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Characteristics of chronic fatigue syndrome in a Japanese community population

Chronic fatigue syndrome in Japan

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Abstract

This study seeks to estimate the prevalence of chronic fatigue syndrome (CFS) and assess the characteristics of CFS in a community population in Japan using laboratory tests and questionnaires for lifestyle, fatigue states, and depression states. The design of this study is a cross-sectional observational study. The setting of this study is a medical health checkup program in a general hospital. This study was conducted with 1,430 Japanese (867 men and 563 women), 20 to 78 years of age. We classified participants who complained of fatigue according to the case definition of CFS proposed by the Centers for Disease Control and Prevention in the USA in 1994. Alcohol, caffeine, catechin and total polyphenol consumption, smoking status, sleep duration, and physical activity were evaluated using questionnaires. The prevalence of CFS was 1.0% (95% CI 0.5–1.6%) of a community population in Japan. Although various lifestyle factors of the participants with CFS were similar to those without chronic fatigue, average sleep duration was significantly shorter among the participants with CFS (5.5 ± 0.8 h) compared to those without chronic fatigue (6.3 ± 0.9 h, P < 0.001). Proportion at subjects having average sleep duration of less than 6 h was 64.3% among the participants with CFS in contrast to only 15.0% in those without chronic fatigue (P < 0.001). Among the eight case-defining symptoms, “Unrefreshing sleep” had high sensitivity and high specificity for screening CFS in Japanese population (92.9% and 87.8%, respectively). The average sleep duration was notably shorter in Japanese suffering from CFS. Further longitudinal study is needed to evaluate the possibility of extreme short sleep duration as a major cause of CFS in Japan.

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References

  1. Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A (1994) The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med 121(12):953–959

    PubMed  CAS  Google Scholar 

  2. Holmes GP, Kaplan JE, Gantz NM et al (1988) Chronic fatigue syndrome: a working case definition. Ann Intern Med 108(3):387–389

    PubMed  CAS  Google Scholar 

  3. Reeves WC, Heim C, Maloney EM et al (2006) Sleep characteristics of persons with chronic fatigue syndrome and non-fatigued controls: results from a population-based study. BMC Neurol 6:41

    Article  PubMed  Google Scholar 

  4. Van Hoof E, De Becker P, Lapp C, Cluydts R, De Meirleir K (2007) Defining the occurrence and influence of alpha-delta sleep in chronic fatigue syndrome. Am J Med Sci 333(2):78–84

    Article  PubMed  Google Scholar 

  5. Sharpley A, Clements A, Hawton K, Sharpe M (1997) Do patients with “pure” chronic fatigue syndrome (neurasthenia) have abnormal sleep? Psychosom Med 59(6):592–596

    PubMed  CAS  Google Scholar 

  6. Reilly PA, Littlejohn GO (1990) Fibromyalgia and chronic fatigue syndrome. Curr Opin Rheumatol 2(2):282–290

    Article  PubMed  CAS  Google Scholar 

  7. Wong R, Lopaschuk G, Zhu G et al (1992) Skeletal muscle metabolism in the chronic fatigue syndrome. In vivo assessment by 31P nuclear magnetic resonance spectroscopy. Chest 102(6):1716–1722

    Article  PubMed  CAS  Google Scholar 

  8. Bennett RM (1989) Confounding features of the fibromyalgia syndrome: a current perspective of differential diagnosis. J Rheumatol Suppl 19:58–61

    PubMed  CAS  Google Scholar 

  9. Saggini R, Vecchiet J, Iezzi S et al (2006) Submaximal aerobic exercise with mechanical vibrations improves the functional status of patients with chronic fatigue syndrome. Eura Medicophys 42(2):97–102

    PubMed  CAS  Google Scholar 

  10. Riley MS, O’Brien CJ, McCluskey DR, Bell NP, Nicholls DP (1990) Aerobic work capacity in patients with chronic fatigue syndrome. BMJ 301(6758):953–956

    Article  PubMed  CAS  Google Scholar 

  11. Gibson H, Carroll N, Clague JE, Edwards RH (1993) Exercise performance and fatiguability in patients with chronic fatigue syndrome. J Neurol Neurosurg Psychiatry 56(9):993–998

