Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E-3153, Baltimore, MD 21205-2179, USA.
Am J Epidemiol. 2012 May 15;175(10):1054-61. doi: 10.1093/aje/kwr460. Epub 2012 Jan 10.
The etiology of recurrent attacks of serositis in familial Mediterranean fever (FMF) is not completely understood. Uncontrolled clinical case series have reported that factors associated with emotional, physiological, or physical stress precede and might trigger the attacks. This case-crossover study, conducted between July 2007 and May 2008, aimed to estimate the role of precipitating factors in attacks in a sample of Armenian FMF patients in Yerevan, Armenia, where 104 patients contributed 55 case and 189 control time periods. The authors used conditional logistic regression to compare frequency of exposure to stressful events, strenuous physical activity, menstrual periods, and high-fat food consumption prior to FMF attacks and on attack-free random days. Multiple stressful life events predicted FMF attacks 2 days following the event. After adjustment for treatment, an additional stressful event was associated with an estimated 70% increase in the odds of having an FMF attack on the second day (95% confidence interval: 1.04, 2.79). High levels of perceived stress were also associated with FMF attacks. Physical exertion and high-fat diet did not increase the likelihood of FMF attacks. The possibility of prevention of attacks in FMF needs to be tested through stress-reduction interventions.
家族性地中海热（FMF）反复发作性浆膜炎的病因尚不完全清楚。未受控制的临床病例系列报告称，与情绪、生理或身体应激相关的因素先于并可能引发这些发作。这项病例交叉研究于 2007 年 7 月至 2008 年 5 月在亚美尼亚埃里温进行，旨在评估亚美尼亚 FMF 患者样本中诱发因素在发作中的作用，104 名患者贡献了 55 个病例和 189 个对照时间段。作者使用条件逻辑回归比较了 FMF 发作前和无发作随机日期间，应激事件、剧烈体力活动、月经周期和高脂肪食物摄入的发生频率。多项生活应激事件预测 FMF 发作在事件发生后 2 天。在调整治疗后，额外的应激事件与 FMF 发作的几率增加约 70%（95%置信区间：1.04，2.79）相关。感知到的高压力水平也与 FMF 发作相关。体力消耗和高脂肪饮食不会增加 FMF 发作的可能性。需要通过减轻压力的干预措施来检验预防 FMF 发作的可能性。
