通过分析“我们所有人”研究项目数据揭示的慢性疼痛进展的社会人口统计学差异模式。
Sociodemographically differential patterns of chronic pain progression revealed by analyzing the all of us research program data.
作者信息
Baldwin Edwin, Zhou Jin, Luo Wenting, Hooten W Michael, Fan Jungwei W, Li Haiquan
机构信息
Department of Biosystems Engineering, University of Arizona, Tucson, Arizona, United States of America.
Department of Biostatistics, University of California at Los Angeles, Los Angeles, California, United States of America.
出版信息
PLOS Digit Health. 2025 Jun 17;4(6):e0000687. doi: 10.1371/journal.pdig.0000687. eCollection 2025 Jun.
The differential progression of ten chronic overlapping pain conditions (COPC) and four comorbid mental disorders across demographic groups have rarely been reported in the literature. To fill in this gap, we conducted retrospective cohort analyses using All of Us Research Program data from 1970 to 2023. Separate cohorts were created to assess the differential patterns across sex, race, and ethnicity. Logistic regression models, controlling for demographic variables and household income level, were employed to identify significant sociodemographic factors associated with the differential progression from one COPC or mental condition to another. Among the 139 frequent disease pairs, we identified group-specific patterns in 15 progression pathways. Black or African Americans with a COPC condition had a significantly increased association in progression to other COPCs (CLBP- > IBS, CLBP- > MHA, or IBS- > MHA, OR≥1.25, adj.p ≤ 4.0x10-3) or mental disorders (CLBP- > anxiety, CLBP- > depression, MHA- > anxiety, MHA- > depression, OR≥1.25, adj.p ≤ 1.9x10-2) after developing a COPC. Females had an increased likelihood of chronic low back pain after anxiety and depression (OR≥1.12, adj.p ≤ 1.5x10-2). Additionally, the lowest income bracket was associated with an increased risk of developing another COPC from a COPC (CLBP- > MHA, IBS- > MHA, MHA- > CLBP, or MHA- > IBS, OR≥1.44, adj.p ≤ 2.6x10-2) or from a mental disorder (depression- > MHA, depression- > CLBP, anxiety- > CLBP, or anxiety- > IBS, OR≥1.50, adj.p ≤ 2.0x10-2), as well as developing a mental disorder after a COPC (CLBP- > depression, CBLP- > anxiety, MHA- > anxiety, OR≥1.37,adj.p ≤ 1.6x10-2). To our knowledge, this is the first study that unveils the sociodemographic influence on COPC progression. These findings suggest the importance of considering sociodemographic factors to achieve optimal prognostication and preemptive management of COPCs.
十种慢性重叠疼痛病症（COPC）和四种共病精神障碍在不同人口群体中的差异进展情况在文献中鲜有报道。为填补这一空白，我们使用了“我们所有人研究计划”1970年至2023年的数据进行回顾性队列分析。创建了单独的队列以评估性别、种族和族裔间的差异模式。采用逻辑回归模型，控制人口统计学变量和家庭收入水平，以确定与从一种COPC或精神状况向另一种状况的差异进展相关的重要社会人口学因素。在139对常见疾病中，我们在15条进展途径中发现了特定群体模式。患有COPC病症的黑人或非裔美国人在患上一种COPC后，进展为其他COPC（慢性下腰痛-＞肠易激综合征、慢性下腰痛-＞肌筋膜痛、或肠易激综合征-＞肌筋膜痛，OR≥1.25，校正p≤4.0×10⁻³）或精神障碍（慢性下腰痛-＞焦虑、慢性下腰痛-＞抑郁、肌筋膜痛-＞焦虑、肌筋膜痛-＞抑郁，OR≥1.25，校正p≤1.9×10⁻²）的关联显著增加。女性在焦虑和抑郁后患慢性下腰痛的可能性增加（OR≥1.12，校正p≤1.5×10⁻²）。此外，最低收入阶层与从一种COPC进展为另一种COPC（慢性下腰痛-＞肌筋膜痛、肠易激综合征-＞肌筋膜痛、肌筋膜痛-＞慢性下腰痛、或肌筋膜痛-＞肠易激综合征，OR≥1.44，校正p≤2.6×10⁻²）或从一种精神障碍进展为另一种COPC（抑郁-＞肌筋膜痛、抑郁-＞慢性下腰痛、焦虑-＞慢性下腰痛、或焦虑-＞肠易激综合征，OR≥1.50，校正p≤2.0×10⁻²），以及在患上一种COPC后患上精神障碍（慢性下腰痛-＞抑郁、慢性下腰痛-＞焦虑、肌筋膜痛-＞焦虑，OR≥1.37，校正p≤1.6×10⁻²）的风险增加有关。据我们所知，这是第一项揭示社会人口学对COPC进展影响的研究。这些发现表明，考虑社会人口学因素对于实现COPC的最佳预后和预防性管理至关重要。
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