Biological Markers of Musculoskeletal Pain: A Scoping Review

Codjo Djignefa Djade,1– 3,* Caroline Diorio,1,2,* Danielle Laurin,2– 4,* Septime Pepin Hector Hessou,1 Alfred Kodjo Toi,2 Amédé Gogovor,2 Aboubacar Sidibe,1 Giraud Ekanmian,2 Teegwendé Valérie Porgo,5 Hervé Tchala Vignon Zomahoun,1 Clermont E Dionne1– 3,6,* 1Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec City, QC, Canada; 2Centre de recherche du CHU de Québec-Université Laval, Québec City, QC, Canada; 3Centre d’Excellence sur le Vieillissement de Québec (CEVQ), VITAM – Research Center on Sustainable Health, Québec City, QC, Canada; 4Faculty of Pharmacy, Université Laval, Québec City, QC, Canada; 5World Bank Group, Health, Nutrition, and Population Global Practice, Washington (DC), USA; 6Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec City, QC, Canada*These authors contributed equally to this workCorrespondence: Clermont E Dionne, Centre de recherche du CHU de Québec-Université Laval, Hôpital du Saint-Sacrement, 1050, chemin Ste-Foy, Québec, QC, G1S 4L8, Canada, Tel +1(418) 682-7511 ext. 84675, Fax +1(418) 682-7949, Email clermont.dionne@crchudequebec.ulaval.caBackground: Musculoskeletal pain (MSP) is the leading contributor to disability, limiting mobility and dexterity. As research on the determinants of MSP is evolving, biomarkers can probably play a significant role in understanding its causes and improving its clinical management. This scoping review aimed to provide an overview of the associations between biomarkers and MSP.Methods: This study followed Arksey and O’Malley and PRISMA-ScR recommendations. Keywords related to biomarkers, association, and MSP were searched on PubMed, Embase, Cochrane, and Web of Science databases from inception to September 28th, 2023. Data were systematically retrieved from the retained articles. A narrative synthesis approach – but no quality assessment – was used to map the core themes of biological markers of MSP that emerged from this work.Results: In total, 81 out of 25,165 identified articles were included in this scoping review. These studies were heterogeneous in many aspects. Overall, vitamin D deficiency, dyslipidemia (or hypercholesterolemia), and cytokines (high levels) were the most studied biomarkers with regards to MSP and were most often reported to be associated with non-specific MSP. Cadmium, calcium, C-reactive protein, collagen, creatinine, hormones, omega-3 fatty acids, sodium, tumor necrosis factor-alpha, and vitamin C were also reported to be associated with MSP syndromes, but the evidence on these associations was sketchier. No conclusions could be drawn as to age and sex.Conclusions: Our findings suggest that some biomarkers are associated with specific MSP syndromes, while others would be associated with non-specific syndromes. Among all candidate markers, the evidence seems to be more consistent for vitamin D, cytokines and lipids (total cholesterol, triglycerides, low- and high-density lipoproteins). High-quality studies, stratified by age and sex, are needed to advance our understanding on biomarkers of MSP.Keywords: musculoskeletal pain, biomarkers, scoping review