父母的慢性广泛性疼痛及其与成年子女慢性广泛性疼痛的关联：来自挪威HUNT研究的家族连锁数据。

Parental chronic widespread pain and the association with chronic widespread pain in adult offspring: Family-linkage data from the Norwegian HUNT Study.

作者信息

Zadro J R, Nilsen T I L, Shirley D, Amorim A B, Ferreira P H, Mork P J

机构信息

Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, NSW, Australia.

Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.

出版信息

Eur J Pain. 2018 Apr 28. doi: 10.1002/ejp.1237.

DOI:10.1002/ejp.1237

PMID:29704885

Abstract

BACKGROUND

Individuals experiencing chronic widespread pain (CWP) have greater disability and poorer quality of life compared to those with other chronic painful conditions; although research identifying risk factors for CWP is lacking. We aimed to investigate whether parental CWP increases the risk of offspring CWP, and if offspring body mass index (BMI) and leisure time physical activity modify this association.

METHODS

We included 6589 parent-offspring trios participating in the Norwegian HUNT Study in 1995-1997 and 2006-2008. Logistic regression was used to calculate adjusted odd ratios (ORs) (95% confidence intervals, CIs) as estimates of relative risk for offspring CWP. We analysed the joint effect of parental CWP and offspring BMI or leisure time physical activity on offspring risk of CWP and calculated the relative excess risk due to interaction (RERI).

RESULTS

In total, 886 (13.5%) offspring developed CWP during follow-up. Having one (OR = 1.23, 95% CI, 1.05-1.44) or both parents with CWP (OR = 1.89, 95% CI, 1.50-2.38) increased the risk of offspring CWP. In analyses of joint effects, ORs were 1.84 (95% CI, 1.31-2.56) and 3.35 (95% CI, 1.94-5.77) in normal weight and obese offspring, respectively, when both parents had CWP. The estimate of RERI suggested some synergistic effect (RERI = 1.19, 95% CI, -0.68 to 3.05), although precision was low. Risk of CWP was similar in active (OR = 2.05, 95% CI, 1.56-2.70) and inactive (OR = 1.96, 95% CI, 1.31-2.91) offspring when both parents had CWP.

CONCLUSION

Parental CWP increases the risk of CWP in adult offspring, particularly if both parents have CWP and offspring are obese. This highlights a familial predisposition for CWP and an important target group for preventive measures.

SIGNIFICANCE

The parent-offspring transmission of CWP is stronger in obese offspring (particularly when both parents have CWP). This study is the first to investigate the interaction between modifiable lifestyle factors, familial factors and CWP.

摘要

背景

与患有其他慢性疼痛疾病的个体相比，经历慢性广泛性疼痛（CWP）的个体残疾程度更高，生活质量更差；尽管缺乏关于CWP风险因素的研究。我们旨在调查父母患CWP是否会增加后代患CWP的风险，以及后代体重指数（BMI）和休闲时间身体活动是否会改变这种关联。

方法

我们纳入了1995 - 1997年和2006 - 2008年参与挪威HUNT研究的6589对亲子三人组。采用逻辑回归计算调整后的比值比（OR）（95%置信区间，CI），作为后代患CWP相对风险的估计值。我们分析了父母患CWP与后代BMI或休闲时间身体活动对后代患CWP风险的联合效应，并计算了交互作用导致的相对超额风险（RERI）。

结果

在随访期间，共有886名（13.5%）后代患CWP。父母一方患CWP（OR = 1.23，95% CI，1.05 - 1.44）或父母双方患CWP（OR = 1.89，95% CI，1.50 - 2.38）都会增加后代患CWP的风险。在联合效应分析中，当父母双方都患CWP时，正常体重后代的OR为1.84（95% CI，1.31 - 2.56），肥胖后代的OR为3.35（95% CI，1.94 - 5.77）。RERI估计值表明存在一些协同效应（RERI = 1.19，95% CI， - 0.68至3.05），尽管精度较低。当父母双方都患CWP时，活跃后代（OR = 2.05，95% CI，1.56 - 2.70）和不活跃后代（OR = 1.96，95% CI，1.31 - 2.91）患CWP的风险相似。