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The mediating effect of allostatic load on the association between life course socioeconomic disadvantage and chronic pain: a prospective finding from the National Survey of Midlife Development in the United States

BACKGROUND: Socioeconomic disadvantages (SEDs) are associated with chronic pain (CP) and allostatic load (AL). Few prospective population-based studies have examined the relationship between life course SED, CP interference, and CP widespreadness, and there is no prospective population-based study o...

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Autor principal: Liang, Yunlong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10374263/
https://www.ncbi.nlm.nih.gov/pubmed/37521943
http://dx.doi.org/10.3389/fpain.2023.1213750
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author Liang, Yunlong
author_facet Liang, Yunlong
author_sort Liang, Yunlong
collection PubMed
description BACKGROUND: Socioeconomic disadvantages (SEDs) are associated with chronic pain (CP) and allostatic load (AL). Few prospective population-based studies have examined the relationship between life course SED, CP interference, and CP widespreadness, and there is no prospective population-based study on whether AL mediates the association between SED and CP. OBJECTIVE: In this study, we investigated whether the prospective effect of SED on CP at Midlife in the United States (MIDUS) 3 is consistent with the accumulation of risk model and social mobility model, using the National Survey of MIDUS (n = 593). To prepare for the mediation analysis, we tested (1) whether SED would be prospectively associated with AL in the MIDUS 2 biomarker project, (2) whether AL would be prospectively associated with CP, and (3) whether childhood, as a critical period, moderated the association between AL and CP. In addition, the mediating effect of AL on the association between SED and CP was examined. METHOD: SED was measured using cumulative scores and disadvantage trajectories derived from latent class trajectory modeling (LCTM). After multiple imputations, analyses were conducted using multinomial logistic regression for CP and negative binomial regression for AL, respectively. Finally, mediation analyses and moderated mediation analyses were performed. RESULTS: LCTM identified three SED trajectories, namely, constant low, high to low, and medium to high. The results showed that proximal cumulative SED was associated with high-interference CP. Furthermore, compared with the group with constant low SED, the group with medium-to-high SED was significantly associated with high-interference pain and experienced pain in at least three different sites. Cumulative SED and deteriorating SED trajectories were associated with higher AL, consistent with previous studies. Furthermore, childhood SED moderated the effect of AL on CP widespreadness and unexpectedly demonstrated a protective effect, while other associations between AL and CP were not significant. Subsequent mediation analysis did not yield statistically significant evidence. CONCLUSIONS: People who experienced more recent SED or increasing disadvantage throughout their lives were more likely to suffer from CP, and this association was not mediated by physiological system dysregulation caused by chronic stress. Therefore, measures to alleviate AL may not be effective in protecting socioeconomically disadvantaged populations from CP.
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spelling pubmed-103742632023-07-28 The mediating effect of allostatic load on the association between life course socioeconomic disadvantage and chronic pain: a prospective finding from the National Survey of Midlife Development in the United States Liang, Yunlong Front Pain Res (Lausanne) Pain Research BACKGROUND: Socioeconomic disadvantages (SEDs) are associated with chronic pain (CP) and allostatic load (AL). Few prospective population-based studies have examined the relationship between life course SED, CP interference, and CP widespreadness, and there is no prospective population-based study on whether AL mediates the association between SED and CP. OBJECTIVE: In this study, we investigated whether the prospective effect of SED on CP at Midlife in the United States (MIDUS) 3 is consistent with the accumulation of risk model and social mobility model, using the National Survey of MIDUS (n = 593). To prepare for the mediation analysis, we tested (1) whether SED would be prospectively associated with AL in the MIDUS 2 biomarker project, (2) whether AL would be prospectively associated with CP, and (3) whether childhood, as a critical period, moderated the association between AL and CP. In addition, the mediating effect of AL on the association between SED and CP was examined. METHOD: SED was measured using cumulative scores and disadvantage trajectories derived from latent class trajectory modeling (LCTM). After multiple imputations, analyses were conducted using multinomial logistic regression for CP and negative binomial regression for AL, respectively. Finally, mediation analyses and moderated mediation analyses were performed. RESULTS: LCTM identified three SED trajectories, namely, constant low, high to low, and medium to high. The results showed that proximal cumulative SED was associated with high-interference CP. Furthermore, compared with the group with constant low SED, the group with medium-to-high SED was significantly associated with high-interference pain and experienced pain in at least three different sites. Cumulative SED and deteriorating SED trajectories were associated with higher AL, consistent with previous studies. Furthermore, childhood SED moderated the effect of AL on CP widespreadness and unexpectedly demonstrated a protective effect, while other associations between AL and CP were not significant. Subsequent mediation analysis did not yield statistically significant evidence. CONCLUSIONS: People who experienced more recent SED or increasing disadvantage throughout their lives were more likely to suffer from CP, and this association was not mediated by physiological system dysregulation caused by chronic stress. Therefore, measures to alleviate AL may not be effective in protecting socioeconomically disadvantaged populations from CP. Frontiers Media S.A. 2023-07-13 /pmc/articles/PMC10374263/ /pubmed/37521943 http://dx.doi.org/10.3389/fpain.2023.1213750 Text en © 2023 Liang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pain Research
Liang, Yunlong
The mediating effect of allostatic load on the association between life course socioeconomic disadvantage and chronic pain: a prospective finding from the National Survey of Midlife Development in the United States
title The mediating effect of allostatic load on the association between life course socioeconomic disadvantage and chronic pain: a prospective finding from the National Survey of Midlife Development in the United States
title_full The mediating effect of allostatic load on the association between life course socioeconomic disadvantage and chronic pain: a prospective finding from the National Survey of Midlife Development in the United States
title_fullStr The mediating effect of allostatic load on the association between life course socioeconomic disadvantage and chronic pain: a prospective finding from the National Survey of Midlife Development in the United States
title_full_unstemmed The mediating effect of allostatic load on the association between life course socioeconomic disadvantage and chronic pain: a prospective finding from the National Survey of Midlife Development in the United States
title_short The mediating effect of allostatic load on the association between life course socioeconomic disadvantage and chronic pain: a prospective finding from the National Survey of Midlife Development in the United States
title_sort mediating effect of allostatic load on the association between life course socioeconomic disadvantage and chronic pain: a prospective finding from the national survey of midlife development in the united states
topic Pain Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10374263/
https://www.ncbi.nlm.nih.gov/pubmed/37521943
http://dx.doi.org/10.3389/fpain.2023.1213750
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