Post-Deployment Health Epidemiology Program, Office of Patient Care Services, Department of Veterans Affairs, Washington, DC, United States of America; Center of Excellence for Suicide Prevention, Department of Veterans Affairs, United States of America.
Department of Epidemiology, School of Public Health, West Virginia University, United States of America.
Life Sci. 2021 Oct 1;282:119795. doi: 10.1016/j.lfs.2021.119795. Epub 2021 Jul 4.
Gulf War Illness (GWI) remains a significant health concern for many veterans. The relation of pre-war health conditions and symptoms to GWI could aid in developing a more accurate case definition of GWI. The objective of this study was to investigate pre-war predictors of GWI in a population-based sample of Gulf War veterans using two definitions of GWI.
Data come from the 1995-1997 National Health Survey of Persian Gulf War Era Veterans, a survey of a representative sample of deployed and non-deployed US veterans. Using two definitions of GWI (CDC/Kansas and a newly developed 3-domain definition), we conducted a series of multivariable logistic regression analyses to assess the associations of demographic, lifestyle factors, and pre-war medical conditions and symptoms to subsequent GWI.
All pre-war symptom predictor domains were significantly and positively associated with GWI using a new 3-domain definition with aORs for individual domains ranging from 2.17 (95% CI = 1.99-2.38) for dermatologic conditions to 3.06 (95% CI = 2.78-3.37) for neurological conditions. All symptom predictor domains were associated with significantly increased likelihood of GWI using the CDC/Kansas definition, with aORs ranging from 2.54 (95% CI = 2.31-2.81) for inflammatory conditions to 3.22 (95% CI = 2.94-3.55) for neurological conditions. These estimates were attenuated but remained significant after inclusion of all significant symptom predictor domains.
Results from this study suggest that demographic/lifestyle factors and pre-war medical conditions are strong predictors of GWI. Additional research is needed to confirm these findings, and to clarify the unique characteristics of this common, but still poorly understood illness.
海湾战争综合征（GWI）仍然是许多退伍军人关注的重要健康问题。战前健康状况和症状与 GWI 的关系有助于更准确地确定 GWI 的病例定义。本研究的目的是使用两种 GWI 定义，在基于人群的海湾战争退伍军人样本中调查 GWI 的战前预测因素。
数据来自 1995-1997 年海湾战争时代退伍军人国家健康调查，这是对部署和未部署的美国退伍军人的代表性样本进行的调查。使用两种 GWI 定义（CDC/堪萨斯州和新开发的 3 域定义），我们进行了一系列多变量逻辑回归分析，以评估人口统计学、生活方式因素以及战前医疗状况和症状与随后 GWI 的关联。
使用新的 3 域定义，所有战前症状预测因素领域与 GWI 均呈显著正相关，个体领域的优势比（aOR）范围从皮肤病况的 2.17（95%置信区间[CI] = 1.99-2.38）到神经状况的 3.06（95% CI = 2.78-3.37）。使用 CDC/Kansas 定义，所有症状预测因素领域均与 GWI 的可能性显著增加相关，炎症状况的 aOR 为 2.54（95% CI = 2.31-2.81），神经状况的 aOR 为 3.22（95% CI = 2.94-3.55）。在纳入所有显著的症状预测因素领域后，这些估计值有所减弱，但仍然具有统计学意义。
这项研究的结果表明，人口统计学/生活方式因素和战前医疗状况是 GWI 的强有力预测因素。需要进一步研究来证实这些发现，并阐明这种常见但仍知之甚少的疾病的独特特征。
