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Vitamin D Insufficiency Increases Risk of Chronic Pain Among African Americans Experiencing Motor Vehicle Collision - PubMed

Last updated: 06-08-2020

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Vitamin D Insufficiency Increases Risk of Chronic Pain Among African Americans Experiencing Motor Vehicle Collision - PubMed

doi: 10.1097/j.pain.0000000000001728.
Vitamin D Insufficiency Increases Risk of Chronic Pain Among African Americans Experiencing Motor Vehicle Collision
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Affiliations
1 Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, United States.
2 Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL, United States.
3 Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, United States.
4 Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI, United States.
5 Department of Emergency Medicine, Sinai Grace, Detroit, MI, United States.
6 Department of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, PA, United States.
7 Department of Emergency Medicine, Detroit Receiving, Detroit, MI, United States.
8 Department of Emergency Medicine, St. Joseph Mercy Health System, Ypsilanti, Michigan.
9 Department of Community Dentistry & Behavioral Science, University of Florida College of Dentistry, Gainesville, FL, United States.
10 Department of Emergency Medicine, Rhode Island Hospital, The Alpert Medical School of Brown University, Providence, RI, United States.
11 Lineberger Cancer Center and the Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC, United States.
12 Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC, United States.
PMID: 31651575
Vitamin D Insufficiency Increases Risk of Chronic Pain Among African Americans Experiencing Motor Vehicle Collision
Matthew C Mauck et al. Pain.
2020 Feb
doi: 10.1097/j.pain.0000000000001728.
Authors
Affiliations
1 Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, United States.
2 Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL, United States.
3 Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, United States.
4 Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI, United States.
5 Department of Emergency Medicine, Sinai Grace, Detroit, MI, United States.
6 Department of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, PA, United States.
7 Department of Emergency Medicine, Detroit Receiving, Detroit, MI, United States.
8 Department of Emergency Medicine, St. Joseph Mercy Health System, Ypsilanti, Michigan.
9 Department of Community Dentistry & Behavioral Science, University of Florida College of Dentistry, Gainesville, FL, United States.
10 Department of Emergency Medicine, Rhode Island Hospital, The Alpert Medical School of Brown University, Providence, RI, United States.
11 Lineberger Cancer Center and the Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC, United States.
12 Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC, United States.
PMID: 31651575
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Abstract
African Americans experience an increased burden of motor vehicle collision (MVC), post-MVC musculoskeletal pain, and vitamin D insufficiency. In this prospective multicenter study, we tested the hypothesis that African Americans (n = 133) presenting to the emergency department after MVC with low peritraumatic vitamin D levels would have worse chronic musculoskeletal pain outcomes compared to individuals with sufficient vitamin D. Vitamin D levels were assessed in the early aftermath of MVC through enzyme-linked immunosorbent assay, and pain severity was assessed using the 0 to 10 numeric rating scale at 6 weeks, 6 months, and 1 year. In repeated-measures analysis, African American MVC survivors with vitamin D insufficiency experienced more severe chronic pain (β = 1.18, P = 0.031). In secondary analyses, we assessed for evidence that the effect of vitamin D on post-MVC pain outcomes is mediated, at least in part, by the influence of vitamin D on genetic variants in genes involved in immune system regulation (IL-10 and NLRP3). Genotyping was performed using a genome-wide microarray using collected DNA samples. Secondary analyses suggest that the effect of vitamin D on post-MVC pain outcomes may be influenced by genetic variation in IL-10 and NLRP3. Further studies are needed to assess the impact of vitamin D insufficiency on pain outcomes in African Americans experiencing MVC and other common trauma exposures, to assess factors affecting this relationship, and to assess the efficacy of administering vitamin D in the immediate aftermath of MVC to prevent chronic pain. Such low-cost, nonopioid interventions are urgently needed to address chronic pain development after MVC.
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