Family study of fibromyalgia
Family study of fibromyalgia
复制标题
DOI：
10.1002/art.20042
复制
发表时间：
2004-03-01
影响因子：
--
通讯作者：
Keck, PE
中科院分区：
文献类型：
--
作者：
Arnold, LM;Hudson, JI;Keck, PE
Objective.评估纤维肌痛（FM）的家族聚集性和压痛和疼痛的测量，以及FM和重度心境障碍（重度抑郁障碍或双相情感障碍）的家族共聚集性。符合美国风湿病学会FM标准的先证者和类风湿性关节炎（RA）的对照先证者，并且没有FM的终身诊断，从连续转诊到2个以社区为基础的风湿病实践中招募。先证者年龄在40-55岁之间，至少有一个一级亲属年龄在18岁或以上，可以接受采访和检查。所有先证者和接受采访的亲属进行了测痛仪压痛点检查和结构化的临床访谈。被采访的亲属被问及一级亲属谁是无法接受采访，使用结构化的家庭访谈。采用Logistic回归和线性回归模型，对家系内观察值的相关性进行校正，研究聚集效应和共聚集效应。收集了78名FM先证者的533名亲属和40名RA先证者的272名亲属的信息。FM在家族中聚集性很强：测量FM先证者亲属中FM与RA先证者亲属中FM的比值比（OR）为8.5（95%置信区间[95%CI] 2.8-26，P = 0.0002）。与RA先证者的亲属相比，FM先证者亲属的压痛点数量显著增加，总肌痛评分显著降低。FM与严重心境障碍显著共聚集：FM先证者亲属患严重心境障碍的几率与RA先证者亲属患严重心境障碍的几率的OR值为1.8（95%CI 1.1-2.9，P = 0.013）。FM和减压痛阈在家庭中聚集，FM与家庭中的主要情绪障碍共聚集。这些发现具有重要的临床和理论意义，包括遗传因素参与FM病因学和疼痛敏感性的可能性。此外，情绪障碍和FM可能共享这些遗传因素中的一些。
Objective. To assess for familial aggregation of fibromyalgia (FM) and measures of tenderness and pain, and for familial coaggregation of FM and major mood disorder (major depressive disorder or bipolar disorder).Methods. Probands meeting the American College of Rheumatology criteria for FM and control probands with rheumatoid arthritis (RA) and no lifetime diagnosis of FM were recruited from consecutive referrals to 2 community-based rheumatology practices. Probands were ages 40-55 years and had at least 1 first-degree relative age 18 years or older who was available for interview and examination. All probands and interviewed relatives underwent a dolorimeter tender point examination and a structured clinical interview. Interviewed relatives were asked about first-degree relatives who were not available for interview, using a structured family interview. Logistic and linear regression models, adjusting for the correlation of observation within families, were applied to study the aggregation and coaggregation effects.Results. Information was collected for 533 relatives of 78 probands with FM and 272 relatives of 40 probands with RA. FM aggregated strongly in families: the odds ratio (OR) measuring the odds of FM in a relative of a proband with FM versus the odds of FM in a relative of a proband with RA was 8.5 (95% confidence interval [95% CI] 2.8-26, P = 0.0002). The number of tender points was significantly higher, and the total myalgic score was significantly lower in the relatives of probands with FM compared with the relatives of probands with RA. FM coaggregated significantly with major mood disorder: the OR measuring the odds of major mood disorder in a relative of a proband with FM versus the odds of major mood disorder in a relative of a proband with RA was 1.8 (95% CI 1.1-2.9, P = 0.013).Conclusion. FM and reduced pressure pain thresholds aggregate in families, and FM coaggregates with major mood disorder in families. These findings have important clinical and theoretical implications, including the possibility that genetic factors are involved in the etiology of FM and in pain sensitivity. In addition, mood disorders and FM may share some of these inherited factors.