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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Article info
Publication history
Published online: September 12, 2017
Accepted:
August 22,
2017
Received in revised form:
August 16,
2017
Received:
February 27,
2017
Footnotes
This research was supported in part by funding from the Scan|Design Foundation to the University of Washington's Innovations in Pain Research Program.
D.C.T. has consulted for the following companies in the past 3 years: Pfizer, Nektar, Develco, Ironwood, Mallincrodt, Orexo, and Xydnia. All other authors have no conflicts of interest to declare.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
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© 2017 by the American Pain Society
