Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.
Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.
Acta Odontol Scand. 2021 Oct;79(7):545-553. doi: 10.1080/00016357.2021.1909746. Epub 2021 Apr 16.
Low-grade inflammation and depressiveness have been associated with chronic pain conditions.
To examine whether low-grade inflammation mediates the association between depressive symptoms and temporomandibular (TM) pain in Finnish adults based on the Health 2000/2011 Surveys (BRIF8901).
The sample comprised subjects who underwent clinical TM pain examination (pain on palpation of the masticatory muscles and temporomandibular joints) in 2000 and 2011 and responded to questions on TM pain symptoms in 2011. The serum level of hs-CRP was obtained in both years, and depressiveness was assessed using the Beck Depression Inventory-21 (BDI-21) in 2000 and BDI-13 in 2011. Four subgroups were formed based on the presence of TM pain: No pain, pain in 2000-only, pain in the 2011-only, and pain in both-years. Analyses included Rao Scott's chi-square test cross-sectionally, and multinomial logistic regression longitudinally with the level of hs-CRP and BDI-21 score in 2000 as predictors. Mediation was tested using Hayes A. Processv3.5.
Higher BDI-21/-13 and hs-CRP levels corresponded to higher prevalences of TM pain in both years. Longitudinally, in men, higher hs-CRP level predicted TM pain in 2000-only and TM pain in both-years. Higher BDI-21 score predicted having TM pain in 2011-only. In women, higher BDI-21 score predicted TM pain in 2000-only and having TM pain in both-years. Both BDI-21 and hs-CRP had a direct effect on TM pain outcome with no mediation detected.
While depressiveness may increase the risk of chronic TM pain in women, the risk in men is increased by low-grade inflammation.
低度炎症和抑郁与慢性疼痛状况有关。
基于“健康 2000/2011 调查”（BRIF8901），研究芬兰成年人的低度炎症是否在抑郁症状与颞下颌（TM）疼痛之间起中介作用。
本研究样本包括 2000 年和 2011 年接受 TM 疼痛临床检查（咀嚼肌和颞下颌关节触诊时疼痛）且 2011 年回答 TM 疼痛症状问题的受试者。在这两年中均检测 hs-CRP 血清水平，2000 年使用贝克抑郁量表 21 项（BDI-21）评估抑郁程度，2011 年使用 BDI-13 评估抑郁程度。根据 TM 疼痛的存在情况，将受试者分为 4 个亚组：无痛、2000 年疼痛、2011 年疼痛、两年均疼痛。分析包括 Rao Scott 的卡方检验（横截面）和 2000 年 hs-CRP 水平和 BDI-21 评分的多变量逻辑回归（纵向），作为预测指标。使用 Hayes A. Processv3.5 进行中介检验。
较高的 BDI-21/-13 和 hs-CRP 水平与两年 TM 疼痛的较高患病率相对应。纵向来看，男性中，较高的 hs-CRP 水平预测 2000 年仅出现 TM 疼痛和两年均出现 TM 疼痛。较高的 BDI-21 评分预测 2011 年仅出现 TM 疼痛。女性中，较高的 BDI-21 评分预测 2000 年仅出现 TM 疼痛和两年均出现 TM 疼痛。BDI-21 和 hs-CRP 对 TM 疼痛结果均有直接影响，未发现中介作用。
虽然抑郁可能会增加女性慢性 TM 疼痛的风险，但男性的风险则由低度炎症增加。
