victor R Gordeuk
- Department of Medicine, Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA
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41
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Alkhatatbeh MJ, Abdul-Razzak KK, Khasawneh LQ, Saadeh NA. Prevalence of musculoskeletal pain in association with serum 25-hydroxyvitamin D concentrations in patients with type 2 diabetes mellitus. Biomed Rep 2018; 8:571-577. [PMID: 29904613 DOI: 10.3892/br.2018.1093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/25/2018] [Indexed: 01/08/2023] Open
Abstract
The aim of the present study was to investigate the prevalence of musculoskeletal pain in patients with type 2 diabetes mellitus (T2DM) in association with 25-hydroxyvitamin D levels, anxiety, depression and neuropathy. A cross-sectional study was conducted involving a total of 124 T2DM patients. Musculoskeletal pain was determined by self-reporting of painful body sites. Pain intensity was assessed using a scale of 0-10. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Neuropathy was assessed using the PainDETECT questionnaire. The concentration of 25-hydroxyvitamin D was measured using liquid chromatography-tandem mass spectrometry. Fasting blood sugar (FBS) was determined using the hexokinase method and glycated hemoglobin (HbA1c) level was determined using turbidimetric inhibition immunoassay. The neck, lower back and head were reported as the most common painful sites (affected in 60.5, 60.5 and 56.5% of patients, respectively). Pain in the lower extremities, including the knees, lower legs and feet, was more common compared with pain in the upper extremities. The pain measurements of number of painful sites and pain intensity did not differ significantly among patients with sufficient (>30 ng/ml), insufficient (20-30 ng/ml) and deficient (<20 ng/ml) vitamin D levels (P>0.05). The pain measurements were identified to have no correlation with age, body mass index, FBS, HbA1c level, 25-hydroxyvitamin D concentration, anxiety or depression (P>0.05). However, the pain measurements were correlated with duration of T2DM and neuropathy score (P<0.05). Further regression analysis demonstrated that the pain measurements were significantly associated with the neuropathy score (P<0.05). In conclusion, musculoskeletal pain in patients with T2DM was not associated with 25-hydroxyvitamin D concentration, but was associated with neuropathy score. This may encourage further investigations to assess the etiology of musculoskeletal pain in T2DM, and whether vitamin D supplementation and management of neuropathy would be of value as pain relief treatment.
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Affiliation(s)
- Mohammad J Alkhatatbeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Khalid K Abdul-Razzak
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Lubna Q Khasawneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Nesreen A Saadeh
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
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Food pyramid for subjects with chronic pain: foods and dietary constituents as anti-inflammatory and antioxidant agents. Nutr Res Rev 2018; 31:131-151. [PMID: 29679994 DOI: 10.1017/s0954422417000270] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Emerging literature suggests that diet constituents may play a modulatory role in chronic pain (CP) through management of inflammation/oxidative stress, resulting in attenuation of pain. We performed a narrative review to evaluate the existing evidence regarding the optimum diet for the management of CP, and we built a food pyramid on this topic. The present review also describes the activities of various natural compounds contained in foods (i.e. phenolic compounds in extra-virgin olive oil (EVO)) listed on our pyramid, which have comparable effects to drug management therapy. This review included 172 eligible studies. The pyramid shows that carbohydrates with low glycaemic index should be consumed every day (three portions), together with fruits and vegetables (five portions), yogurt (125 ml), red wine (125 ml) and EVO; weekly: legumes and fish (four portions); white meat, eggs and fresh cheese (two portions); red or processed meats (once per week); sweets can be consumed occasionally. The food amounts are estimates based on nutritional and practical considerations. At the top of the pyramid there is a pennant: it means that CP subjects may need a specific customised supplementation (vitamin B12, vitamin D, n-3 fatty acids, fibre). The food pyramid proposal will serve to guide dietary intake with to the intent of alleviating pain in CP patients. Moreover, a targeted diet can also help to solve problems related to the drugs used to combat CP, i.e. constipation. However, this paper would be an early hypothetical proposal due to the limitations of the studies.
