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Are cardiometabolic markers of allostatic load associated with pronociceptive processes in Native Americans?: A structural equation modeling analysis from the Oklahoma Study of Native American Pain Risk
- Source :
- J Pain
- Publication Year :
- 2021
-
Abstract
- Native Americans (NAs) experience higher rates of chronic pain than the general U.S. population, but the risk factors for this pain disparity are unknown. NAs also experience high rates of stressors and cardiovascular and metabolic health disparities (eg, diabetes, cardiovascular disease) consistent with allostatic load (stress-related wear-and-tear on homeostatic systems). Given that allostatic load is associated with chronic pain, then allostatic load may contribute to their pain disparity. Data from 302 healthy, pain-free men and women (153 NAs, 149 non-Hispanic Whites [NHW]) were analyzed using structural equation modeling to determine whether cardiometabolic allostatic load (body mass index, blood pressure, heart rate variability) mediated the relationship between NA ethnicity and experimental measures of pronociceptive processes: temporal summation of pain (TS-pain) and the nociceptive flexion reflex (TS-NFR), conditioned pain modulation of pain (CPM-pain) and NFR (CPM-NFR), and pain tolerance. Results indicated that NAs experienced greater cardiometabolic allostatic load that was related to enhanced TS-NFR and impaired CPM-NFR. Cardiometabolic allostatic load was unrelated to measures of pain perception (CPM-pain, TS-pain, pain sensitivity). This suggests cardiometabolic allostatic load may promote spinal sensitization in healthy NAs, that is not concomitant with pain sensitization, perhaps representing a unique pain risk phenotype in NAs. Perspective: Healthy, pain-free Native Americans experienced greater cardiometabolic allostatic load that was associated with a pronociceptive pain phenotype indicative of latent spinal sensitization (ie, spinal sensitization not associated with hyperalgesia). This latent spinal sensitization could represent a pain risk phenotype for this population.
- Subjects :
- Adult
Male
Nociception
Pain Threshold
medicine.medical_specialty
Pain tolerance
Population
Disease
Article
Nociceptive flexion reflex
03 medical and health sciences
0302 clinical medicine
030202 anesthesiology
Internal medicine
medicine
Humans
education
American Indian or Alaska Native
education.field_of_study
Central Nervous System Sensitization
business.industry
Chronic pain
Cardiometabolic Risk Factors
Oklahoma
Middle Aged
medicine.disease
Allostatic load
Anesthesiology and Pain Medicine
Neurology
Allostasis
Latent Class Analysis
Hyperalgesia
Female
Neurology (clinical)
medicine.symptom
Chronic Pain
business
Body mass index
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- J Pain
- Accession number :
- edsair.doi.dedup.....bd460aa022896f27c8c12dfeb77552c7