Rheumatology Unit, Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Italy.
Rheumatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Italy.
Clin Exp Rheumatol. 2023 Jun;41(6):1310-1316. doi: 10.55563/clinexprheumatol/4mlktj. Epub 2023 Jun 28.
Fibromyalgia (FM) is a chronic syndrome characterised by widespread musculoskeletal pain associated with symptoms such as fatigue, sleep disturbances and cognitive impairment. Prevalence is higher in females but the application of the 2010/2011 and 2016 revision of the American College of Rheumatology (ACR) criteria reduced prevalence differences and the actual female:male ratio is approximately 3:1. Even if lately some studies have been conducted regarding FM gender differences, disease severity is still assessed using questionnaires, such as the Revised Fibromyalgia Impact Questionnaire (FIQR), designed and validated through a predominantly female sample. The aim of this pilot study was to compare the 21 items of the FIQR among male and female patients in order to evaluate the possible existence of a gender bias.
In this case-control study, consecutive patients with a diagnosis of FM (2016 ACR criteria) were asked to answer an online survey, including demographic characteristics, disease variables and the Italian version of the FIQR. Among the 544 patients that compiled the questionnaire, 78 patients, 39 males and 39 females, matched for age and disease duration, were consecutively enrolled in order to compare their FIQR scores.
The univariate analysis showed that total FIQR scores and physical function domain scores were significantly higher in females and, among the 21 items of the FIQR, the female group obtained significantly higher scores in 6 of them. Our results showed that female patients obtain significantly higher scores in the FIQR total score and physical function domain score, in particular in 5 out of the 9 sub-items of the FIQR physical function domain.
These preliminary results indicate that the use of the FIQR as a severity index in male patients probably underestimates the disease impact in this group.
纤维肌痛(FM)是一种以广泛肌肉骨骼疼痛为特征的慢性综合征,伴有疲劳、睡眠障碍和认知障碍等症状。女性的患病率较高,但美国风湿病学会(ACR)2010/2011 年和 2016 年修订标准的应用降低了患病率差异,实际的女性与男性比例约为 3:1。即使最近有一些关于 FM 性别差异的研究,但疾病严重程度仍通过修订后的纤维肌痛影响问卷(FIQR)等问卷进行评估,FIQR 是通过主要为女性的样本设计和验证的。本研究旨在比较男性和女性 FM 患者 FIQR 的 21 个项目,以评估是否存在性别偏见。
在这项病例对照研究中,连续诊断为 FM 的患者(2016 ACR 标准)被要求在线回答问卷,包括人口统计学特征、疾病变量和 FIQR 的意大利语版本。在完成问卷的 544 名患者中,为了比较他们的 FIQR 评分,连续纳入了 78 名年龄和疾病持续时间相匹配的男性和女性患者,他们各 39 名。
单变量分析显示,女性的 FIQR 总分和身体功能域评分明显较高,在 FIQR 的 21 个项目中,女性组在其中 6 个项目中得分明显较高。我们的结果表明,女性患者在 FIQR 总分和身体功能域评分中得分明显较高,特别是在 FIQR 身体功能域的 9 个子项中的 5 个子项中。
这些初步结果表明,在男性患者中使用 FIQR 作为严重程度指数可能低估了该组疾病的影响。