    Article  PubMed  CAS  Google Scholar 

  12. Lawrie SM, MacHale SM, Power MJ, Goodwin GM (1997) Is the chronic fatigue syndrome best understood as a primary disturbance of the sense of effort? Psychol Med 27(5):995–999

    Article  PubMed  CAS  Google Scholar 

  13. LaManca JJ, Peckerman A, Walker J et al (1999) Cardiovascular response during head-up tilt in chronic fatigue syndrome. Clin Physiol 19(2):111–120

    Article  PubMed  CAS  Google Scholar 

  14. De Becker P, Roeykens J, Reynders M, McGregor N, De Meirleir K (2000) Exercise capacity in chronic fatigue syndrome. Arch Intern Med 160(21):3270–3277

    Article  PubMed  Google Scholar 

  15. Fulcher KY, White PD (2000) Strength and physiological response to exercise in patients with chronic fatigue syndrome. J Neurol Neurosurg Psychiatry 69(3):302–307

    Article  PubMed  CAS  Google Scholar 

  16. Bazelmans E, Bleijenberg G, Van Der Meer JW, Folgering H (2001) Is physical deconditioning a perpetuating factor in chronic fatigue syndrome? A controlled study on maximal exercise performance and relations with fatigue, impairment and physical activity. Psychol Med 31(1):107–114

    Article  PubMed  CAS  Google Scholar 

  17. Cook DB, Nagelkirk PR, Peckerman A, Poluri A, Lamanca JJ, Natelson BH (2003) Perceived exertion in fatiguing illness: civilians with chronic fatigue syndrome. Med Sci Sports Exerc 35(4):563–568

    Article  PubMed  Google Scholar 

  18. Cook DB, Nagelkirk PR, Peckerman A, Poluri A, Lamanca JJ, Natelson BH (2003) Perceived exertion in fatiguing illness: Gulf War veterans with chronic fatigue syndrome. Med Sci Sports Exerc 35(4):569–574

    Article  PubMed  Google Scholar 

  19. Nagelkirk PR, Cook DB, Peckerman A et al (2003) Aerobic capacity of Gulf War veterans with chronic fatigue syndrome. Mil Med 168(9):750–755

    PubMed  Google Scholar 

  20. van’t Leven M, Zielhuis G, Avan der Meer JW, Verbeek AL, Bleijenberg G (2010) Fatigue and chronic fatigue syndrome-like complaints in the general population. Eur J Public Health 20(3):251–257

    Article  PubMed  Google Scholar 

  21. Grant JE, Veldee MS, Buchwald D (1996) Analysis of dietary intake and selected nutrient concentrations in patients with chronic fatigue syndrome. J Am Diet Assoc 96(4):383–386

    Article  PubMed  CAS  Google Scholar 

  22. Heap LC, Peters TJ, Wessely S (1999) Vitamin B status in patients with chronic fatigue syndrome. J R Soc Med 92(4):183–185

    PubMed  CAS  Google Scholar 

  23. Cox IM, Campbell MJ, Dowson D (1991) Red blood cell magnesium and chronic fatigue syndrome. Lancet 337(8744):757–760

    Article  PubMed  CAS  Google Scholar 

  24. De Lorenzo F, Hargreaves J, Kakkar VV (1998) Phosphate diabetes in patients with chronic fatigue syndrome. Postgrad Med J 74(870):229–232

    Article  PubMed  Google Scholar 

  25. Kuratsune H, Yamaguti K, Takahashi M, Misaki H, Tagawa S, Kitani T (1994) Acylcarnitine deficiency in chronic fatigue syndrome. Clin Infect Dis 18(Suppl 1):S62–S67

    Article  PubMed  Google Scholar 

  26. Plioplys AV, Plioplys S (1995) Serum levels of carnitine in chronic fatigue syndrome: clinical correlates. Neuropsychobiology 32(3):132–138

    Article  PubMed  CAS  Google Scholar 

  27. Clague JE, Edwards RH, Jackson MJ (1992) Intravenous magnesium loading in chronic fatigue syndrome. Lancet 340(8811):124–125

