Vitamin D and chronic widespread pain in a white middle-aged British population: evidence from a cross-sectional population survey
Ann Rheum Dis 2009;68:817-822 doi:10.1136/ard.2008.090456
Background: Identified aetiological factors for chronic widespread pain (CWP) are largely related to emotional and behavioural factors, but current management leads to modest improvement in symptoms. Vitamin D deficiency has been suggested as a new modifiable risk factor for CWP.
Objective: To examine the association between vitamin D status (measured by 25-hydroxyvitamin D OH)D and CWP in a nationwide population sample of white British adults, accounting for potential mediating and confounding lifestyle factors.
Methods: 9377 participants born 1 week in March 1958, in England, Scotland or Wales and completing a biomedical assessment at age 45; 6824 eligible participants had data on 25(OH)D and completed pain manikins.
Results: Prevalence of CWP varied by 25(OH)D concentration in women but not in men, with the lowest prevalence observed for women with
- 14.4% for <25 nmol/l,
- 14.8% for 25–49 nmol/l,
- 11.6% for 50–74 nmo/l,
- 8.2% for 75–99 nmol/l and
- 9.8% for participants with ?100 nmol/l).
There was an interaction between 25(OH)D concentration and gender in relation to CWP (interaction, p?=?0.006), which was not fully explained by differences in lifestyle or social factors (adjusted interaction, p?=?0.03). For women, the association between 25(OH)D concentration and CWP persisted after full adjustment (odds ratio (OR) for <75 nmol/l vs 75–99 nmol/l 1.57, 95% CI 1.09 to 2.26), while no evidence for an association was apparent in men (OR?=?1.03, 95% CI 0.75 to 1.43).
Conclusion: Current vitamin D status was associated with CWP in women but not in men.
Follow-up studies are needed to evaluate whether higher vitamin D intake might have beneficial effects on the risk of CWP.
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