{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:50:44Z","timestamp":1777884644505,"version":"3.51.4"},"reference-count":57,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcohol, Clinical and Experimental Research"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic pain, heavy alcohol use, and metabolic dysfunction frequently cooccur, yet their interrelationships remain inadequately characterized, contributing to fragmented therapeutic approaches. This study quantifies independent and interactive associations between these conditions and pain interference in a nationally representative sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional analysis of 30,442 adults (51.1% women) participating in the 2007\u20132012 National Health and Nutrition Examination Survey (NHANES), representing an estimated 301,890,165 US adults. Primary exposures included heavy alcohol use (defined by National Institute on Alcohol Abuse and Alcoholism criteria), metabolic dysfunction (indexed by obesity status, Triglyceride\u2010Glucose Index [TyG], and Systemic Inflammation Index [SII]), and sleep duration. Our main outcome was pain interference, measured as days in the past 30\u2009days during which pain disrupted usual activities. We utilized survey\u2010weighted quasi\u2010Poisson regression models, adjusting for age, gender, and race\/ethnicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Heavy alcohol use was independently associated with 34% more days of pain interference (IRR\u2009=\u20091.34, 95% CI\u2009=\u20091.16\u20131.55), while obesity was associated with a 50% increase (IRR\u2009=\u20091.50, 95% CI\u2009=\u20091.35\u20131.67). Higher TyG (IRR\u2009=\u20091.19, 95% CI\u2009=\u20091.10\u20131.30) and SII (IRR\u2009=\u20091.01, 95% CI\u2009=\u20091.01\u20131.02) were also consistently associated with increased pain interference. The interaction between heavy alcohol use and obesity suggested additive rather than synergistic effects (IRR\u2009=\u20090.82, 95% CI\u2009=\u20090.65\u20131.05). Each additional hour of sleep was associated with a 14% reduction in pain interference (IRR\u2009=\u20090.86, 95% CI\u2009=\u20090.83\u20130.88). In a secondary analysis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099756), higher physical activity was associated with 10% fewer days of pain interference (IRR\u2009=\u20090.90, 95% CI\u2009=\u20090.87\u20130.93).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Heavy alcohol use and metabolic dysfunction demonstrate independent, additive effects on pain interference, with concurrent conditions corresponding to maximal days of pain interference. Sleep duration and physical activity emerge as potentially modifiable protective factors. These findings support the implementation of integrated therapeutic approaches targeting multiple pathophysiological domains to optimize clinical outcomes in this complex patient population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70108","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T04:49:11Z","timestamp":1750913351000},"page":"1768-1777","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pain interference, alcohol use, and metabolic health: Insights from a nationally representative study"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8702-5436","authenticated-orcid":false,"given":"Gabriel P. A.","family":"Costa","sequence":"first","affiliation":[{"name":"Department of Psychiatry Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale University School of Medicine  New Haven Connecticut USA"},{"name":"VA Connecticut Healthcare System  West Haven Connecticut USA"},{"name":"Clinical Neuroscience Research Unit (CNRU), Connecticut Mental Health Center (CMHC)  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio C.","family":"Nunes","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale University School of Medicine  New Haven Connecticut USA"},{"name":"VA Connecticut Healthcare System  West Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Pittman","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Sofuoglu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale University School of Medicine  New Haven Connecticut USA"},{"name":"VA Connecticut Healthcare System  West Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismene","family":"Petrakis","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7357-8215","authenticated-orcid":false,"given":"Joao P.","family":"De Aquino","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale University School of Medicine  New Haven Connecticut USA"},{"name":"VA Connecticut Healthcare System  West Haven Connecticut USA"},{"name":"Clinical Neuroscience Research Unit (CNRU), Connecticut Mental Health Center (CMHC)  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"163","DOI":"10.35946\/arcr.v38.2.02","article-title":"Alcohol and gut\u2010derived inflammation","volume":"38","author":"Bishehsari F.","year":"2017","journal-title":"Alcohol Research: Current Reviews"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2403664"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0179826"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/db06-1491"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16456"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","unstructured":"Chakravorty S. Morales K.H. Perlis M.L. Kuna S.T. He S. Oslin D.W.et\u00a0al. (2025)A randomized controlled trial of cognitive behavioral therapy for insomnia during early recovery from alcohol use disorder among veterans.MedRxiv. Available from:https:\/\/doi.org\/10.1101\/2025.01.03.25319973","DOI":"10.1101\/2025.01.03.25319973"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-63453-6"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.20230886"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12020242"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-51878-y"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S305399"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/15291006211008157"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-006-1790-5"},{"key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"223","DOI":"10.35946\/arcr.v37.2.07","article-title":"The gastrointestinal microbiome: alcohol effects on the composition of intestinal microbiota","volume":"37","author":"Engen P.A.","year":"2015","journal-title":"Alcohol Research: Current Reviews"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2021.613858"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00757-8"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2013.08.007"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002264"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.729950"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.4703-13.2014"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200109000-00007"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0288"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2023.2237396"},{"key":"e_1_2_8_25_1","article-title":"Exercise therapy for chronic low back pain","volume":"9","author":"Hayden J.A.","year":"2021","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2024.4789"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms19102947"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-14-0442"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21858"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2018.08.026"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2023.137397"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1123\/jmpb.2018-0068"},{"key":"e_1_2_8_33_1","first-page":"1","article-title":"National health and nutrition examination survey: analytic guidelines, 1999\u20102010","volume":"2","author":"Johnson C.L.","year":"2013","journal-title":"Vital and Health Statistics"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-68440-1"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2024.3599"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3005123"},{"key":"e_1_2_8_37_1","unstructured":"Lucas J.W. & Sohi I. (2024)Chronic pain and high\u2010impact chronic pain in U.S. adults 2023. US Department of Health & Human Services Centers for Disease Control and Prevention National Center for Health Statistics."},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-062566"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001446"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2006.03.006"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2012.140"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102661"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1532-2149.2013.00298.x"},{"key":"e_1_2_8_44_1","unstructured":"National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2024)Drinking levels and patterns defined. Nih.gov."},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2021.155110"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-48267-2"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.46234\/ccdcw2023.068"},{"key":"e_1_2_8_48_1","volume-title":"Multiple imputation for nonresponse in surveys","author":"Rubin D.B.","year":"2009"},{"key":"e_1_2_8_49_1","volume-title":"Key substance use and mental health indicators in the United States: results from the 2023 National Survey on Drug Use and Health. NSDUH series H\u201059","author":"Substance Abuse Mental Health Services Administration","year":"2024"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2018.07.014"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/osp4.759"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2841"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1089\/neur.2023.0096"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1274356"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12062245"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.933913"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2015.02.005"}],"container-title":["Alcohol, Clinical and Experimental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acer.70108","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acer.70108","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acer.70108","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T02:32:42Z","timestamp":1777602762000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acer.70108"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,26]]},"references-count":57,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/acer.70108"],"URL":"https:\/\/doi.org\/10.1111\/acer.70108","archive":["Portico"],"relation":{},"ISSN":["2993-7175","2993-7175"],"issn-type":[{"value":"2993-7175","type":"print"},{"value":"2993-7175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,26]]},"assertion":[{"value":"2025-02-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}