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Investigating the Burden of Chronic Pain: An Inflammatory and Metabolic Composite
Kimberly T Sibille1, Ólöf A Steingrímsdóttir2, Roger B Fillingim3
1Department of Aging & Geriatric Research, University of Florida, Gainesville, FL 32610, USA; Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32610, USA.
Insights
Chronic pain is linked to a higher composite of risk factors, including body mass index and triglycerides. This association strengthens with increasing pain severity, highlighting a significant biological burden.
Area of Science:
- Cardiovascular disease and cancer research
- Pain medicine and management
- Biomarkers and risk factor analysis
Background:
- Chronic pain contributes significantly to increased morbidity and mortality, particularly from cardiovascular disease and cancer.
- Understanding the biological burden of chronic pain is crucial for developing effective interventions.
- Previous research indicates a link between chronic pain and adverse health outcomes.
Purpose of the Study:
- To investigate the association between chronic pain severity and a composite measure of cardiovascular risk factors.
- To determine if a dose-response relationship exists between pain severity and the risk factor composite.
- To explore the influence of health behaviors on this relationship.
Main Methods:
- Analysis of data from 12,982 participants in the 6th Tromsø study.
- Utilized questionnaires covering demographics, health behaviors, comorbidities, and chronic pain symptoms.
- Risk factor composite included body mass index, fibrinogen, C-reactive protein, and triglycerides.
Main Results:
- Individuals with chronic pain exhibited a significantly greater risk factor composite compared to pain-free individuals, even after excluding inflammation-related conditions (p < 0.001).
- A significant dose-response relationship was observed, with increasing pain severity correlating with a higher risk factor composite (p < 0.001).
- Health behaviors, such as exercise and smoking, influenced the risk factor composite in individuals with chronic pain.
Conclusions:
- The composite of cardiovascular risk factors is elevated in individuals with chronic pain.
- Pain severity directly correlates with the magnitude of this biological risk composite.
- This composite serves as a valuable indicator sensitive to pain severity and behavioral influences, with potential clinical and research applications.
Abstract:
Background. Chronic pain is associated with increased morbidity and mortality, predominated by cardiovascular disease and cancer. Investigating related risk factor measures may elucidate the biological burden of chronic pain. Objectives. We hypothesized that chronic pain severity would be positively associated with the risk factor composite. Methods. Data from 12,982 participants in the 6th Tromsø study were analyzed. Questionnaires included demographics, health behaviors, medical comorbidities, and chronic pain symptoms. The risk factor composite was comprised of body mass index, fibrinogen, C-reactive protein, and triglycerides. Chronic pain severity was characterized by frequency, intensity, time/duration, and total number of pain sites. Results. Individuals with chronic pain had a greater risk factor composite than individuals without chronic pain controlling for covariates and after excluding inflammation-related health conditions (p < 0.001). A significant "dose-response" relationship was demonstrated with pain severity (p < 0.001). In individuals with chronic pain, the risk factor composite varied by health behavior, exercise, lower levels and smoking, and higher levels. Discussion. The risk factor composite was higher in individuals with chronic pain, greater with increasing pain severity, and influenced by health behaviors. Conclusions. Identification of a biological composite sensitive to pain severity and adaptive/maladaptive behaviors would have significant clinical and research utility.
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