    Article  PubMed  CAS  Google Scholar 

  28. Gantz NM (1991) Magnesium and chronic fatigue. Lancet 338(8758):66

    Article  PubMed  CAS  Google Scholar 

  29. Kaslow JE, Rucker L, Onishi R (1989) Liver extract-folic acid-cyanocobalamin vs placebo for chronic fatigue syndrome. Arch Intern Med 149(11):2501–2503

    Article  PubMed  CAS  Google Scholar 

  30. Soetekouw PM, Wevers RA, Vreken P et al (2000) Normal carnitine levels in patients with chronic fatigue syndrome. Neth J Med 57(1):20–24

    Article  PubMed  CAS  Google Scholar 

  31. Goedendorp MM, Knoop H, Schippers GM, Bleijenberg G (2009) The lifestyle of patients with chronic fatigue syndrome and the effect on fatigue and functional impairments. J Hum Nutr Diet 22(3):226–231

    Article  PubMed  CAS  Google Scholar 

  32. Kim CH, Shin HC, Won CW (2005) Prevalence of chronic fatigue and chronic fatigue syndrome in Korea: community-based primary care study. J Korean Med Sci 20(4):529–534

    Article  PubMed  Google Scholar 

  33. Yiu YM, Qiu MY (2005) A preliminary epidemiological study and discussion on traditional Chinese medicine pathogenesis of chronic fatigue syndrome in Hong Kong. Zhong Xi Yi Jie He Xue Bao 3(5):359–362

    Article  PubMed  Google Scholar 

  34. Kawakami N, Iwata N, Fujihara S, Kitamura T (1998) Prevalence of chronic fatigue syndrome in a community population in Japan. Tohoku J Exp Med 186(1):33–41

    Article  PubMed  CAS  Google Scholar 

  35. Masuda A, Nozoe SI, Matsuyama T, Tanaka H (1994) Psychobehavioral and immunological characteristics of adult people with chronic fatigue and patients with chronic fatigue syndrome. Psychosom Med 56(6):512–518

    PubMed  CAS  Google Scholar 

  36. Kawai K, Kawai A (1992) Studies on the relationship between chronic fatigue syndrome and Epstein–Barr virus in Japan. Intern Med 31(3):313–318

    Article  PubMed  CAS  Google Scholar 

  37. Hamaguchi M, Kojima T, Takeda N et al (2005) The metabolic syndrome as a predictor of nonalcoholic fatty liver disease. Ann Intern Med 143(10):722–728

    PubMed  CAS  Google Scholar 

  38. Suzuki E, Yorifuji T, Ueshima K et al (2009) Sleep duration, sleep quality and cardiovascular disease mortality among the elderly: a population-based cohort study. Prev Med 49:135–141

    Article  PubMed  Google Scholar 

  39. WW ZUNG (1965) A self-rating depression scale. Arch Gen Psychiatry 12:63–70

    Google Scholar 

  40. Fukuda K, Kobayashi S (1973) Seishin Shinkeigaku Zasshi 75:673–679

    PubMed  CAS  Google Scholar 

  41. Aaron DJ, Kriska AM, Dearwater SR, Cauley JA, Metz KF, LaPorte RE (1995) Reproducibility and validity of an epidemiologic questionnaire to assess past year physical activity in adolescents. Am J Epidemiol 142(2):191–201

    PubMed  CAS  Google Scholar 

  42. Yoshiike N, Matsumura Y, Zaman MM, Yamaguchi M (1998) Descriptive epidemiology of body mass index in Japanese adults in a representative sample from the National Nutrition Survey 1990–1994. Int J Obes Relat Metab Disord 22(7):684–687

    Article  PubMed  CAS  Google Scholar 

  43. Lockley SW, Skene DJ, Arendt J (1999) Comparison between subjective and actigraphic measurement of sleep and sleep rhythms. J Sleep Res 8(3):175–183

    Article  PubMed  CAS  Google Scholar 

  44. Ohayon MM (2002) Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 6(2):97–111

    Article  PubMed  Google Scholar 

  45. Wu T, Willett WC, Hankinson SE, Giovannucci E (2005) Caffeinated coffee, decaffeinated coffee, and caffeine in relation to plasma C-peptide levels, a marker of insulin secretion, in U.S. women. Diab Care 28(6):1390–1396

