Plasma Vitamin C Concentrations Were Negatively Associated with Tingling, Prickling or Pins and Needles Sensation in Patients with Postherpetic Neuralgia
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Site and Subjects
2.2. Measurement of Plasma Vitamin C Concentrations
2.3. Evaluation of Spontaneous Pain and Items in the LANSS Questionnaire
2.4. Statistical Analysis
3. Results
3.1. Primary Outcomes: Correlations between Spontaneous Pain/Items in the LANSS and Plasma Vitamin C in PHN Patients
3.2. Secondary Outcomes: The Cutoff for Plasma Vitamin C Concentrations to Predict Tingling, Prickling or Pins and Needles Sensation
3.3. The Proportions of Items in the LANSS Questionnaire in Patients with Different Plasma Vitamin C
3.4. Factors Associated with Plasma Vitamin C deficiency
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Data Availability
Abbreviations
AUC | area under the ROC curve |
H. pylori | Helicobacter pylori |
HZ | herpes zoster |
LANSS | Leeds assessment of neuropathic symptoms and signs Pain Scale |
NMDA | N-methyl-D-aspartate |
NRS | numeric rating pain scale |
NSAIDs | nonsteroidal anti-inflammatory drugs |
PHN | postherpetic neuralgia |
PUD | peptic ulcer disease |
ROS | reactive oxygen species |
VZV | varicella-zoster virus |
Appendix A
Chi Mei Medical Center Pain Clinic |
First Visit Questionnaire |
1. Does the pain produce unpleasant sensations such as tingling, prickling or pins and needles? | Yes (5) No (0) |
2. Is there a different skin aspect in the painful areas, i.e., skin redder than usual or appearing mottled? | Yes (5) No (0) |
3. Does stroking the skin in the painful area or wearing tight clothing items produce unpleasant sensations? | Yes (3) No (0) |
4. Do you experience any sensations like electric shocks, bursting or jumping corresponding to painful episodes, i.e., unexplained bursts of pain? | Yes (2) No (0) |
5. Do you experience burning sensations in the painful areas or a sudden temperature change? | Yes (1) No (0) |
6. Result from stroking the nonpainful area and the described painful area with cotton wool: | Allodynia in painful area (5) Normal sensations in both areas (0) |
7. Result to touching (pinprick) both areas with a 23-gauge needle: | Altered PPT in the painful area (3) Equal sensations in both areas (0) |
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Parameters | Mean (SD) |
---|---|
Age, mean (SD) (years) | 66.45 (11.34) |
Body height, mean (SD) (cm) | 158.67 (11.42) |
Body weight, mean (SD) (kg) | 55.99 (11.86) |
Male, n (%) | 63 (52.5%) |
Duration of pain, mean (SD) (months) | 8.55 (7.50) |
Plasma concentrations of vitamin C (6–15 mg/L) | |
mean (SD) (mg/L) | 6.34 (3.80) |
Well-nourished (≥10 mg/L; 56.8 μmol/L), n (%) | 19 (15.8%) |
Adequate (6–10 mg/L; 34.1–56.8 μmol/L), n (%) | 38 (31.7%) |
Deficiency (<6 mg/L; 34.1 μmol/L), n (%) | 63 (52.5%) |
Comorbidities/habits (n, %) | |
Hypertension | 47 (39.2%) |
Diabetes mellitus | 31 (25.8%) |
Peptic ulcer disease | 37 (30.8%) |
Cancers | 12 (10.0%) |
COPD | 15 (12.5%) |
Chronic kidney disease with dialysis | 0 (0%) a |
Hypercholesterolemia | 13 (10.8%) |
Smoking (Male: 31; Female: 0; heavy smokers b: 21) | 31 (25.8%) |
Alcohol intake | 5 (4.2%) |
Low intake of fruits and vegetables c | 46 (38.3%) |
Spearman Correlation Coefficient | p | |
---|---|---|
Plasma vitamin C concentrations vs. Spontaneous pain (NRS 0–10) | −0.420 * | <0.001 |
vs. Items in the LANSS questionnaire | ||
Tingling, prickling or pins and needles sensation (NRS 0–10) | −0.449 * | <0.001 |
A different skin aspect (Yes: 1; No: 0) | −0.250 | 0.007 |
Abnormally sensitive to touch (Yes: 1; No: 0) | −0.231 | 0.011 |
Sudden electric shocks, bursting, jumping pain (NRS 0–10) | −0.104 | 0.265 |
Burning pain (NRS 0–10) | −0.173 | 0.058 |
Allodynia (NRS 0–10) | −0.139 | 0.131 |
Altered pin-prick threshold (Yes: 1; No: 0) | −0.113 | 0.218 |
Cutoff for Plasma Vitamin C Concentrations | ≥7.05 mg/L (n = 47) | <7.05 mg/L (n = 73) | p | ≥5.68 mg/L (n = 57) | <5.68 mg/L (n = 63) | p |
