Chronic physical illness in early life and risk of chronic widespread and regional pain at age 68: evidence from the 1946 British birth cohort.
Chronic physical illness in early life and risk of chronic widespread and regional pain at age 68: evidence from the 1946 British birth cohort.
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DOI：
10.1097/j.pain.0000000000000663
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发表时间：
2016-10
期刊：
影响因子：
7.4
通讯作者：
Cooper R
中科院分区：
文献类型：
--
作者：
Muthuri SG;Kuh D;Bendayan R;Macfarlane GJ;Cooper R
补充数字内容可在正文中找到。在英国的一项出生队列研究中，早年患有严重疾病的经历与68岁时慢性广泛性疼痛的风险增加有关。这项研究旨在利用具有全国代表性的英国大型出生队列、医学研究理事会(MRC)全国健康与发展调查(NSHD)的数据，研究早年严重疾病与老年疼痛风险之间的关系。严重疾病被定义为25岁之前任何需要住院治疗28天的疾病经历。疼痛在68岁时自我报告，根据美国风湿病学会的标准定义为慢性广泛性疼痛(CWP)。用多项Logistic回归检验早期严重疾病与煤工尘肺、慢性局部疼痛(CRP)和其他疼痛的相关性，无疼痛为参照类别。对性别、社会经济地位、成人健康状况、健康行为和心理社会因素进行了调整。在2401名数据完整的NSHD参与者中，10.5%的人报告了CWP(13.2%的女性和7.7%的男性)，30.2%的人报告了CRP，14.8%的人报告了其他疼痛。与无大病史者相比，早期有大病史者患煤工尘肺(RRR=1.62[95%CI：1.21~2.17])和C反应蛋白(RRR=1.25[95%CI：1.01~1.54])的可能性较高。在完全调整的模型中，早期严重疾病仍然与CWP相关(RRR=1.43[95%CI：1.05-1.95])，但与CRP的相关性减弱(RRR=1.19[95%CI：0.96-1.48])。与其他疼痛无关。这些发现表明，那些早年经历过严重疾病的人可能比其他人需要更多的支持，以将他们在晚年患煤工尘埃沉着病的风险降至最低。
Supplemental Digital Content is Available in the Text. In a British birth cohort study, experience of serious illness in earlier life is associated with increased risk of chronic widespread pain at age 68. This study aimed to examine the associations between serious illness in earlier life and risk of pain in old age using data from a large nationally representative British birth cohort, the Medical Research Council (MRC) National Survey of Health and Development (NSHD). Serious illness was defined as any experience of illness before age 25 requiring hospital admission of ≥28 days. Pain was self-reported at age 68, with chronic widespread pain (CWP) defined according to American College of Rheumatology criteria. Multinomial logistic regression was used to test associations of serious illness in early life with CWP, chronic regional pain (CRP), and other pain, with no pain as the referent category. Adjustment was made for sex, socioeconomic position, adult health status, health behaviours, and psychosocial factors. Of 2401 NSHD participants with complete data, 10.5% reported CWP (13.2% of women and 7.7% of men), 30.2% reported CRP, and 14.8% other pain. Compared with those with no history of serious illness, those who experienced serious illness in early life had a higher likelihood of CWP (relative risk ratio [RRR] = 1.62 [95% CI: 1.21-2.17]) and of CRP (RRR = 1.25 [95% CI: 1.01-1.54]) after adjusting for sex. In fully adjusted models, serious illness in early life remained associated with CWP (RRR = 1.43 [95% CI: 1.05-1.95]), but associations with CRP were attenuated (RRR = 1.19 [95% CI: 0.96-1.48]). There were no associations with other pain. These findings suggest that those who have experienced serious illness in earlier life may require more support than others to minimise their risk of CWP in later life.
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作者：
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