Interação entre qualidade do meio ambiente, estresse e a variação do gene APOE na determinação da suscetibilidade à fibromialgia

Abstract

Introduction: Fibromyalgia is a multifactorial disease, of which etiology is based on interaction between genetic susceptibility and environment. However, few studies attempted to identify the risk factors. Objective: To investigate the genetic influence and its interaction with environmental quality and stress, as possible risk factors for fibromyalgia development. Patients and Methods: This cross-sectional study investigated two groups of women, of which 47 had a clinical diagnosis of fibromyalgia, and 41 women comprising thre control group, all from the town of Novo Hamburgo, RS. The apolipoprotein E (APOE) gene polymorphism was analyzed in DNA extracted from total blood, in both samples. Environmental factors were studied through Lipp's Inventory of Stress Symptoms for Adults and by applying the WHOQOL-100 domain V. Results: Among the patients, more women had high stress levels when compared to the control sample (P < 0.001); moreover, the average scores of the WHOQOL-100 domain V, which analyze environment quality, were lower in this group (P < 0.001). APOE genotypic and allelic frequencies were similar between the two groups. Multivariate analysis showed that low WHOQOL-100 scores increase the chance of disease development by 57.7 times (P < 0.001), and that high stress levels were related with the disease (OR = 197.2; P < 0.001). This approach pointed out an interaction between stress and presence of E*2 allele (P = 0.028). Fibromyalgia was much more frequent in patients with high stress levels that were E*2 non-carriers (estimated OR = 265.1), when compared to patients with the same stress level, but E*2 carriers (estimated OR = 1.06). Conclusion: E*2 allele presence could have a protective action regarding the association between fibromyalgia and stress.

Percepção de estresse e sintomas depressivos: funcionalidade e impacto na qualidade de vida em mulheres com fibromialgia

“…35 When investigating the relationship between pain and stress in patients with FM and healthy individuals, Ferreira et al 42 have found no signifi cant difference in the number of stressing events between both groups, attributing their result to the way patients cope with stress, and not only to the intensity of the events experienced. Differently, Becker et al 43 have reported a relationship between high levels of stress and that syndrome, in addition to the existence of an interaction between the apolipoprotein E gene polymorphism and stress in FM.…”

Correlação Da Episiotomia Com O Grau De Perda Urinária Feminina

“…Os 17 artigos que usaram como instrumento o WHOQOL-100 tiveram como público alvo profissionais da saúde (5 artigos); portadores de dor e/ou doença crônica (seis artigos, sendo dor crônica, 2; portadores de lúpus eritematoso sistêmico, 2; deficientes visuais, 1 e mulheres mastectomizadas, 1 artigo); idosos (2 artigos), cuidadores ( 1artigo). Dois artigos, embora avaliando uma condição crônica, a fibromialgia, foram considerados em separado, pois avaliaram um domínio específico -o ambientecomo um fator de risco para o desenvolvimento da doença, em associação a fatores genéticos (BECKER et al, 2010e MERGENER et al, 2011. Ressalte-se o refinamento estatístico de todos os artigos consultados, com amostragem adequada, estatística analítica e, em seis artigos, sendo cinco os de avaliação de condições crônicas, grupo controle.…”

Influência da interação entre qualidade ambiental e o SNP T102C do gene HTR2A sobre a suscetibilidade à fibromialgia

“…Other studies of patients with FMS have shown that pain is the worst aspect related to the low quality of life reported by patients. [25][26][27] Such studies have aimed only at assessing how much the disease and its treatment infl uence the quality of life of patients, associating the results with clinical aspects or comparing them with healthy individuals or patients with other diseases. All these approaches have concluded that the use of the WHOQOL-100 questionnaire as an instrument for clinical follow-up is very interesting to assess symptoms.…”