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A case-control study to assess possible triggers & cofactors in Chronic Fatigue Syndrome (CFS)

  [ 89 votes ]   [ Discuss This Article ] • May 20, 1996

PURPOSE: To assess possible triggers and cofactors for chronic
fatigue syndrome (CFS) and to compare levels of selected
cytokines between cases and an appropriately matched control

PATIENTS AND METHODS: We conducted a case-control study
of 47 cases of CFS obtained through a regional CFS research
program maintained at a tertiary care medical center. One
age-, gender-, and neighborhood-matched control was identified
for each case through systematic community telephone sampling.
Standardized questionnaires were administered to cases and
controls. Sera were assayed for transforming growth
factor-beta (TGF-beta), interleukin-1 beta, interleukin-6,
tumor necrosis factor-alpha, and antibody to Borrelia
burgdorferi and Babesia microti.

RESULTS: Cases were more
likely to have exercised regularly before illness onset than
controls (67% versus 40%; matched odds ratio (MOR) = 3.4; 95%
CI = 1.2 to 11.8; P = 0.02). Female cases were more likely to
be nulliparous prior to onset of CFS than controls (51% versus
31%; MOR = 8.0; 95% CI = 1.03 to 170; P = 0.05). History of
other major factors, including silicone-gel breast implants
(one female case and one female control), pre-morbid history
of depression (15% of cases, 11% of controls) and history of
allergies (66% of cases, 51% of controls) were similar for
cases and controls. However, cases were more likely to have a
diagnosis of depression subsequent to their diagnosis of CFS
compared to a similar time frame for controls (MOR =
undefined; 95% CI lower bound = 2.5; P < 0.001). Positive
antibody titers to B burgdorferi (one case and one control)
and B microti (zero cases and two controls) were also similar.

CONCLUSIONS: Further investigation into the role of prior
routine exercise as a cofactor for CFS is warranted. This
study supports the concurrence of CFS and depression, although
pre-morbid history of depression was similar for both groups.

MacDonald KL, Osterholm MT, LeDell KH, White KE, Schenck CH, Chao
CC, Persing DH, Johnson RC, Barker JM, Peterson PK

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