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Mat S, Jaafar MH, Sockalingam S, Raja J, Kamaruzzaman SB, Chin AV, Abbas AA, Chan CK, Hairi NN, Othman S, Cumming R, Tan MP. Vitamin D deficiency is associated with ethnicity and knee pain in a multi-ethnic South-East Asian nation: Results from Malaysian Elders Longitudinal Research (MELoR). Int J Rheum Dis 2018; 21:930-936. [PMID: 29611292 DOI: 10.1111/1756-185x.13279] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIM To determine the association between vitamin D and knee pain among participants of the Malaysian Elders Longitudinal Research (MELoR) study. METHOD This was a cross-sectional study from the MELoR study consisting of a representative group of 1011 community-dwelling older persons (57% female), mean age 86.5 (54-94) years; 313 were Malays, 367 Chinese and 330 Indians. Participants were asked if they had knee pain. Levels of serum 25-hydroxy cholecalciferol (25-[OH]D), an indicator of vitamin D status, were measured using routine laboratory techniques. RESULTS In unadjusted analysis, presence of knee pain was significantly associated with vitamin D deficiency (odds ratio [OR] 1.42; 95% confidence interval (CI) 1.08-1.85, P 0.011). Vitamin D levels were significantly associated with ethnicity differences where Malays (OR 7.08; 95% CI 4.94-10.15) and Indians (OR 6.10; 95% CI 4.28-9.71) have lower levels of vitamin D compared to Chinese. Subsequent multivariate analysis revealed that the association between vitamin D deficiency and knee pain was confounded by ethnic differences. CONCLUSION A previous study suggested that vitamin D deficiency was associated with knee pain. This relationship was reproduced in our study, but we further established that the association was explained by ethnic variations. As vitamin D status is dependent on skin tone, diet and sunlight exposure, which are all effected by ethnicity, future studies are now required to determine whether a true relationship exists between vitamin D and knee pain.
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Affiliation(s)
- Sumaiyah Mat
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohamad Hasif Jaafar
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Jasmin Raja
- Department of Rheumatology, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Ai-Vyrn Chin
- Geriatric Division, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Azlina Amir Abbas
- National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), Department of Orthopaedic Surgery, University of Malaya, Kuala Lumpur, Malaysia
| | - Chee Ken Chan
- National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), Department of Orthopaedic Surgery, University of Malaya, Kuala Lumpur, Malaysia
| | - Noran Naqiah Hairi
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sajaratulnisah Othman
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Robert Cumming
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia.,Geriatric Division, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Abstract
Integrative health modalities can provide useful tools in the management of persistent pain in the primary care setting. These modalities, such as acupuncture, mind-body medicine, diet and herbs, and movement strategies can be safely used and may provide patients with hope and empowerment. It is highly recommended that the patient work alongside trained professionals for a given modality and/or an interprofessional team.
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The association between vitamin D concentration and pain: a systematic review and meta-analysis. Public Health Nutr 2018; 21:2022-2037. [DOI: 10.1017/s1368980018000551] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AbstractObjectivePain-related conditions, such as chronic widespread pain and fibromyalgia, are major burdens for individuals and the health system. Evidence from previous research on the association between circulating 25-hydroxyvitamin D (25(OH)D) concentrations and pain is conflicting. Thus, we aimed to determine if there is an association between mean 25(OH)D concentration (primary aim), or proportion of hypovitaminosis D (secondary aim), and pain conditions in observational studies.DesignPublished observational research on 25(OH)D concentration and pain-related conditions was systematically searched for in electronic sources (MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials) and a random-effects meta-analysis was conducted on included studies.ResultsEighty-one observational studies with a total of 50 834 participants were identified. Compared with controls, mean 25(OH)D concentration was significantly lower in patients with arthritis (mean difference (MD): −12·34 nmol/l;P<0·001), muscle pain (MD: −8·97 nmol/l;P=0·003) and chronic widespread pain (MD: −7·77 nmol/l;P<0·001), but not in patients with headache or migraine (MD: −2·53 nmol/l;P=0·06). The odds of vitamin D deficiency was increased for arthritis, muscle pain and chronic widespread pain, but not for headache or migraine, compared with controls. Sensitivity analyses revealed similar results.ConclusionsA significantly lower 25(OH)D concentration was observed in patients with arthritis, muscle pain and chronic widespread pain, compared with those without. These results suggest that low 25(OH)D concentrations may be associated with pain conditions.
