ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 84

Sexual Dimorphism in the Association Between Multi-Site Pain and Other Fibromyalgia Features:  an Analysis of Data from Three UK Population-Based Studies

Linda E. Dean1, Lesley Arnold2, Robert Bennett3, Leslie J. Crofford4, Don Goldenberg5, Elisa Flüß1, Daniel J. Clauw6, Mary-Ann Fitzcharles7, Eduardo Paiva8, Roland Staud9 and Gary J. Macfarlane1, 1Musculoskeletal Research Collaboration (Epidemiology Group), University of Aberdeen, Aberdeen, United Kingdom, 2University of Cincinnati, Cincinnati, OH, 3SN-Office of Research & Development, Oregon Health & Science Univ, Portland, OR, 4Medicine, Vanderbilt University, Nashville, TN, 5Newton-Wellesley Hospital, Newton, MA, 6Anesthesiology, University of Michigan, Ann Arbor, MI, 7MGH, Montreal, QC, Canada, 8Rheumatology, Universidade Federal do Parana, Curitiba Parana, Brazil, 9University of Florida, Gainesville, FL

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords:

Session Information

Date: Sunday, November 8, 2015

Title: Fibromyalgia, Soft Tissue Disorders, Regional and Specific Clinical Pain Syndromes Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

The 2011 modification of the preliminary 2010 American College of Rheumatology criteria for fibromyalgia require the self-report of multi-site pain in addition to a number of additional symptoms: fatigue, sleep disturbance, somatic symptoms and cognitive problems.  As part of the ACTTION[1]initiative – developing a new taxonomy for pain conditions, including fibromyalgia – the current study aimed to investigate whether there is sexual dimorphism between the presence of multi-site pain (MSP) and these additional features.

Methods:

Three UK-based population studies were used for the current analysis: the 1958 Birth Cohort, EpiFunD and SHAMA studies.  MSP was defined as the presence of pain in at least eight body sites, (as indicated on 4-view body manikins with a total of 35 designated sites), regardless of location.

Amongst those reporting MSP, the relationship between gender and: fatigue (lowest tertile of SF-36 Vitality (VT) Scale), sleep disturbance (Estimation of Sleep Problem Scale score 12-20), presence of somatic symptoms (Somatic Symptom Scale) and poor mood (highest tertile of General Health Questionnaire, lowest tertile of SF-36 Mental Health (MH), and Hospital Anxiety and Depression Scales (HADS)), were assessed using logistic regression models including terms for gender.  Results are presented as Odds Ratio (OR), with 95% Confidence Intervals (CI).

Results: 

There were 26,452 participants across the three study populations (mean age range: 42-55 yrs, proportion male: 43-52%).  The prevalence of MSP ranged between 12 and 17% and, within these groups, 35-47% were male. 

Amongst those reporting MSP; females reported higher levels of sleep disturbance [OR 1.2, 95% CI 1.002-1.7] and more somatic symptoms compared to males [mean 1.8, CI 1.7-1.9 vs. 1.5, 1.3-1.6].  There was also some indication that females reported higher levels of fatigue [SF36 VT 1.7, 0.97-2.9], poorer mental health [GHQ 1.4, 1.2-1.6; SF36 MH 1.3, 0.8-2.3], in addition to higher levels of anxiety [HADs 1.2, 0.9-1.7], although differences were small and not always statistically significant.  There was, however, no indication that females exhibited higher levels of clinical/borderline depression [HADS 0.8, 0.6-1.1]. 

Conclusion:

Amongst those with MSP, sex differences in the reporting of features typical of fibromyalgia are generally small and not always statistically significant, though females exhibit more sleep problems and higher levels of fatigue.

[1] Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks

Disclosure: L. E. Dean, None; L. Arnold, Pfizer Inc, 2,Eli Lilly and Company, 2,Forest Laboratories, 2,Daiichi Pharmaceutical Co, 2,Theravance, 2,Tonix, 2,Pfizer Inc, 5,Forest Laboratories, 5,Daiichi Pharmaceutical Co., 5,Theravance, 5,Innovative Med Concepts, 5,Ironwood, 5,Zynerba, 5,Pfizer Inc, 8; R. Bennett, None; L. J. Crofford, None; D. Goldenberg, Pfizer Inc, 5,Pfizer Inc, 6; E. Flüß, None; D. J. Clauw, Abbott Laboratories, 5,Cerephex, 5,Eli Lilly and Company, 5,Forrest Laboratories, 5,Johnson & Johnson, 5,Merck Pharmaceuticals, 5,Pfizer Inc, 5,Purdue Pharma L.P., 5,Samumed, 5,Theravance, 5,Tonix, 5,UCB, 5,Zynerba, 5,Abbott Laboratories, 6,Cerephex, 6,Eli Lilly and Company, 6,Forest Laboratories, 6,Johnson & Johnson, 6,Merck Pharmaceuticals, 6,Pfizer Inc, 6,Purdue Pharma L.P., 6,Samumed, 6,Theravance, 6,Tonix, 6,UCB, 6,Zynerba, 6; M. A. Fitzcharles, Abbvie, 5,Amgen, 5,Janssen Pharmaceutica Product, L.P., 5,Bristol-Myers Squibb, 5,Johnson & Johnson, 5,Janssen Pharmaceutica Product, L.P., 8,Eli Lilly and Company, 8,Johnson & Johnson, 8; E. Paiva, Pfizer Inc, 8; R. Staud, None; G. J. Macfarlane, None.

To cite this abstract in AMA style:

Dean LE, Arnold L, Bennett R, Crofford LJ, Goldenberg D, Flüß E, Clauw DJ, Fitzcharles MA, Paiva E, Staud R, Macfarlane GJ. Sexual Dimorphism in the Association Between Multi-Site Pain and Other Fibromyalgia Features:  an Analysis of Data from Three UK Population-Based Studies [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/sexual-dimorphism-in-the-association-between-multi-site-pain-and-other-fibromyalgia-features-an-analysis-of-data-from-three-uk-population-based-studies/. Accessed .

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