---|---|---|---|---|---|---|
Tingling, prickling or pins and needles sensations, n (%) | 29 (61.7) | 71 (97.3) | <0.001 | 44 (74.6) | 59 (96.7) | <0.001 |
A different skin aspect in the painful areas, n (%) | 26 (55.3) | 51 (69.9) | 0.105 | 34 (57.6) | 43 (70.5) | 0.142 |
Abnormally sensitive to touch in the painful area, n (%) | 18 (38.3) | 36 (49.3) | 0.236 | 23 (39.0) | 31 (50.8) | 0.193 |
Sudden electric shocks, bursting or jumping pain, n (%) | 24 (51.1) | 39 (48.9) | 0.800 | 32 (54.2) | 31 (50.8) | 0.708 |
Burning pain, n (%) | 9 (19.1) | 22 (30.1) | 0.180 | 13 (22.0) | 18 (29.5) | 0.350 |
Allodynia in painful area, n (%) | 23 (48.9) | 45 (61.6) | 0.170 | 29 (49.2) | 39 (63.9) | 0.102 |
Altered pin-prick threshold, n (%) | 20 (42.6) | 21 (28.8) | 0.120 | 24 (40.7) | 17 (27.9) | 0.139 |
Well-Nourished | Deficient | |||||
---|---|---|---|---|---|---|
Cutoff for Plasma Vitamin C Concentrations | ≥10 mg/L (n = 19) | <10 mg/L (n = 101) | p | ≥6.0 mg/L (n = 57) | <6.0 mg/L (n = 63) | |
Tingling, prickling or pins and needles sensations, n (%) | 11 (57.9) | 89 (88.1) | <0.001 | 39 (68.4) | 61 (96.8) | <0.001 |
A different skin aspect in the painful areas, n (%) | 8 (42.1) | 69 (68.3) | 0.029 | 33 (57.9) | 44 (69.8) | 0.173 |
Abnormally sensitive to touch in the painful area, n (%) | 6 (31.6) | 48 (47.5) | 0.200 | 22 (38.6) | 32 (50.8) | 0.180 |
Sudden electric shocks, bursting or jumping pain, n (%) | 6 (31.6) | 57 (56.4) | 0.047 | 31 (54.4) | 32 (50.8) | 0.694 |
Burning pain, n (%) | 2 (10.5) | 29 (28.7) | 0.097 | 12 (21.1) | 19 (30.2) | 0.255 |
Allodynia in painful area, n (%) | 7 (36.8) | 61 (60.4) | 0.057 | 28 (49.1) | 40 (63.5) | 0.113 |
Altered pin-prick threshold, n (%) | 10 (52.6) | 31 (30.7) | 0.064 | 24 (42.1) | 17 (27.0) | 0.081 |
Vitamin C Deficiency (<6 mg/L) (n = 63, 52.5%) | ||||
---|---|---|---|---|
Variables | Crude Odds Ratio (95% CI) | pb | Adjusted Odds Ratio (95% CI) | pb |
Gender (male vs. female) | 2.23 (1.08, 4.64) | 0.030 * | ||
Age (≥70 vs. <70 years old) | 0.89 (0.43, 1.84) | 0.761 | ||
Hypertension | 2.48 (1.16, 5.31) | 0.018 * | ||
Diabetes mellitus | 1.95 (0.84, 4.53) | 0.120 | ||
Peptic ulcer disease | 5.95 (2.60, 13.61) | <0.001 * | 3.25 (1.28–8.28) | 0.014 * |
Cancer | 3.0 (0.77, 11.69) | 0.100 | ||
COPD | 1.42 (0.47, 4.26) | 0.534 | ||
Hypercholesterolemia | 1.06 (0.33, 3.37) | 0.918 | ||
Smoking | 10.65 (4.30, 26.37) | <0.001 * | 3.60 (1.33–9.77) | 0.010 * |
Alcohol intake | 3.80 (0.41, 35.01) | 0.208 | ||
Low intake of fruits and vegetables before outbreaks of herpes zoster a | 11.61 (4.53, 29.72) | <0.001 * | 2.66 (1.09–6.48) | 0.032 * |
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Wang, L.-K.; Lin, Y.-T.; Hung, K.-C.; Chang, C.-Y.; Wu, Z.-F.; Hu, M.-L.; Chen, J.-Y. Plasma Vitamin C Concentrations Were Negatively Associated with Tingling, Prickling or Pins and Needles Sensation in Patients with Postherpetic Neuralgia. Nutrients 2020, 12, 2384. https://doi.org/10.3390/nu12082384
Wang L-K, Lin Y-T, Hung K-C, Chang C-Y, Wu Z-F, Hu M-L, Chen J-Y. Plasma Vitamin C Concentrations Were Negatively Associated with Tingling, Prickling or Pins and Needles Sensation in Patients with Postherpetic Neuralgia. Nutrients. 2020; 12(8):2384. https://doi.org/10.3390/nu12082384
Chicago/Turabian StyleWang, Li-Kai, Yao-Tsung Lin, Kuo-Chuan Hung, Chia-Yu Chang, Zhi-Fu Wu, Miao-Lin Hu, and Jen-Yin Chen. 2020. "Plasma Vitamin C Concentrations Were Negatively Associated with Tingling, Prickling or Pins and Needles Sensation in Patients with Postherpetic Neuralgia" Nutrients 12, no. 8: 2384. https://doi.org/10.3390/nu12082384
APA StyleWang, L.-K., Lin, Y.-T., Hung, K.-C., Chang, C.-Y., Wu, Z.-F., Hu, M.-L., & Chen, J.-Y. (2020). Plasma Vitamin C Concentrations Were Negatively Associated with Tingling, Prickling or Pins and Needles Sensation in Patients with Postherpetic Neuralgia. Nutrients, 12(8), 2384. https://doi.org/10.3390/nu12082384