Heikkala Eveliina, Karppinen Jaro
Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland.
Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
Fam Pract. 2025 Jun 4;42(4). doi: 10.1093/fampra/cmaf057.
Musculoskeletal (MSK) pain is known to influence health-related quality of life (HRQoL), but the role of co-occurring chronic diseases in HRQoL in a MSK pain population has been less studied. This study aimed to evaluate (i) whether chronic disease clusters are related to HRQoL and (ii) whether these relationships differ in magnitude from those between the number of chronic diseases and HRQoL among people with MSK pain.
The Northern Finland Birth Cohort 1966 and its 46-year data collection point were used. The chronic disease clusters for individuals reporting any MSK pain within the past year were previously formulated using latent class analysis and consisted of: Psychiatric (co-existing mental health disorder, substance use disorder, and asthma), Metabolic (referring to the burden of metabolic diseases), and Relatively healthy. HRQoL was measured with a 15-dimension questionnaire. General linear regression model was used.
Among 4490 participants, both the Psychiatric and Metabolic clusters associated with clinically significantly reduced HRQoL, when contrasted with the Relatively healthy cluster, but the association was stronger for the Psychiatric cluster. Similarly, the adjusted mean difference in HRQoL was higher for the Psychiatric cluster than for the multimorbidity (two or more diseases) category when compared with the reference categories (Relatively healthy cluster and no chronic diseases, respectively).
The present findings imply the clinical relevance of the previously identified chronic disease clusters and suggest that pure counts of chronic diseases may not be enough to describe the role of chronic diseases in HRQoL in MSK pain.
已知肌肉骨骼(MSK)疼痛会影响健康相关生活质量(HRQoL),但并存的慢性病在MSK疼痛人群的HRQoL中的作用研究较少。本研究旨在评估:(i)慢性病集群是否与HRQoL相关;(ii)在MSK疼痛患者中,这些关系在程度上是否与慢性病数量和HRQoL之间的关系有所不同。
使用了1966年芬兰北部出生队列及其46年的数据收集点。先前通过潜在类别分析为过去一年中报告有任何MSK疼痛的个体制定了慢性病集群,包括:精神类(并存心理健康障碍、物质使用障碍和哮喘)、代谢类(指代谢疾病负担)和相对健康类。使用一份15维度问卷测量HRQoL。采用一般线性回归模型。
在4490名参与者中,与相对健康类集群相比,精神类和代谢类集群均与临床上显著降低的HRQoL相关,但精神类集群的相关性更强。同样,与参考类别(分别为相对健康类集群和无慢性病)相比,精神类集群的HRQoL调整后平均差异高于多病共存(两种或更多疾病)类别。
本研究结果表明了先前确定的慢性病集群的临床相关性,并表明单纯的慢性病计数可能不足以描述慢性病在MSK疼痛患者HRQoL中的作用。