缺铁、焦虑、抑郁和多种疼痛状况的终生病史之间的关联：一项使用大规模国家数据库的观察性研究。
Associations Between Lifetime Histories of Iron Deficiency, Anxiety, Depression and Multiple Pain Conditions: An Observational Study Using a Large-Scale National Database.
作者信息
Champion David, Bui Minh, Aouad Phillip, Teng Arthur, Walters Arthur S, Karroum Elias Georges, Tan Aidan Christopher, Yang Zijing, Joyce Emily, Jaaniste Tiina
机构信息
School of Clinical Medicine, University of New South Wales, UNSW, Sydney, NSW, 2052, Australia.
Department of Pain Medicine, Sydney Children`s Hospital, Randwick, NSW, 2031, Australia.
出版信息
J Pain Res. 2025 Jul 30;18:3781-3792. doi: 10.2147/JPR.S497122. eCollection 2025.
PURPOSE
Our aims were to investigate in adults, as we have shown in three paediatric samples, associations between a history of iron deficiency (whenever acquired and treated) and history (> 3 months) of primary, overlapping and multisite chronic pain conditions, and to investigate associations between history of iron deficiency, anxiety, and depression.
PARTICIPANTS AND METHODS
We recruited adult twins and their families from the Australian Twin Registry database. Responders addressed questionnaires about lifetime history of iron deficiency >3 months, diagnosed and treated by a physician, and a history >3 months of listed pain conditions, anxiety and depression. The emphasis was on life history, not current status, of each of these conditions and such questions were the only practical method. Logistic regression, using generalized estimating equation to account for correlations within twin families, was employed to assess relationships between iron deficiency and pain conditions and the psychological conditions.
RESULTS
Of the 1519 adult responders, 1326 addressed the criteria for iron deficiency, and the prevalence was 38.7% in females and 2.4% in males. Iron deficiency as statistical predictor was significantly associated with migraine (Odds ratio (OR)=1.70, p=0.001), headache (OR=1.37, p=0.03), recurrent abdominal pain (OR=1.97, p<0.001), dysmenorrhea (OR=2.18, p<0.001), anxiety (OR=1.88, p<0.001) and depression (OR=2.06, p<0.001). Iron deficiency, anxiety and depression, as statistical predictors, were univariately and multivariately associated with the number of pain conditions (all p<0.05).
CONCLUSION
A history of iron deficiency in a community sample of adults was associated with most individual, primary, overlapping and multisite pain conditions tested, and multivariately associated with the number of pain conditions, and with anxiety and depression. We hypothesize, consistent with these results, that previous or current iron deficiency, even when treated, influences pain sensitivity and multiplicity directly and through known effects on anxiety and depression.
目的
正如我们在三个儿科样本中所显示的那样，我们的目标是在成年人中研究缺铁病史（无论何时发生及是否接受治疗）与原发性、重叠性和多部位慢性疼痛状况病史（超过3个月）之间的关联，并研究缺铁病史、焦虑和抑郁之间的关联。
参与者与方法
我们从澳大利亚双胞胎登记数据库中招募成年双胞胎及其家人。应答者填写了关于由医生诊断并治疗的超过3个月缺铁病史以及超过3个月的所列疼痛状况、焦虑和抑郁病史的问卷。重点是这些状况中的每一种的生活史，而非当前状态，此类问题是唯一可行的方法。采用逻辑回归，并使用广义估计方程来考虑双胞胎家庭内部的相关性，以评估缺铁与疼痛状况以及心理状况之间的关系。
结果
在1519名成年应答者中，1326人符合缺铁标准，女性患病率为38.7%，男性为2.4%。缺铁作为统计预测指标与偏头痛（优势比（OR）=1.70，p = 0.001）、头痛（OR = 1.37，p = 0.03）、复发性腹痛（OR = 1.97，p < 0.001）、痛经（OR = 2.18，p < 0.001）、焦虑（OR = 1.88，p < 0.001）和抑郁（OR = 2.06，p < 0.001）显著相关。缺铁、焦虑和抑郁作为统计预测指标，在单变量和多变量分析中均与疼痛状况的数量相关（所有p < 0.05）。
结论
在一个成年人社区样本中，缺铁病史与所测试的大多数个体性、原发性、重叠性和多部位疼痛状况相关，并且在多变量分析中与疼痛状况的数量以及焦虑和抑郁相关。与这些结果一致，我们推测，既往或当前的缺铁，即使经过治疗，也会直接以及通过对焦虑和抑郁的已知影响来影响疼痛敏感性和疼痛的多样性。
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