Reduced hypothalamic-pituitary-adrenal axis activity in chronic multi-site musculoskeletal pain: partly masked by depressive and anxiety disorders

Table 4 **Associations* between cortisol measures and the presence of chronic multi-site musculoskeletal pain in persons without and with a lifetime depressive and/or anxiety disorder**

	Chronic pain without LDA (n = 60) *vs.* controls (n = 264)		Chronic pain with LDA (n = 411) *vs.* controls (n = 264)		Chronic pain with LDA *vs.* chronic pain without LDA^c
	OR (95% CI)	P	OR (95% CI)	P	P
At awakening
Sociodemographic^a	0.67 (0.47, 0.94)	0.02	0.94 (0.79, 1.12)	0.50	0.04
Lifestyle & disease^b	0.66 (0.46, 0.93)	0.02	0.90 (0.74, 1.09)	0.27	0.07
AUCg
Sociodemographic^a	0.61 (0.43, 0.89)	0.009	1.04 (0.86, 1.25)	0.68	0.003
Lifestyle & disease^b	0.62 (0.42, 0.90)	0.01	0.96 (0.79, 1.18)	0.72	0.02
AUCi
Sociodemographic^a	0.95 (0.69, 1.32)	0.77	1.15 (0.96, 1.38)	0.14	0.24
Lifestyle & disease^b	1.00 (0.71, 1.40)	0.99	1.11 (0.91, 1.36)	0.30	0.51
Mean evening level
Sociodemographic^a	0.89 (0.61, 1.29)	0.53	0.96 (0.79, 1.17)	0.68	0.67
Lifestyle & disease^b	0.93 (0.64, 1.33)	0.68	0.82 (0.66, 1.02)	0.07	0.49
Diurnal slope
Sociodemographic^a	0.71 (0.49, 1.01)	0.06	1.03 (0.85, 1.24)	0.80	0.03
Lifestyle & disease^b	0.70 (0.49, 0.99)	0.05	1.04 (0.85, 1.27)	0.69	0.02
Cortisol suppression ratio
Sociodemographic^a	0.89 (0.65, 1.21)	0.44	0.95 (0.81, 1.11)	0.51	0.67
Lifestyle & disease^b	0.86 (0.62, 1.19)	0.36	0.99 (0.83, 1.17)	0.87	0.40

LDA = Lifetime depressive and/or anxiety disorder.
*Based on adjusted multinomial logistic regression analyses using persons without chronic pain and without LDA as the reference group (n = 264); OR per 1 SD increase; At awakening: SD = 6.78, AUCg: SD = 6.87, AUCi: SD = 6.39, mean evening level: SD = 3.43, diurnal slope: SD = 0.45, cortisol suppression ratio: SD = 1.58.
^aAdjusted for awakening time, working on day of sampling, month of sampling, ≤6 hours of sleep, age, sex, years of education; ^badditionally adjusted for body mass index, smoking, alcohol intake, physical activity, and chronic diseases; ^cbased on the same multinomial logistic regression analyses using chronic pain without LDA as the reference group.

ISSN: 1471-2474