Arnold Lesley M, Hudson James I, Hess Evelyn V, Ware Avis E, Fritz Deborah A, Auchenbach Megan B, Starck Linsey O, Keck Paul E
University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0559, USA.
Arthritis Rheum. 2004 Mar;50(3):944-52. doi: 10.1002/art.20042.
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).
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.
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).
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.
评估纤维肌痛（FM）的家族聚集性以及压痛和疼痛指标，评估FM与重性心境障碍（重度抑郁症或双相情感障碍）的家族共同聚集性。
从连续转诊至两家社区风湿病诊所的患者中招募符合美国风湿病学会FM标准的先证者以及患有类风湿关节炎（RA）且终生未诊断出FM的对照先证者。先证者年龄在40 - 55岁之间，且至少有一名18岁或以上的一级亲属可接受访谈和检查。所有先证者及接受访谈的亲属均接受压痛计压痛点检查和结构化临床访谈。使用结构化家庭访谈，向接受访谈的亲属询问那些无法接受访谈的一级亲属的情况。应用逻辑回归和线性回归模型，并对家庭内部观察值的相关性进行校正，以研究聚集和共同聚集效应。
收集了78名FM先证者的533名亲属以及40名RA先证者的272名亲属的信息。FM在家族中具有强烈的聚集性：衡量FM先证者亲属患FM的几率与RA先证者亲属患FM的几率的比值比（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先证者的亲属的压痛点数量显著更多，而总肌痛评分显著更低。FM与重性心境障碍有显著的共同聚集性：衡量FM先证者亲属患重性心境障碍的几率与RA先证者亲属患重性心境障碍的几率的OR为1.8（95%CI 1.1 - 2.9，P = 0.013）。
FM和降低的压力疼痛阈值在家族中聚集，且FM与重性心境障碍在家族中共同聚集。这些发现具有重要的临床和理论意义，包括遗传因素可能参与FM病因及疼痛敏感性的可能性。此外，心境障碍和FM可能共享一些这些遗传因素。
