Jiang Li, D'Souza Ryan S, Oh Terry, Vincent Ann, Mohabbat Arya B, Ashmore Zachary, Mauck William D, Ge Lin, Whipple Mary O, McAllister Samantha J, Wang Zhen, Qu Wenchun
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
Mayo Clin Proc Innov Qual Outcomes. 2020 Dec 10;4(6):767-774. doi: 10.1016/j.mayocpiqo.2020.06.009. eCollection 2020 Dec.
To investigate sex-related differences in patients with fibromyalgia (FM) in terms of demographic characteristics and clinical features, including tender point count (TPC), mood disorders, sleep problems, FM symptom severity, fatigue, cognitive dysfunction, and quality of life (QOL).
We studied 668 consecutive patients with FM (606 women) from May 1, 2012, to November 30, 2013. Validated questionnaires assessed outcomes of depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), sleep problems (Medical Outcomes Study Sleep Scale), FM symptom severity (Revised Fibromyalgia Impact Questionnaire), fatigue (Multidimensional Fatigue Inventory), cognitive dysfunction (Multiple Ability Self-report Questionnaire), and QOL (36-Item Short Form Health Survey). Nonparametric Mann-Whitney and Pearson χ tests were used to compare continuous and categorical outcome measures, respectively, between men and women. Linear regression models were performed for all continuous dependent variables, adjusting for age, body mass index, ethnicity, marital status, and highest education level completed. <.05 was considered statistically significant. The Benjamini-Hochberg procedure was used to adjust for multiple comparisons.
Multiple linear regression analysis revealed a significant association of female sex and greater TPC (<.001), lower overall FM symptom severity (lower overall Revised Fibromyalgia Impact Questionnaire score; =.03), and higher QOL subscale score for vitality (36-Item Short Form Health Survey vitality subscale score; =.02). After adjustment for multiple comparisons, only the association between female sex and greater TPC remained significant. There were no sex-related differences in demographic characteristics, depression, anxiety, sleep problems, FM symptom severity, cognitive dysfunction, and QOL.
A higher TPC may be associated with female sex in patients with FM. The assumption of other sex-based differences in the clinical presentation of FM was not supported in our study.
探讨纤维肌痛（FM）患者在人口统计学特征和临床特征方面的性别差异，包括压痛点计数（TPC）、情绪障碍、睡眠问题、FM症状严重程度、疲劳、认知功能障碍和生活质量（QOL）。
我们研究了2012年5月1日至2013年11月30日期间连续收治的668例FM患者（606例女性）。使用经过验证的问卷评估抑郁（患者健康问卷-9）、焦虑（广泛性焦虑障碍-7）、睡眠问题（医学结局研究睡眠量表）、FM症状严重程度（修订的纤维肌痛影响问卷）、疲劳（多维疲劳量表）、认知功能障碍（多项能力自评问卷）和QOL（36项简短健康调查）的结果。分别使用非参数曼-惠特尼检验和Pearson χ检验比较男性和女性之间的连续和分类结局指标。对所有连续的因变量进行线性回归模型分析，并对年龄、体重指数、种族、婚姻状况和最高学历进行校正。P <.05被认为具有统计学意义。采用Benjamini-Hochberg程序对多重比较进行校正。
多元线性回归分析显示，女性性别与更高的TPC（P <.001）、更低的总体FM症状严重程度（更低的总体修订纤维肌痛影响问卷得分；P =.03）以及更高的活力QOL子量表得分（36项简短健康调查活力子量表得分；P =.02）之间存在显著关联。在对多重比较进行校正后，仅女性性别与更高的TPC之间的关联仍然显著。在人口统计学特征、抑郁、焦虑、睡眠问题、FM症状严重程度、认知功能障碍和QOL方面不存在性别差异。
FM患者中较高的TPC可能与女性性别有关。我们的研究不支持FM临床表现中其他基于性别的差异这一假设。
