A logistic regression analysis of risk factors in ME/CFS pathogenesis.
Lacerda, Eliana M, Geraghty, Keith, Kingdon, Caroline C et al. · BMC neurology · 2019 · DOI
Quick Summary
This study looked at what factors might increase someone's risk of developing ME/CFS by comparing 269 people with ME/CFS to people with multiple sclerosis and healthy controls. Researchers found that having frequent colds or infections before illness onset, being single, having lower income, and having a family history of anxiety or neurological illness were linked to higher ME/CFS risk. The study suggests that infections may play an important role in how ME/CFS develops, which differs from multiple sclerosis.
Why It Matters
Understanding risk factors may help identify people more likely to develop ME/CFS and provides evidence supporting the infectious trigger hypothesis, which could inform prevention strategies and guide future research into disease mechanisms. This study directly addresses inconsistencies in the literature about which factors matter most in ME/CFS pathogenesis.
Observed Findings
History of frequent infections before disease onset was associated with 25.5 times higher ME/CFS risk versus healthy controls.
Frequent colds before onset were associated with 8.26 times higher ME/CFS risk versus healthy controls.
Being single and having lower income were associated with approximately 4.4 and 3.7 times higher ME/CFS risk, respectively.
Family history of neurological illness was associated with 6.1 times higher risk of severe (versus mild-moderate) ME/CFS.
Severe ME/CFS cases showed earlier disease onset compared to mild-moderate cases.
Inferred Conclusions
Prior infections appear to be a major distinguishing risk factor for ME/CFS compared to MS, suggesting infection-related pathways may be particularly relevant to ME/CFS development.
Socioeconomic factors (income, marital status) and psychiatric/neurological family history are associated with ME/CFS risk, indicating potential complex interplay between biological, psychological, and social factors.
Risk profiles differ significantly between ME/CFS and healthy controls, between ME/CFS and MS, and between mild-moderate and severe ME/CFS presentations.
Remaining Questions
Do infections directly trigger ME/CFS pathogenesis, or do they represent a marker of immune dysfunction that predisposes to the disease?
What This Study Does Not Prove
This study does not prove that infections cause ME/CFS—it only shows an association. The cross-sectional design means researchers cannot establish temporal relationships or causality. Additionally, the study was limited to factors investigators chose to examine, so other unmeasured risk factors may be equally or more important.
Tags
Symptom:Fatigue
Phenotype:Infection-TriggeredSevere
Method Flag:PEM Not DefinedWeak Case DefinitionSmall SampleExploratory OnlySevere ME Included