ARC Epidemiology Unit, University of Manchester, Oxford Road, Manchester M13 9PT, UK.
Ann Rheum Dis. 2010 Aug;69(8):1448-52. doi: 10.1136/ard.2009.116053. Epub 2010 May 24.
A study was undertaken to test the hypothesis that musculoskeletal pain is associated with low vitamin D levels but the relationship is explained by physical inactivity and/or other putative confounding factors.
Men aged 40-79 years completed a postal questionnaire including a pain assessment and attended a clinical assessment (lifestyle questionnaire, physical performance tests, 25-hydroxyvitamin D3 (25-(OH)D) levels from fasting blood sample). Subjects were classified according to 25-(OH)D levels as 'normal' (> or = 15 ng/ml) or 'low' (< 15 ng/ml). The relationship between pain status and 25-(OH)D levels was assessed using logistic regression. Results are expressed as ORs and 95% CIs.
3075 men of mean (SD) age 60 (11) years were included in the analysis. 1262 (41.0%) subjects were pain-free, 1550 (50.4%) reported 'other pain' that did not satisfy criteria for chronic widespread pain (CWP) and 263 (8.6%) reported CWP. Compared with patients who were pain-free, those with 'other pain' and CWP had lower 25-(OH)D levels (n=239 (18.9%), n=361 (23.3) and n=67 (24.1%), respectively, p<0.05). After adjusting for age, having 'other pain' was associated with a 30% increase in the odds of having low 25-(OH)D while CWP was associated with a 50% increase. These relationships persisted after adjusting for physical activity levels. Adjusting for additional lifestyle factors (body mass index, smoking and alcohol use) and depression attenuated these relationships, although pain remained moderately associated with increased odds of 20% of having low vitamin D levels.
These findings have implications at a population level for the long-term health of individuals with musculoskeletal pain.
本研究旨在验证肌肉骨骼疼痛与低维生素 D 水平相关的假设，但这种关系可以通过身体活动不足和/或其他潜在混杂因素来解释。
40-79 岁的男性完成了一份邮寄问卷，其中包括疼痛评估，并参加了临床评估（生活方式问卷、身体机能测试、空腹血样中的 25-羟基维生素 D3（25-(OH)D）水平）。根据 25-(OH)D 水平，受试者被分为“正常”（≥15ng/ml）或“低”（<15ng/ml）。使用逻辑回归评估疼痛状况与 25-(OH)D 水平之间的关系。结果表示为 OR 和 95%CI。
共纳入 3075 名平均（标准差）年龄 60（11）岁的男性。1262 名（41.0%）受试者无疼痛，1550 名（50.4%）报告“其他疼痛”，但不符合慢性广泛性疼痛（CWP）的标准，263 名（8.6%）报告 CWP。与无痛患者相比，有“其他疼痛”和 CWP 的患者 25-(OH)D 水平较低（分别为 239 名[18.9%]、361 名[23.3%]和 67 名[24.1%]，p<0.05）。调整年龄后，有“其他疼痛”的患者发生低 25-(OH)D 的几率增加 30%，而 CWP 则增加 50%。这些关系在调整身体活动水平后仍然存在。调整其他生活方式因素（体重指数、吸烟和饮酒）和抑郁后，这些关系减弱，但疼痛与 20%维生素 D 水平较低的几率增加仍存在中度相关性。
这些发现对肌肉骨骼疼痛患者的人群长期健康具有重要意义。
