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海湾战争时期队列和生物库中的海湾战争病:堪萨斯和疾病控制中心的定义。

Gulf War illness in the Gulf War Era Cohort and Biorepository: The Kansas and Centers for Disease Control definitions.

机构信息

Cooperative Studies Program Epidemiology Center-Durham, Durham VA Medical Center, Durham VA Health Care System, Durham, NC, USA; Duke University Sanford School of Public Policy, Center for Child and Family Policy, Duke Margolis Center for Health Policy, Durham, NC, USA.

Cooperative Studies Program Epidemiology Center-Durham, Durham VA Medical Center, Durham VA Health Care System, Durham, NC, USA; Computational Biology and Bioinformatics Program, Duke University School of Medicine, Durham, NC, USA.

出版信息

Life Sci. 2021 Aug 1;278:119454. doi: 10.1016/j.lfs.2021.119454. Epub 2021 Mar 31.


DOI:10.1016/j.lfs.2021.119454
PMID:33811897
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10148241/
Abstract

AIMS: This study characterizes Gulf War Illness (GWI) among U.S. veterans who participated in the Gulf War Era Cohort and Biorepository (GWECB). MAIN METHODS: Mailed questionnaires were collected between 2014 and 2016. Self-reported GWI symptoms, symptom domain criteria, exclusionary diagnoses, and case status were examined based on the originally published Kansas and Centers for Disease Control (CDC) definitions in the GWECB cohort (n = 849 deployed to Gulf and n = 267 non-deployed). Associations among GWI and deployment status, demographic, and military service characteristics were examined using logistic regression. KEY FINDINGS: Among deployed veterans in our sample, 39.9% met the Kansas criteria and 84.2% met the CDC criteria for GWI. Relative to non-deployed veterans, deployed veterans had a higher odds of meeting four GWI case status-related measures including the Kansas symptom criteria (aOR = 2.05, 95% CI = 1.50, 2.80), Kansas GWI case status (aOR = 1.42, 95% CI = 1.05, 1.93), the CDC GWI case status (aOR = 1.57, 95% CI = 1.07, 2.29) and the CDC severe criteria (aOR = 2.67, 95% CI = 1.79, 3.99). Forty percent met the Kansas exclusionary criteria, with no difference by deployment status. Some symptoms were nearly universally endorsed. SIGNIFICANCE: This analysis provides evidence of a sustained, multisymptom illness in veterans who deployed to the Persian Gulf War compared to non-deployed Gulf War era veterans nearly 25 years later. Differences in symptoms attributed to GWI by deployment status have diminished since initial reports, suggesting the need to update GWI definitions to account for aging-related conditions and symptoms. This study provides a foundation for future efforts to establish a single GWI case definition and analyses that employ the biorepository.

摘要

目的:本研究对参加海湾战争时代队列和生物库(GWECB)的美国退伍军人中的海湾战争病(GWI)进行了描述。

方法:2014 年至 2016 年间收集了邮寄问卷。根据 GWECB 队列中最初发表的堪萨斯州和疾病控制与预防中心(CDC)的定义(n=849 名部署到海湾地区,n=267 名非部署),检查了自我报告的 GWI 症状、症状域标准、排除性诊断和病例状态。使用逻辑回归检查 GWI 与部署状态、人口统计学和军事服务特征之间的关联。

主要发现:在我们的样本中,部署的退伍军人中有 39.9%符合堪萨斯州标准,84.2%符合疾病预防控制中心的 GWI 标准。与非部署的退伍军人相比,部署的退伍军人更有可能符合四项与 GWI 病例状态相关的测量标准,包括堪萨斯州症状标准(OR=2.05,95%CI=1.50,2.80)、堪萨斯州 GWI 病例状态(OR=1.42,95%CI=1.05,1.93)、疾病预防控制中心 GWI 病例状态(OR=1.57,95%CI=1.07,2.29)和疾病预防控制中心严重标准(OR=2.67,95%CI=1.79,3.99)。40%符合堪萨斯州排除标准,与部署状态无关。有些症状几乎普遍得到认可。

意义:这项分析提供了证据,证明与近 25 年前参加波斯湾战争的非部署海湾战争时代退伍军人相比,部署到波斯湾战争的退伍军人患有持续的多症状疾病。由于最初的报告,与部署状态相关的归因于 GWI 的症状差异已经缩小,这表明需要更新 GWI 定义,以考虑与年龄相关的疾病和症状。本研究为未来努力建立单一 GWI 病例定义和使用生物库进行分析奠定了基础。

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[3]
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Environ Health. 2024-10-25

[4]
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[5]
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Mil Med Res. 2024-7-8

[6]
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J Aging Health. 2025-6

[7]
The prevalence of mild cognitive impairment in Gulf War veterans: a follow-up study.

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[8]
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[9]
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[10]
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本文引用的文献

[1]
Gulf War Era Veterans' perspectives on research: a qualitative study.

Life Sci. 2021-12-15

[2]
Research tool for classifying Gulf War illness using survey responses: Lessons for writing replicable algorithms for symptom-based conditions.

Life Sci. 2021-10-1

[3]
A Systematic Review of Therapeutic Interventions and Management Strategies for Gulf War Illness.

Mil Med. 2021-1-30

[4]
Changes in Health Status in the Ft. Devens Gulf War Veterans Cohort: 1997-2017.

Neurosci Insights. 2020-8-20

[5]
Prevalence of Chronic Multisymptom Illness/Gulf War Illness Over Time Among Millennium Cohort Participants, 2001 to 2016.

J Occup Environ Med. 2020-1

[6]
Treatment for Gulf War Illness (GWI) with KPAX002 (methylphenidate hydrochloride + GWI nutrient formula) in subjects meeting the Kansas case definition: A prospective, open-label trial.

J Psychiatr Res. 2019-8-9

[7]
Metabolic features of Gulf War illness.

PLoS One. 2019-7-26

[8]
The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild Traumatic Brain Injury.

Brain Sci. 2018-11-13

[9]
The Gulf War Era Cohort and Biorepository: A Longitudinal Research Resource of Veterans of the 1990-1991 Gulf War Era.

Am J Epidemiol. 2018-11-1

[10]
Multiple Mild Traumatic Brain Injuries Are Associated with Increased Rates of Health Symptoms and Gulf War Illness in a Cohort of 1990-1991 Gulf War Veterans.

Brain Sci. 2017-7-9

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