Background & Aims
Fibromyalgia (FM) and chronic fatigue syndrome (CFS) have similar symptoms, including pain and psychological distress (1, 2). One of the pathomechanisms underlying those diseases is inflammation, a typical contributor to neurodegenerative diseases and cardiovascular diseases (CVDs) (3, 4). However, the prevalence and risks of neurodegeneration and CVDs induced by FM and CFS have not been compared. This study sought to estimate prevalence and compare cumulative risks of neurodegeneration and CVDs between FM and CFS by analyzing multiregional, real-world data collected from the TriNetX research platform.
Methods
We collected data from the TriNetX Global Collaborative Network, which provides access to real-world data from 118 healthcare organizations. We defined two cohorts based on the ICD-10 codes: the FM cohort and the CFS cohort of adult patients (? 18 years old). We estimated the prevalence of neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, and multiple sclerosis, as well as cardiovascular disorders such as major adverse cardiovascular events (MACEs), ischemic brain complications, and ischemic heart diseases. We compare the cumulative risks of those diseases between the two cohorts after conducting 1: 1 propensity score matching using age at index, gender, BMI, systolic blood pressure, diastolic blood pressure, diabetes, hypertension, metabolic disorders, chronic kidney disease, COPD, mood disorders, sleep disorders, HbA1c, LDL, HDL, cholesterol, and triglyceride levels. We conducted data analyses in May 2024, utilizing built-in functions.
Results
The prevalence of neurodegenerative diseases and CVDs ranged from 0.020 to 2.556% and 10.67 to 20.79%, respectively, which were increased by age. When conducting 1:1 propensity score matching, most standardized differences in baseline clinical and preclinical features between the FM cohort (n = 32,737) and CFS cohort (n = 32,737) were smaller than 0.1 after matching, indicating a well-executed matching procedure. The odds of neurodegenerative disorders induced by FM were significantly higher than those induced by CFS (Alzheimer’s disease: OR = 1.961, 95% CI = 1.590–2.418; Parkinson’s disease: OR = 1.630, 95% CI = 1.313–2.022; Multiple sclerosis: OR = 2.040, 95% CI = 1.559–2.670), except Huntington’s disease (OR = 1.000, 95% CI = 0.416–2.402). Furthermore, the odds of CVDs induced by FM were 2-3 times higher than those induced by CFS (ischemic brain complications: OR = 2.454, 95% CI = 2.288–2.632; ischemic heart disease: OR = 2.923, 95% CI = 2.680–3.187; MACEs: OR = 2.571, 95% CI = 2.428–2.721).
Conclusions
FM might have a higher risk of neurodegeneration and cardiovascular disorders compared to CFS. This is the first study using large-scale, multiregional data from TriNetX to estimate prevalence and compare the cumulative risks of neurodegeneration and cardiovascular disorders caused by FM and CFS. The findings raise the need for further investigation of the differences in pathomechanisms by which FM and CFS impact the central nervous system and cardiovascular system. Our study also supports further studies regarding the prevention and prognosis of neurodegeneration and cardiovascular risks in FM and CFS.
References
1. Clauw D. J. (2014). Fibromyalgia: a clinical review. JAMA, 311(15), 1547–1555. https://doi.org/10.1001/jama.2014.3266
2. Prins, J. B., van der Meer, J. W., & Bleijenberg, G. (2006). Chronic fatigue syndrome. Lancet (London, England), 367(9507), 346–355. https://doi.org/10.1016/S0140-6736(06)68073-2
3. Romano, G. F., Tomassi, S., Russell, A., Mondelli, V., & Pariante, C. M. (2015). Fibromyalgia and chronic fatigue: the underlying biology and related theoretical issues. Advances in psychosomatic medicine, 34, 61–77. https://doi.org/10.1159/000369085
4. Alfaddagh A, Martin SS, Leucker TM, Michos ED, Blaha MJ, Lowenstein CJ, Jones SR, Toth PP. Inflammation and cardiovascular disease: From mechanisms to therapeutics. Am J Prev Cardiol. 2020 Nov 21;4:100130. doi: 10.1016/j.ajpc.2020.100130
Presenting Author
Nguyen Thanh Nhu
Poster Authors
Topics
- Specific Pain Conditions/Pain in Specific Populations: Fibromyalgia