与化学不耐受相关的疾病合并症

Raymond F. Palmer, Tatjana Walker, Roger B. Perales, R. Rincon, C. Jaén, Claudia S. Miller
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引用次数: 2

摘要

背景:化学不耐受(CI)的特点是由一次性高剂量或持续低剂量暴露于环境毒物引起的多系统症状。先前的研究调查的是症状群,而不是明确的共病群。我们使用潜在类别建模方法来确定与CI相关的共病疾病群集的数量和类型。方法:招募200名有和没有CI的调查对象,完成快速环境暴露和敏感性量表(QEESI)和17项合并症检查表。采用logistic回归模型预测组间共病的发生率。使用潜在类别分析来检查来自17种共病的二分类项目反应模式。结果:QEESI得分最高的个体与得分最低的个体相比,出现各种共病的概率显著增加(P < 0.0001)。发现3个潜伏类疾病聚集。第1类(占样本的17%)的特征是由肠易激综合征(IBS)、关节炎、抑郁、焦虑、纤维肌痛和慢性疲劳组成的群集。第二类(占样本的53%)的特点是任何合并症的可能性都很低。第三类(占样本的30%)仅以过敏为特征。讨论:我们已经证明,在CI患者的子集中,几种显著的共病形成了一个独特的统计集群。了解这些疾病群可以帮助医生和其他卫生保健工作者更好地了解CI患者。因此,评估患者的CI可能有助于确定其CI症状的显著发起者和触发者,从而指导潜在的治疗工作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Disease comorbidities associated with chemical intolerance
Background: Chemical intolerance (CI) is characterized by multisystem symptoms initiated by a one-time high-dose or a persistent low-dose exposure to environmental toxicants. Prior studies have investigated symptom clusters rather than defined comorbid disease clusters. We use a latent class modeling approach to determine the number and type of comorbid disease clusters associated with CI. Methods: Two hundred respondents with and without CI were recruited to complete the Quick Environmental Exposure and Sensitivity Inventory (QEESI), and a 17-item comorbid disease checklist. A logistic regression model was used to predict the odds of comorbid disease conditions between groups. A latent class analysis was used to inspect the pattern of dichotomous item responses from the 17 comorbid diseases. Results: Those with the highest QEESI scores had significantly greater probability of each comorbid disease compared to the lowest scoring individuals (P < 0.0001). Three latent class disease clusters were found. Class 1 (17% of the sample) was characterized by a cluster consisting of irritable bowel syndrome (IBS), arthritis, depression, anxiety, fibromyalgia, and chronic fatigue. The second class (53% of the sample) was characterized by a low probability of any of the co-morbid diseases. The third class (30% of the sample) was characterized only by allergy. Discussion: We have demonstrated that several salient comorbid diseases form a unique statistical cluster among a subset of individuals with CI. Understanding these disease clusters may help physicians and other health care workers to gain a better understanding of individuals with CI. As such, assessing their patients for CI may help identify the salient initiators and triggers of their CI symptoms—therefore guide potential treatment efforts.
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