Research Article Investigating the Burden of Chronic Pain: An Inflammatory and Metabolic Composite Kimberly T. Sibille, 1,2 Ólöf A. Steingrímsdóttir, 3 Roger B. Fillingim, 2 Audun Stubhaug, 4,5 Henrik Schirmer, 6,7 Huaihou Chen, 8 Bruce S. McEwen, 9 and Christopher S. Nielsen 3,4 1 Department of Aging & Geriatric Research, University of Florida, Gainesville, FL 32610, USA 2 Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32610, USA 3 Department of Ageing and Health, Norwegian Institute of Public Health, 0403 Oslo, Norway 4 Department of Pain Management and Research, Oslo University Hospital, 0424 Oslo, Norway 5 Faculty of Medicine, University of Oslo, 0316 Oslo, Norway 6 Department of Clinical Medicine, Faculty of Health Sciences, Te Arctic University, 9038 Tromsø, Norway 7 Department of Cardiology, University Hospital North Norway, 9038 Tromsø, Norway 8 Department of Biostatistics, University of Florida, Gainesville, FL 32610, USA 9 Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, Te Rockefeller University, New York, NY 10065, USA Correspondence should be addressed to Kimberly T. Sibille; ksibille@uf.edu Received 18 August 2015; Accepted 17 February 2016 Academic Editor: Kenneth D. Craig Copyright © 2016 Kimberly T. Sibille et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Chronic pain is associated with increased morbidity and mortality, predominated by cardiovascular disease and cancer. Investigating related risk factor measures may elucidate the biological burden of chronic pain. Objectives. We hypothesized that chronic pain severity would be positively associated with the risk factor composite. Methods. Data from 12,982 participants in the 6th Tromsø study were analyzed. Questionnaires included demographics, health behaviors, medical comorbidities, and chronic pain symptoms. Te risk factor composite was comprised of body mass index, fbrinogen, C-reactive protein, and triglycerides. Chronic pain severity was characterized by frequency, intensity, time/duration, and total number of pain sites. Results. Individuals with chronic pain had a greater risk factor composite than individuals without chronic pain controlling for covariates and afer excluding infammation-related health conditions ( < 0.001). A signifcant “dose-response” relationship was demonstrated with pain severity ( < 0.001). In individuals with chronic pain, the risk factor composite varied by health behavior, exercise, lower levels and smoking, and higher levels. Discussion. Te risk factor composite was higher in individuals with chronic pain, greater with increasing pain severity, and infuenced by health behaviors. Conclusions. Identifcation of a biological composite sensitive to pain severity and adaptive/maladaptive behaviors would have signifcant clinical and research utility. 1. Introduction Living with pain is linked with poor health and increased morbidity and mortality [1–5]. Individuals reporting “pain lasting at least one day during the past month” showed an increased incidence of and poorer survival rate from cancer [1] and an increased all-cause mortality over an eight- year period compared to those without pain [6]. Chronic widespread pain was associated with higher mortality rates over a 12-year period [3]. Further, Torrance and colleagues (2010) reported that severe chronic pain was related to increased all-cause mortality and to circulatory system dis- ease deaths [5]. One method to initiate the investigation of the biological burden related to chronic pain is to explore biological mea- sures associated with disease states linked with increased inci- dence of morbidity and mortality in individuals with chronic pain. For example, the leading causes of increased mortality reported in musculoskeletal and widespread pain conditions include cancer, cardiovascular disease, and other circulatory Hindawi Publishing Corporation Pain Research and Management Volume 2016, Article ID 7657329, 11 pages http://dx.doi.org/10.1155/2016/7657329