    Article  CAS  Google Scholar 

  46. Dittner AJ, Wessely SC, Brown RG (2004) The assessment of fatigue: a practical guide for clinicians and researchers. J Psychosom Res 56(2):157–170

    Article  PubMed  CAS  Google Scholar 

  47. Kroenke K, Wood DR, Mangelsdorff AD, Meier NJ, Powell JB (1988) Chronic fatigue in primary care. Prevalence, patient characteristics, and outcome. JAMA 260(7):929–934

    Article  PubMed  CAS  Google Scholar 

  48. Lloyd AR (1990) Muscle versus brain: chronic fatigue syndrome. Med J Aust 153(9):530–534

    PubMed  CAS  Google Scholar 

  49. Bates DW, Schmitt W, Buchwald D et al (1993) Prevalence of fatigue and chronic fatigue syndrome in a primary care practice. Arch Intern Med 153(24):2759–2765

    Article  PubMed  CAS  Google Scholar 

  50. Daugherty SA, Henry BE, Peterson DL, Swarts RL, Bastien S, Thomas RS (1991) Chronic fatigue syndrome in northern Nevada. Rev Infect Dis 13(Suppl 1):S39–S44

    Article  PubMed  Google Scholar 

  51. Levine PH (1994) Epidemic neuromyasthenia and chronic fatigue syndrome: epidemiological importance of a cluster definition. Clin Infect Dis 18(Suppl 1):S16–S20

    Article  PubMed  Google Scholar 

  52. Briggs NC, Levine PH (1994) A comparative review of systemic and neurological symptomatology in 12 outbreaks collectively described as chronic fatigue syndrome, epidemic neuromyasthenia, and myalgic encephalomyelitis. Clin Infect Dis 18(Suppl 1):S32–S42

    Article  PubMed  Google Scholar 

  53. Harvey SB, Wadsworth M, Wessely S, Hotopf M (2008) Etiology of chronic fatigue syndrome: testing popular hypotheses using a national birth cohort study. Psychosom Med 70(4):488–495

    Article  PubMed  Google Scholar 

  54. Schur E, Afari N, Goldberg J, Buchwald D, Sullivan PF (2007) Twin analyses of fatigue. Twin Res Hum Genet 10(5):729–733

    Article  PubMed  Google Scholar 

  55. Majer M, Jones JF, Unger ER et al (2007) Perception versus polysomnographic assessment of sleep in CFS and non-fatigued control subjects: results from a population-based study. BMC Neurol 7:40

    Article  PubMed  Google Scholar 

  56. Neu D, Cappeliez B, Hoffmann G, Verbanck P, Linkowski P, Le Bon O (2009) High slow-wave sleep and low-light sleep: chronic fatigue syndrome is not likely to be a primary sleep disorder. J Clin Neurophysiol 26(3):207–212

    Article  PubMed  Google Scholar 

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Acknowledgement

The authors thank all of the staff members in the health checkup center at Murakami Memorial Hospital and also thank Tosei Murase Ph.D. who proof read this article. This study was supported by a grant from the Gifu Medical Association. All authors are independent of the funder.

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Authors and Affiliations

  1. Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Masahide Hamaguchi & Yutaka Kawahito

  2. Department of Endocrinology and Metabolism, Murakami Memorial Hospital, Asahi University, 3-23 Hashimoto-cho, Gifu, 500-8523, Japan

    Noriyuki Takeda

  3. Department of Gastroenterology, Murakami Memorial Hospital, Asahi University, 3-23 Hashimoto-cho, Gifu, 500-8523, Japan

    Takahiro Kato & Takao Kojima

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  1. Masahide Hamaguchi
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  2. Yutaka Kawahito
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  3. Noriyuki Takeda
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  4. Takahiro Kato
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  5. Takao Kojima
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Correspondence to Masahide Hamaguchi.

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Hamaguchi, M., Kawahito, Y., Takeda, N. et al. Characteristics of chronic fatigue syndrome in a Japanese community population. Clin Rheumatol 30, 895–906 (2011). https://doi.org/10.1007/s10067-011-1702-9

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  • DOI: https://doi.org/10.1007/s10067-011-1702-9

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