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Background <p>Chronic fatigue syndrome (CFS) is an often overlooked and debilitating multisystem disorder. Furthermore, the risk factors and pathophysiology of this disease remain unknown. This study aimed to assess risk factors for CFS by investigating the relationships between fatigue, sleep quality, and gastrointestinal symptoms in CFS patients, and to explore the possible pathophysiology of CFS.</p> Methods <p>This is a prospective study conducted at the Health Check-up Center of Shanghai Shuguang Hospital. A total of 1,821 participants were included, with 956 in the case group and 865 in the control group. We performed a multidimensional assessment by evaluating various clinical symptoms, including multidimensional fatigue, insomnia, and gastrointestinal discomfort. Multivariable logistic regression was used to assess risk factors for CFS, including general biological, lifestyle, psychological, and social factors.</p> Results <p>An MFI-20 assessment revealed that the CFS group reported all aspects of fatigue twice as severe as those of the HC group, including more severe general fatigue [13.12 (12.95–13.30) vs 8.76 (8.55–8.96)], physical fatigue [12.91 (12.70–13.13) vs 7.94 (7.73–8.14)], reduced activity [12.88 (12.65–13.11) vs 7.71 (7.51–7.91)], reduced motivation [12.75 (12.52–12.97) vs 7.86 (7.65–8.07)], and mental fatigue [12.78 (12.56–13.00) vs 7.82 (7.62–8.02)] (p-values all &lt;0.001). Compared with the HC group, the CFS group, CFS with insomnia group, and CFS with insomnia and gastrointestinal discomfort group showed increased scores in the MFI-20, PSQI, and GSRS. Participants who were male (adjusted OR [aOR]=1.579; 95% CI, 1.275–1.956, p&lt;0.001), smokers (adjusted OR [aOR]= 0.693; 95% CI, 0.535–0.898, p=0.006), single (aOR=2.542; 95% CI, 1.076–6.007, p=0.034), or undergraduates (aOR= 0.563; 95% CI, 0.323–0.980, p=0.042) had higher odds of CFS.</p> Discussion <p>Age, smoking, marital status, educational level, and other general biological and lifestyle factors were associated with fatigue. CFS comorbidities and the presence of insomnia and gastrointestinal symptoms were closely linked to a poorer health status and were the main contributors to differences in health outcomes, which may represent an important area for future research.</p>

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Associated factors and assessment of clinical symptoms including fatigue, insomnia, and gastrointestinal discomfort of chronic fatigue syndrome: a cross-sectional case-control study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月7日

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  • Fangfang Xie,
  • Yanli You,
  • Jianwen Ma,
  • Haotian Han,
  • Min Fang,
  • Jiatuo Xu,
  • Fei Yao

摘要

Background

Chronic fatigue syndrome (CFS) is an often overlooked and debilitating multisystem disorder. Furthermore, the risk factors and pathophysiology of this disease remain unknown. This study aimed to assess risk factors for CFS by investigating the relationships between fatigue, sleep quality, and gastrointestinal symptoms in CFS patients, and to explore the possible pathophysiology of CFS.

Methods

This is a prospective study conducted at the Health Check-up Center of Shanghai Shuguang Hospital. A total of 1,821 participants were included, with 956 in the case group and 865 in the control group. We performed a multidimensional assessment by evaluating various clinical symptoms, including multidimensional fatigue, insomnia, and gastrointestinal discomfort. Multivariable logistic regression was used to assess risk factors for CFS, including general biological, lifestyle, psychological, and social factors.

Results

An MFI-20 assessment revealed that the CFS group reported all aspects of fatigue twice as severe as those of the HC group, including more severe general fatigue [13.12 (12.95–13.30) vs 8.76 (8.55–8.96)], physical fatigue [12.91 (12.70–13.13) vs 7.94 (7.73–8.14)], reduced activity [12.88 (12.65–13.11) vs 7.71 (7.51–7.91)], reduced motivation [12.75 (12.52–12.97) vs 7.86 (7.65–8.07)], and mental fatigue [12.78 (12.56–13.00) vs 7.82 (7.62–8.02)] (p-values all <0.001). Compared with the HC group, the CFS group, CFS with insomnia group, and CFS with insomnia and gastrointestinal discomfort group showed increased scores in the MFI-20, PSQI, and GSRS. Participants who were male (adjusted OR [aOR]=1.579; 95% CI, 1.275–1.956, p<0.001), smokers (adjusted OR [aOR]= 0.693; 95% CI, 0.535–0.898, p=0.006), single (aOR=2.542; 95% CI, 1.076–6.007, p=0.034), or undergraduates (aOR= 0.563; 95% CI, 0.323–0.980, p=0.042) had higher odds of CFS.

Discussion

Age, smoking, marital status, educational level, and other general biological and lifestyle factors were associated with fatigue. CFS comorbidities and the presence of insomnia and gastrointestinal symptoms were closely linked to a poorer health status and were the main contributors to differences in health outcomes, which may represent an important area for future research.