Mundal Ingunn, Gråwe Rolf W, Bjørngaard Johan H, Linaker Olav M, Fors Egil A
Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
BMC Musculoskelet Disord. 2014 Jun 20;15:213. doi: 10.1186/1471-2474-15-213.
Chronic widespread pain (CWP) is common and associated with prominent negative consequences. The aim of this study was to assess the prevalence of persistent CWP in an 11-year prospective cohort study in the general population, and to examine anxiety, depression, alcohol use, poor sleep, body mass index (BMI) and chronic disease, along with demographic, lifestyle and other health-related variables as possible predictors for the assumed CWP persistence.
CWP was defined as having pain at three or more predefined sites (involving the trunk and upper and lower limbs) for at least three months in the last year. We used a Norwegian general population cohort of 28,367 individuals who responded to both the second (1995-1997) and the third (2006-2008) waves of the Nord-Trøndelag Health Study (HUNT2 and HUNT3, respectively). Data were analysed with logistic regression models.
CWP prevalence in HUNT2 was 17%. Of those reporting CWP in HUNT2, 53% still reported CWP at follow-up in HUNT3. Adjusted analyses revealed that depression and alcohol consumption were not substantially associated with the 11-year prospective CWP outcome. Poor sleep, obesity and chronic disease predicted persistent CWP, and being male and/or 60 years or older was protective.
This cohort study revealed that nearly half of the participants with baseline CWP resolved from CWP 11 years later. Among those whose CWP did not resolve, obesity, sleeping problems and chronic disease predicted CWP persistence, while aging and male sex was protective. Anxiety, mixed anxiety and depression, former smoking, and overweight were weakly associated, while depression, moderate exercise, and alcohol use were not associated with persistent CWP.
慢性广泛性疼痛（CWP）很常见，且会带来严重的负面后果。本研究的目的是在一项针对普通人群的11年前瞻性队列研究中评估持续性CWP的患病率，并研究焦虑、抑郁、饮酒、睡眠不佳、体重指数（BMI）和慢性病，以及人口统计学、生活方式和其他与健康相关的变量，作为假定的CWP持续性的可能预测因素。
CWP被定义为在过去一年中，在三个或更多预定义部位（包括躯干以及上肢和下肢）疼痛至少三个月。我们使用了挪威普通人群队列中的28367名个体的数据，这些个体分别对北特伦德拉格健康研究的第二轮（1995 - 1997年）和第三轮（2006 - 2008年）（分别为HUNT2和HUNT3）进行了回应。数据采用逻辑回归模型进行分析。
HUNT2中CWP的患病率为17%。在HUNT2中报告有CWP的人群中，53%在HUNT3随访时仍报告有CWP。校正分析显示，抑郁和饮酒与11年前瞻性CWP结局没有实质性关联。睡眠不佳、肥胖和慢性病可预测持续性CWP，而男性和/或60岁及以上则具有保护作用。
这项队列研究表明，近一半基线患有CWP的参与者在11年后CWP症状消失。在那些CWP未消失的参与者中，肥胖、睡眠问题和慢性病可预测CWP的持续性，而年龄增长和男性具有保护作用。焦虑、混合性焦虑和抑郁、既往吸烟以及超重与之存在弱关联，而抑郁、适度运动和饮酒与持续性CWP无关。
