Centre for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
Centre for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
BMJ Open. 2022 Nov 2;12(11):e066037. doi: 10.1136/bmjopen-2022-066037.
It has been suggested that infections can trigger functional somatic disorders (FSD). However, current evidence is limited by inconsistent findings in smaller studies conducted in clinical settings within selected populations and short follow-up times. We aimed to test the hypothesis that former infections are associated with FSD using data from nationwide registries and a large population-based cohort study, the Danish Study of Functional Disorders study.
FSD cases were identified in a cross-sectional population-based cohort and linked retrospectively to former hospital contacts with infections identified in the Danish National Patient Registry. The associations between FSD and former infections within 17 years were analysed using logistic regressions to calculate ORs and 95% CIs adjusted for age, sex and subjective social status.
A population-based cohort in Denmark examined between 2011 and 2015.
A total of 9656 men and women aged 18-76 years.
FSD measured by various delimitations, including bodily distress syndrome (BDS), irritable bowel (IB), chronic fatigue (CF), chronic widespread pain (CWP), and multiple chemical sensitivity (MCS).
Overall, infections were associated with increased risk of all delimitations of FSD. The associations were more pronounced for multisystemic FSD. The number of prior infections increased the risk in a dose-response manner (p<0.0001). Bacterial but not viral infections were significantly associated with BDS (OR 1.69 (95% CI 1.46 to 1.96)), IB (OR 1.41 (95% CI 1.06 to 1.88)), CWP (OR 1.47 (95% CI 1.13 to 1.90)) and CF (OR 1.62 (95% CI 1.34 to 1.96)), but not MCS.
Former infections leading to hospital contacts were associated with a higher risk of having FSD. These associations were more pronounced for bacterial than viral infections, and more infections increased the risk in a dose-response manner. These results tend to support the idea that severe infections could play a role in FSD.
有观点认为感染可引发功能性躯体障碍（FSD）。然而，当前的证据受到了限制，因为在特定人群的临床环境中进行的规模较小的研究结果不一致，随访时间也较短。我们旨在使用全国性登记处和一项大型基于人群的队列研究——丹麦功能性障碍研究的数据，检验感染与 FSD 相关的假设。
在一项基于人群的横断面队列研究中确定 FSD 病例，并回顾性地将其与丹麦国家患者登记处中确定的感染相关的既往医院就诊联系起来。使用逻辑回归分析 FSD 与 17 年内既往感染之间的关联，以计算调整年龄、性别和主观社会地位后 OR 和 95%CI。
丹麦的一个基于人群的队列，研究时间为 2011 年至 2015 年。
年龄在 18-76 岁之间的共 9656 名男性和女性。
采用多种界定方法测量 FSD，包括躯体不适综合征（BDS）、肠易激（IB）、慢性疲劳（CF）、慢性广泛疼痛（CWP）和多种化学物质敏感（MCS）。
总体而言，感染与所有 FSD 界定的风险增加相关。多系统 FSD 的相关性更为显著。既往感染次数呈剂量反应式增加风险（p<0.0001）。细菌感染而非病毒感染与 BDS（OR 1.69（95%CI 1.46-1.96））、IB（OR 1.41（95%CI 1.06-1.88））、CWP（OR 1.47（95%CI 1.13-1.90））和 CF（OR 1.62（95%CI 1.34-1.96））显著相关，但与 MCS 无关。
导致医院就诊的既往感染与 FSD 风险增加相关。这些关联在细菌感染中比病毒感染更为显著，且感染次数越多，呈剂量反应式增加风险。这些结果倾向于支持严重感染可能在 FSD 中起作用的观点。
