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Chronic Pain and Telomere Length in Community-Dwelling Adults: Findings From the 1999 to 2002 National Health and Nutrition Examination Survey

  • Alta M. Steward
    Affiliations
    Center for Pain Research on Impact, Measurement, and Effectiveness, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington

    Computational Neuroscience Program, University of Washington, Seattle
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  • Julia D. Morgan
    Affiliations
    Center for Pain Research on Impact, Measurement, and Effectiveness, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington

    Macalester College, St. Paul, Minnesota
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  • Juan P. Espinosa
    Affiliations
    Center for Pain Research on Impact, Measurement, and Effectiveness, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington
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  • Dennis C. Turk
    Affiliations
    Center for Pain Research on Impact, Measurement, and Effectiveness, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington
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  • Kushang V. Patel
    Correspondence
    Address reprint requests to Kushang V. Patel, PhD, Box 356540, 1959 NE Pacific Street, Seattle, WA 98115.
    Affiliations
    Center for Pain Research on Impact, Measurement, and Effectiveness, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington

    Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, Washington
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Published:September 12, 2017DOI:https://doi.org/10.1016/j.jpain.2017.08.006

      Highlights

      • Biopsychosocial stress associated with chronic pain may accelerate the aging process.
      • Leukocyte telomere length (LTL) is a recognized biomarker of cellular aging.
      • In this nationally representative study, chronic pain was not associated with LTL.
      • There were no significant interactive effects of pain and emotional distress on LTL.
      • Further investigation of LTL with more comprehensive assessment of pain is needed.

      Abstract

      Chronic pain is a common condition associated with psychological distress, functional impairments, and age-associated comorbidity. Preliminary studies, on the basis of relatively small sample sizes, suggest that the combination of chronic pain and stress is associated with telomere shortening, a widely recognized marker of cellular aging. We sought to determine the cross-sectional association of chronic pain with telomere length in 7,816 community-dwelling adults ages 20 years and older who participated in the 1999 to 2002 National Health and Nutrition Examination Survey. Consistent with previous studies, leukocyte telomere length was assessed using the quantitative polymerase chain reaction method and compared with a DNA reference standard to compute a telomere to single copy gene ratio. Standardized, in-person interviews were used to identify chronic regional pain and chronic widespread pain in 784 (10.0%) and 266 (3.4%) participants, respectively. Older age, male sex, obesity, and less physical activity were associated with shorter telomere length (P <.05 for all comparisons); however, there was no association of chronic pain with telomere length. The age-adjusted means (standard error) of telomere length telomere to single copy gene ratios were 1.04 (.02), 1.03 (.02), and 1.02 (.02) in participants with no chronic pain, chronic regional pain, and chronic widespread pain, respectively (P = .69). In addition, chronic pain did not modify the effects of age, sex, race/ethnicity, education, or psychological distress on telomere length. In summary, chronic regional and widespread pain were not associated with telomere length in this nationally representative study; however, we could not determine associations of pain duration and severity with telomere length because of limitations in pain assessment data.

      Perspective

      The findings from the current study do not support the hypothesis that chronic pain accelerates cellular aging measured according to leukocyte telomere length. Additional population-based studies with more detailed assessments of pain and stress are needed to further investigate potential interactive effects on telomere length and other biomarkers of aging.

      Key words

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