aDepartment of Physical Medicine and Rehabilitation, National Yang-Ming University and Taipei Veterans General Hospital, Taipei, TaiwanbDepartment of Health Services Administration, College of Public Health, China Medical University, Taichung, TaiwancHarvard University, Intended A.B. Physics, Cambridge, MA, USAdDivision of General Surgery, Department of Surgery, Shin-Kong Memorial Hospital, Taipei, TaiwaneDepartment of Surgery, School of Medicine, Fu Jen Catholic University, New Taipei City, TaiwanfManagement Office for Health Data, China Medical University Hospital, Taichung, TaiwangCollege of Medicine, China Medical University, Taichung, TaiwanhGraduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, TaiwaniDepartment of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, TaiwanjDepartment of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
Pain. 2017 Oct;158(10):1971-1978. doi: 10.1097/j.pain.0000000000000994.
Fibromyalgia (FM) tends to coexist with gastroesophageal reflux disease (GERD). This retrospective cohort study was conducted to determine the bidirectional association between FM and GERD, using a nationwide database, the National Health Insurance of Taiwan. We established 2 study arms, including 35,117 patients with FM in arm 1 and 34,630 patients with GERD in arm 2, newly diagnosed between 2000 and 2010. For each study arm, we randomly selected 4-fold subjects with neither FM nor GERD from the same database, frequency matched by sex, age, and diagnosis date, as the respective control cohorts. Incidence of GERD in arm 1 and incidence of FM in arm 2 were estimated by the end of 2011. The overall incidence of GERD was 1.6-fold greater in the FM cohort than in the non-FM cohort (12.0 and 7.61 per 1000 person-years, crude hazard ratio [HR] = 1.58, 95% confidence interval [CI] = 1.51-1.66), with an adjusted HR (aHR) of 1.27 (95% CI = 1.22-1.33) after controlling for sex, age, comorbidities, and medications. The GERD cohort ultimately had a 1.5-fold higher incidence of FM than the non-GERD cohort (5.76 vs 3.96 per 1000 person-years), with an aHR of 1.44 (95% CI = 1.29-1.60). The present study suggests a bidirectional relationship between FM and GERD. There is a greater risk of developing GERD for patients with FM than developing FM for patients with GERD.
纤维肌痛（FM）往往与胃食管反流病（GERD）共存。本回顾性队列研究使用台湾全民健康保险数据库，旨在确定 FM 和 GERD 之间的双向关联。我们建立了 2 个研究组，包括第 1 组的 35117 名 FM 患者和第 2 组的 34630 名 GERD 患者，他们均于 2000 年至 2010 年期间被确诊。对于每个研究组，我们从相同的数据库中随机选择了 4 倍没有 FM 或 GERD 的患者，按性别、年龄和诊断日期进行频数匹配，作为各自的对照组。到 2011 年底，估计了第 1 组中 GERD 的发病率和第 2 组中 FM 的发病率。与非 FM 组相比，FM 组的 GERD 总体发病率高 1.6 倍（12.0 和 7.61 例/1000 人年，粗危险比[HR] = 1.58，95%置信区间[CI] = 1.51-1.66），调整性别、年龄、合并症和药物后，调整后的 HR（aHR）为 1.27（95%CI = 1.22-1.33）。最终，GERD 组发生 FM 的发病率比非 GERD 组高 1.5 倍（5.76 比 3.96 例/1000 人年），aHR 为 1.44（95%CI = 1.29-1.60）。本研究表明 FM 和 GERD 之间存在双向关系。与患有 GERD 的患者相比，患有 FM 的患者发生 GERD 的风险更高。
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