Vitamin D and chronic widespread pain in a white middle-aged British population: evidence from a cross-sectional population survey
- 1MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, UK
- 2Aberdeen Pain Research Collaboration (Epidemiology group), University of Aberdeen, Aberdeen, UK
- Dr E Hyppönen, MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK;
- Accepted 27 May 2008
- Published Online First 12 August 2008
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 (25(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 75–99 nmol/l (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.
Competing interests: None.
Funding: Data collection at age 44-46 years and support for KA and DJB was provided by the UK Medical Research Council (grant G0000934), 25(OH)D assays were funded by the BUPA Foundation. EH is funded by the Department of Health (UK) Public Health Career Scientist Award. This work was undertaken at Great Ormond Street Hospital/University College London, Institute of Child Health, which received a proportion of funding from the Department of Health’s National Institute of Health Research (“Biomedical Research Centres” funding). The Medical Research Council provides funds for the MRC Centre of Epidemiology for Child Health.
Ethics approval: Ethical approval was obtained from the South East Multi-Centre Research Ethics Committee (ref 01/1/44).
▸ An additional table is published online only at http://ard.bmj.com/content/vol68/issue6