Arthritis Research UK Centre for Epidemiology, Division of Musculoskeletal & Dermatological Sciences, University of Manchester, Manchester, UK.
NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
Rheumatology (Oxford). 2019 Nov 1;58(11):1923-1927. doi: 10.1093/rheumatology/kez028.
To test whether central sensitization was associated with greater fatigue, independently of musculoskeletal pain.
2477 prospective cohort study participants completed a baseline questionnaire comprising the Chalder Fatigue Scale (CFQ), pain, demographics, physical activity, anxiety, depression and medication use. In a clinical assessment of 290 (11.7%) participants, central sensitization was measured by the wind-up ratio test at the hand (WUR-H) and foot (WUR-F). Bioelectric impedance determined proportion body fat. All participants were followed up 12 months later, at which time they completed the CFQ. Linear regression, with inverse probability sampling weights, tested the relationship between WUR at baseline and CFQ at 12 months, adjusted for baseline CFQ, demographics, lifestyle factors, mental health and baseline pain.
At baseline, the median interquartile range WUR-H and WUR-F were similar (2.3 (1.5, 4.0) and 2.4 (1.6, 3.9) respectively) and did not differ by sex (difference WUR-H: -0.29, 95% confidence interval -1.28-0.71; WUR-F: -0.57 (-1.50-0.36) or age(WUR-H: -0.53, -1.49-0.43; WUR-F:-0.08, -0.98-0.82). WUR-H scores (β = 0.11, 95% confidence interval: 0.07-0.16) and WUR-F scores (0.13, 0.08-0.17) were positively associated with CFQ scores at follow-up, independently of baseline CFQ and other covariates. These associations were not explained by baseline pain.
Fatigue was predicted by central sensitization, independently of the presence of pain. For those seeking to treat fatigue, the benefit of interventions that reduce central sensitization should be investigated.
检验中枢敏化是否与疲劳有关，且与肌肉骨骼疼痛无关。
2477 名前瞻性队列研究参与者完成了基线问卷，包括 Chalder 疲劳量表（CFQ）、疼痛、人口统计学、体育活动、焦虑、抑郁和药物使用情况。在对 290 名（11.7%）参与者的临床评估中，通过手部（WUR-H）和足部（WUR-F）的上旋比测试测量中枢敏化。生物电阻抗确定体脂比例。所有参与者在 12 个月后进行随访，此时他们完成了 CFQ。使用逆概率抽样权重的线性回归测试了基线时 WUR 与 12 个月时 CFQ 的关系，调整了基线 CFQ、人口统计学、生活方式因素、心理健康和基线疼痛。
基线时，中位数四分位距 WUR-H 和 WUR-F 相似（分别为 2.3（1.5，4.0）和 2.4（1.6，3.9）），且不分性别（WUR-H 差值：-0.29，95%置信区间-1.28-0.71；WUR-F：-0.57（-1.50-0.36）或年龄（WUR-H：-0.53，-1.49-0.43；WUR-F：-0.08，-0.98-0.82）。WUR-H 评分（β=0.11，95%置信区间：0.07-0.16）和 WUR-F 评分（0.13，0.08-0.17）与随访时的 CFQ 评分呈正相关，且与基线 CFQ 和其他协变量无关。这些关联不能用基线疼痛来解释。
疲劳与中枢敏化有关，且与疼痛的存在无关。对于那些寻求治疗疲劳的人，应该研究减少中枢敏化的干预措施的益处。
