CONTEXT: Recent studies have considered the role of inflammation in the development of both cardiovascular disease (CVD) and musculoskeletal conditions, such as rheumatoid arthritis. Studies suggest that inflammation plays a significant role in the development of cardiovascular disease. In conditions of chronic pain, as with rheumatoid arthritis, inflammation has also been noted through elevated levels of inflammatory markers. There are currently no studies that examine the possible connection between inflammatory markers related to increased risk of cardiovascular disease and nonspecific chronic musculoskeletal pain (NCMP). OBJECTIVE: The purpose of this study was to determine whether urinary levels of microalbumin (MA) and F2-isoprostanes (F2-isoPs), inflammatory biomarkers associated with increased CVD risk, are elevated in persons with NCMP compared to nonpain case controls. NCMP refers to pain present for more than 3 days per week and for more than 12 weeks. This type of pain is not due to injury but is associated with interference of normal function. DESIGN: Nonrandomized observational study. METHODS: A cross-sectional study with 120 participants (60 pain subjects, 60 nonpain case-controls). A single first-morning void urine sample was collected from each subject. Urine specific gravity and total volume were measured and then a sample was sent to a lab for analysis of MA and F2-isoPs. Inflammatory biomarker levels in the pain and nonpain groups were compared. RESULTS: There were no significant differences in F2-isoPs levels between the chronic pain group (0.65ng/mg ± 0.05) and the nonpain group (0.80ng/mg ± 0.07) (95% CI (-0.32, 0.03)). However, MA levels were significantly higher in the chronic pain group (2.41mg/g ± 0.24) compared to the nonpain group (1.88mg/g ± 0.14) (95% CI (0.34, 1.68)). MACR levels were also significantly higher in the chronic pain group (2.07mg/g ± 0.31) compared to the nonpain group (1.14mg/g ± 0.14) (95% CI (0.32, 1.64)). CONCLUSION: These findings suggest a possible link between at least one inflammatory marker (microalbumin) and NCMP. This in turn allows for a limited but reasonable inference that NCMP may be a risk factor for cardiovascular disease, mediated through the MA inflammatory biomarker. Further research is needed to more fully understand the possible connection between NCMP and CVD.



College and Department

Life Sciences; Exercise Sciences



Date Submitted


Document Type





chronic pain, inflammation, cardiovascular disease, inflammatory biomarkers, microalbumin, F2-isoprostanes