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Oskovi Kaplan ZA, Taşçi Y, Topçu HO, Erkaya S. 25-Hydroxy vitamin D levels in premenopausal Turkish women with uterine leiomyoma. Gynecol Endocrinol 2018; 34:261-264. [PMID: 29067857 DOI: 10.1080/09513590.2017.1391774] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
We aimed to evaluate the relationship between serum 25-hydroxy vitamin D levels and the risk of uterine fibroids in premenopausal women in Turkish population in this prospective observational cross-sectional study. Sixty-eight women with at least one uterine leiomyoma ≥10 mm were compared with 56 healthy controls. Serum 25-(OH) vitamin D3 levels were measured by electrochemiluminescence immunoassay. The groups were similar in terms of age, BMI, gravidity and parity numbers. The mean level of 25-(OH) D3 were 7.28 ± 4.94 ng/ml and 78% of patients (n = 97) had severe vitamin D deficiency ( < 10 ng/mL). Vitamin D levels were significantly lower in the study group (6.54 ± 4.66 ng/ml vs. 8.18 ± 5.16 ng/ml, respectively; p = .009). Vitamin D levels were not correlated with size, volume, localization and number of leiomyomas. Traditional covered clothing style, low education level and being housewife were risk factors for Vitamin D deficiency. This is the first study that investigates the vitamin D levels in women with leiomyomas in Turkish population. Influence of vitamin D on uterine leiomyoma formation to may lead to new preventive strategies in the future.
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Affiliation(s)
| | - Yasemin Taşçi
- a Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
| | - Hasan Onur Topçu
- a Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
| | - Salim Erkaya
- a Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey
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Monthly vitamin D supplementation, pain, and pattern of analgesic prescription: secondary analysis from the randomized, double-blind, placebo-controlled Vitamin D Assessment study. Pain 2018; 159:1074-1082. [DOI: 10.1097/j.pain.0000000000001189] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Babaei M, Esmaeili Jadidi M, Heidari B, Gholinia H. Vitamin D deficiency is associated with tibial bone pain and tenderness. A possible contributive role. Int J Rheum Dis 2018; 21:788-795. [PMID: 29314669 DOI: 10.1111/1756-185x.13253] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Vitamin D deficiency is associated with osteomalacia and a variety of musculoskeletal pain. This study aimed to determine the association of vitamin D deficiency with tibial bone pain and tenderness. METHODS Patients with leg pain, defined as local pain and tenderness over tibial bones for ≥ 6 weeks were consecutively selected. Secondary causes of pain were excluded by appropriate clinical, radiological and laboratory examinations. Serum 25-hydroxyvitamin D (25-OHD) was assessed by enzyme-linked immunosorbent assay method and levels < 20 ng/mL were considered as deficiency. Age- and sex-matched subjects without leg pain served as controls. Multiple logistic regression analysis was used to determine associations. RESULTS One hundred and eighteen patients and 114 controls aged 46.8 ± 14.8 and 44.6 ± 14.1 years, respectively (P = 0.93) were analyzed. Mean 25-OHD level was significantly lower (P = 0.001) and the prevalence of 25-OHD deficiency was significantly higher in the patients as compared with the controls (75.4% vs. 23.6%), odds ratio (OR) = 9.54 (95% CI, 5.22-17.45, P = 0.001). There was a negative dose-response relationship between serum 25-OHD and tibial bone pain by OR = 17.33 (95% CI, 6.48-46.3) in subjects with 25-OHD < 10 ng/mL, and OR = 14.7 (95% CI, 6.35-34.6) in serum 25-OHD levels at 10-19.9 ng/mL, and OR = 2.58 (95% CI, 1.08-6.1) in those with 25-OHD at 20-29.9 ng/mL as compared with 25-OHD ≥ 30 ng/mL. After controlling for demographic and biochemical factors, the association reached a stronger level of 19.8 (6.9-56.3) in subjects with serum 25-OHD < 10 ng/mL and 14.4 (5.8-34.6) in those with serum 25-OHD at levels of 10-19.9 ng/mL and 1.85 (0.73-4.6) in 20-29 ng/mL. CONCLUSION These findings indicate a possible contributive role for serum 25-OHD deficiency in the development of pain and tenderness over the tibial bone.
