title: Increased Risk of New-Onset Fibromyalgia Among Chronic Osteomyelitis Patients: Evidence From a Taiwan Cohort Study.
abstract: Chronic inflammation, which changes the neurotransmitter metabolism and kindles neuroendocrine system dysfunction in the central nervous system, might cause fibromyalgia (FM) formation. In FM patients without traditional FM risk factors, such as hypertension, hyperlipidemia, diabetes, sleep disorder, depression, and anxiety, the chronic inflammatory process is a possible risk factor for FM. Thus, we investigated whether chronic osteomyelitis (COM), a disease characterized by chronic inflammation, increases FM risk. Including data for 1 million enrollees, the Longitudinal Health Insurance Database was used, and 1,244 COM patients without FM history and 4,976 randomly selected sex- and age-matched control subjects without COM or FM history were extracted. The development of FM over a 13-year follow-up period from 1999 to 2011 was evaluated, and FM risk was estimated using the Cox proportional regression model. The aforementioned FM risk factors were more common in COM patients, who had a significantly greater FM risk than did the control subjects. Compared with those who had no associated risk factors, patients with COM had a greater FM risk than did the control subjects (adjusted hazard ratio [aHR] = 1.32, 95% confidence interval [CI], .99-1.75). Younger people had an even greater risk (age younger than 35 years: aHR = 1.58, 95% CI, 1.03-2.44; age 60 years or older: aHR = 1.03, 95% CI, .78-1.36). To our knowledge, this is the first study to link COM to an enhanced risk of FM development. The results imply that COM is a predictor of FM, suggesting that close follow-up for patients with COM is required to prevent FM, especially in younger populations.
  
  
  
  COM is associated with the augmented risk of developing FM, and rigorous treatments for COM patients might decrease the future risk of FM formation, especially in those with relatively younger ages.
authors.affiliation: Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Jiunn-Horng
authors.initials: JH
authors.lastname: Chen
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Muo
authors.affiliation: School of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
authors.affiliation: School of Medicine, China Medical University, Taichung, Taiwan; Department of Neurology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chon-Haw
authors.initials: CH
authors.lastname: Tsai
authors.affiliation: School of Medicine, China Medical University, Taichung, Taiwan; Department of Neurology, China Medical University Hospital, Taichung, Taiwan. Electronic address: d8333@mail.cmuh.org.tw.
authors.forename: Chun-Hung
authors.initials: CH
authors.lastname: Tseng
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000150:complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012306:Risk; D018570:Risk Assessment; D013624:Taiwan / Q000453:epidemiology
keywords: Chronic inflammation; chronic osteomyelitis; fibromyalgia