Prevalence of fibromyalgia in asthma and its impact on asthma control: a case-control study

Asthma and fibromyalgia are chronic conditions that significantly impair quality of life and share common inflammatory and neurophysiological mechanisms.
This study aimed to investigate the prevalence of fibromyalgia in asthma patients and examine its impact on asthma control.
In this case-control study, 120 patients diagnosed with asthma and 120 age- and sex-matched healthy controls were enrolled. Fibromyalgia was diagnosed based on the 2016 revised ACR criteria using the Widespread Pain Index (WPI) and Symptom Severity Scale (SSS). Asthma control was assessed using the Asthma Control Test (ACT). The relationship between fibromyalgia and asthma control was analyzed using independent t-tests, chi-square tests, logistic regression, and ROC analysis.
The prevalence of fibromyalgia in the asthma group was 16.7% compared to 3.3% in controls (p < 0.001). Asthma patients with fibromyalgia had significantly lower ACT scores than those without (18.2 ± 2.9 vs. 20.1 ± 2.4; p = 0.004). The proportion of patients with uncontrolled asthma was higher among those with fibromyalgia (60% vs. 35%). Logistic regression showed that fibromyalgia was associated with increased odds of uncontrolled asthma (OR = 2.16), although this was not statistically significant (p = 0.103). ACT scores showed no significant correlation with WPI or SSS. ROC analysis revealed that the ACT score had no discriminatory power in identifying fibromyalgia (AUC = 0.50).
Fibromyalgia is a common comorbidity in asthma patients and may adversely affect perceived asthma control. However, the ACT score alone may not be a reliable indicator of fibromyalgia presence, suggesting the need for multidimensional assessment tools in routine asthma care.

哮喘与纤维肌痛均为慢性疾病，可显著降低患者生活质量，且二者共享相似的炎症与神经生理学机制。
本研究旨在探讨哮喘患者中纤维肌痛的患病率，并分析其对哮喘控制水平的影响。
本研究为病例对照研究，共纳入120例确诊哮喘患者及120例年龄、性别匹配的健康对照者。纤维肌痛的诊断依据2016年修订的美国风湿病学会（American College of Rheumatology, ACR）标准，采用广泛疼痛指数（Widespread Pain Index, WPI）与症状严重程度量表（Symptom Severity Scale, SSS）进行评估；哮喘控制水平则通过哮喘控制测试（Asthma Control Test, ACT）进行评价。本研究采用独立样本t检验、卡方检验、逻辑回归及受试者工作特征（Receiver Operating Characteristic, ROC）分析，探讨纤维肌痛与哮喘控制水平之间的关联。
哮喘组纤维肌痛患病率为16.7%，对照组为3.3%（p<0.001）。合并纤维肌痛的哮喘患者ACT评分显著低于未合并者（18.2±2.9 vs. 20.1±2.4；p=0.004）。合并纤维肌痛的哮喘患者中，哮喘未控制的比例更高（60% vs. 35%）。逻辑回归分析显示，纤维肌痛与哮喘未控制的比值比升高相关（OR=2.16），但该差异未达到统计学显著性（p=0.103）。ACT评分与WPI、SSS均无显著相关性。ROC分析结果显示，ACT评分无法有效鉴别纤维肌痛（AUC=0.50）。
纤维肌痛是哮喘患者常见的共病，可能对患者主观感知的哮喘控制水平产生不利影响。然而，仅凭ACT评分无法可靠识别纤维肌痛的存在，这提示在常规哮喘诊疗中需采用多维度评估工具。