Brooks Larry, Hadi Joseph, Amber Kyle T, Weiner Michelle, La Riche Christopher L, Ference Tamar
Department of Rehabilitation Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
Anesco Interventional Pain Institute, Margate, FL, USA.
J Pain Res. 2015 Aug 20;8:561-9. doi: 10.2147/JPR.S86573. eCollection 2015.
This retrospective chart review investigated differences in the prevalence of medical comorbidity between women with fibromyalgia (FM) (n=219) and a control group women with chronic pain (CP) without FM (n=116). The specific aims were to compare the prevalence of autoimmune, psychiatric, endocrine, gynecologic pathology, the relationship between timing of gynecologic surgery, and pain onset. We additionally sought to compare the number of comorbidities in an ethnically diverse cohort.
This was a retrospective chart review of patients seen in FM or CP clinics at an academic medical center in 2009-2010.
Logistic regression modeling found that gynecologic, endocrine, and autoimmune diagnoses were independently associated with a diagnosis of FM. Detailed analyses showed that thyroid disease (P<0.01) and gynecologic surgery (P<0.05) were significantly more common in FM. Women with FM were more likely to have multiple autoimmune, endocrine, gynecologic, or psychiatric pathologies. A relationship was observed between the timing of gynecologic surgery and pain onset in FM, with more surgeries observed in the years just prior to pain onset or in the year after pain onset. A similar pattern was not found in the control group.
This study demonstrates that autoimmune, endocrine, and gynecologic pathologies occur more commonly in women with FM than in those with CP, which is consistent with findings in less ethnically diverse samples. Moreover, a relationship was found between timing of pain onset and gynecologic surgery. A larger prospective study of the relationship between gynecologic surgery and pain onset in FM is warranted.
本回顾性病历审查研究了纤维肌痛（FM）女性患者（n = 219）与无FM的慢性疼痛（CP）对照组女性患者（n = 116）之间医学合并症患病率的差异。具体目的是比较自身免疫性、精神性、内分泌性、妇科病理学的患病率，以及妇科手术时间与疼痛发作之间的关系。我们还试图比较不同种族队列中的合并症数量。
这是一项对2009 - 2010年在一家学术医疗中心FM或CP诊所就诊患者的回顾性病历审查。
逻辑回归模型发现，妇科、内分泌和自身免疫性诊断与FM诊断独立相关。详细分析表明，甲状腺疾病（P < 0.01）和妇科手术（P < 0.05）在FM患者中显著更常见。FM女性更有可能患有多种自身免疫性、内分泌性、妇科或精神性疾病。观察到FM患者中妇科手术时间与疼痛发作之间存在关联，在疼痛发作前几年或疼痛发作后一年观察到更多手术。在对照组中未发现类似模式。
本研究表明，自身免疫性、内分泌性和妇科疾病在FM女性中比在CP女性中更常见，这与在种族多样性较低样本中的研究结果一致。此外，发现疼痛发作时间与妇科手术之间存在关联。有必要对FM中妇科手术与疼痛发作之间的关系进行更大规模的前瞻性研究。