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Affiliation(s)
- Mansour Babaei
- Mobility Impairment Research Center, Babol University Of Medical Sciences, Babol, Iran.,Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.,Division Rheumatology, Department of Medicine, Rouhani Hospital, Babol, Iran
| | | | - Behzad Heidari
- Mobility Impairment Research Center, Babol University Of Medical Sciences, Babol, Iran.,Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Hemmat Gholinia
- Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.,Student Research Committee, Master of Biostatistics and Epidemiology, Babol University of Medical Science, Babol, Iran.,Health Research Center, Master of Biostatistics and Epidemiology, Babol University of Medical Science, Babol, Iran
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Helde-Frankling M, Björkhem-Bergman L. Vitamin D in Pain Management. Int J Mol Sci 2017; 18:E2170. [PMID: 29057787 PMCID: PMC5666851 DOI: 10.3390/ijms18102170] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 09/29/2017] [Accepted: 10/11/2017] [Indexed: 12/12/2022] Open
Abstract
Vitamin D is a hormone synthesized in the skin in the presence of sunlight. Like other hormones, vitamin D plays a role in a wide range of processes in the body. Here we review the possible role of vitamin D in nociceptive and inflammatory pain. In observational studies, low vitamin D levels have been associated with increased pain and higher opioid doses. Recent interventional studies have shown promising effects of vitamin D supplementation on cancer pain and muscular pain-but only in patients with insufficient levels of vitamin D when starting intervention. Possible mechanisms for vitamin D in pain management are the anti-inflammatory effects mediated by reduced cytokine and prostaglandin release and effects on T-cell responses. The recent finding of vitamin D-mediated inhibition of Prostaglandin E2 (PGE2) is especially interesting and exhibits a credible mechanistic explanation. Having reviewed current literature, we suggest that patients with deficient levels defined as 25-hydroxyvitamin D (25-OHD) levels <30 nmol/L are most likely to benefit from supplementation, while individuals with 25-OHD >50 nmol/L probably have little benefit from supplementation. Our conclusion is that vitamin D may constitute a safe, simple and potentially beneficial way to reduce pain among patients with vitamin D deficiency, but that more randomized and placebo-controlled studies are needed before any firm conclusions can be drawn.
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Affiliation(s)
- Maria Helde-Frankling
- ASIH Stockholm Södra, Långbro Park, Palliative Home Care and Hospice Ward, Bergtallsvägen 12, SE-125 59 Älvsjö, Sweden.
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden.
| | - Linda Björkhem-Bergman
- ASIH Stockholm Södra, Långbro Park, Palliative Home Care and Hospice Ward, Bergtallsvägen 12, SE-125 59 Älvsjö, Sweden.
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden.
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Fayed HL, Saleh AH. Frequency of vitamin D inadequacy among Saudi males visiting a Rheumatology Outpatient Clinic of a tertiary hospital in Al-Qassim region: Effect of vitamin D supplementation. THE EGYPTIAN RHEUMATOLOGIST 2017. [DOI: 10.1016/j.ejr.2017.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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