Sarzi-Puttini Piercarlo, Atzeni Fabiola, Di Franco Manuela, Lama Nicola, Batticciotto Alberto, Iannuccelli Cristina, Dell'Acqua Donata, de Portu Simona, Riccieri Valeria, Carrabba Mario, Buskila Dan, Doria Andrea, Valesini Guido
Rheumatology Unit, L. Sacco University Hospital, Milan, Italy.
Autoimmunity. 2008 Feb;41(1):74-9. doi: 10.1080/08916930701620035.
To investigate the prevalence of antipolymer antibody (APA) in patients with fibromyalgia (FM) and to examine its association with FM severity symptoms.
The study population consisted of 79 FM patients and 75 controls: 32 with psoriatic arthritis and 43 with rheumatoid arthritis APA levels were indirectly assayed using a commercial ELISA kit from Corgenix (Westmister, Colorado, USA). Optical density (OD) values were recorded on duplicates of each of the reference and patient samples. Among clinical variables we investigated pain, measured according to visual analog scales (VAS: 0-100), fatigue, stiffness, anxiety, depression, all measured by VAS (0-100), and health status measured by Fibromyalgia Impact Questionnaire (FIQ).
Sixteen of the 79 FM patients (20.3%) and 12/78 controls (15.4%) were positive for APAs (P = 0.536). Following ROC analysis, area under curve (AUC) was 0.49 (95% CI: 0.40, 0.58). Focusing on FM patients, we observed a correlation between APA titre and pain (tau: - 0.221; P = 0.020) and fatigue (tau: - 0.205; P = 0.032) at univariate analysis. Binomial regression analysis, controlling for clinical and demographic variables, showed that pain (PPR: 0.923; P = 0.007) and fatigue (PPR: 0.948; P = 0.024) were significantly associated with APA test sensitivity.
APA test exhibited a low sensitivity in FM patients and it did not distinguish this group of patients from the controls enrolled in this study. Interestingly, positive APA test prevalence increased with less severe pain or fatigue.
调查纤维肌痛（FM）患者中抗聚合物抗体（APA）的患病率，并研究其与FM严重程度症状的关联。
研究人群包括79例FM患者和75例对照：32例银屑病关节炎患者和43例类风湿关节炎患者。使用美国科根尼克斯公司（科罗拉多州威斯敏斯特）的商用ELISA试剂盒间接检测APA水平。记录每个参考样本和患者样本复制品的光密度（OD）值。在临床变量中，我们调查了疼痛（根据视觉模拟量表测量：0 - 100）、疲劳、僵硬、焦虑、抑郁（均通过视觉模拟量表测量：0 - 100）以及通过纤维肌痛影响问卷（FIQ）测量的健康状况。
79例FM患者中有16例（20.3%）APA呈阳性，78例对照中有12例（15.4%）呈阳性（P = 0.536）。经ROC分析，曲线下面积（AUC）为0.49（95%CI：0.40，0.58）。聚焦于FM患者，单因素分析时我们观察到APA滴度与疼痛（tau： - 0.221；P = 0.020）和疲劳（tau： - 0.205；P = 0.032）之间存在相关性。二项回归分析在控制临床和人口统计学变量后显示，疼痛（PPR：0.923；P = 0.007）和疲劳（PPR：0.948；P = 0.024）与APA检测敏感性显著相关。
APA检测在FM患者中敏感性较低，且无法将该组患者与本研究纳入的对照区分开来。有趣的是，APA检测阳性患病率随疼痛或疲劳程度减轻而增加。
