Chronic pelvic pain is heterogeneous with potentially clinically informative subgroups. We aimed to identify subgroups of pelvic pain based on symptom patterns and investigate their associations with inflammatory and chronic pain-related comorbidities. Latent class analysis (LCA) identified subgroups of participants (n = 1255) from the Adolescence to Adulthood (A2A) cohort. Six participant characteristics were included in the LCA: severity, frequency, and impact on daily activities of both menstruation-associated (cyclic) and non-menstruation-associated (acyclic) pelvic pain. Three-step LCA quantified associations between LC subgroups, demographic and clinical variables, and 18 comorbidities (10 with prevalence ≥10%). Five subgroups were identified: none or minimal (23%), moderate cyclic only (28%), severe cyclic only (20%), moderate or severe acyclic plus moderate cyclic (9%), and severe acyclic plus severe cyclic (21%). Endometriosis prevalence within these 5 LCA-pelvic pain-defined subgroups ranged in size from 4% in "none or minimal pelvic pain" to 24%, 72%, 70%, and 94%, respectively, in the 4 pain subgroups, with statistically significant odds of membership only for the latter 3 subgroups. Migraines were associated with significant odds of membership in all 4 pelvic pain subgroups relative to those with no pelvic pain (adjusted odds ratios = 2.92-7.78), whereas back, joint, or leg pain each had significantly greater odds of membership in the latter 3 subgroups. Asthma or allergies had three times the odds of membership in the most severe pain group. Subgroups with elevated levels of cyclic or acyclic pain are associated with greater frequency of chronic overlapping pain conditions, suggesting an important role for central inflammatory and immunological mechanisms.

中文翻译：

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盆腔疼痛的亚组与子宫内膜异位症和炎症合并症有不同的相关性：潜在类别分析。

慢性盆腔疼痛具有异质性，具有潜在的临床信息亚组。我们的目的是根据症状模式识别盆腔疼痛的亚组，并研究它们与炎症和慢性疼痛相关合并症的关系。潜在类别分析 (LCA) 从青春期到成年 (A2A) 队列中确定了参与者亚组 (n = 1255)。 LCA 包含六个参与者特征：月经相关（周期性）和非月经相关（非周期性）盆腔疼痛的严重程度、频率和对日常活动的影响。三步 LCA 量化了 LC 亚组、人口统计学和临床​​变量以及 18 种合并症（10 种患病率≥10%）之间的关联。确定了五个亚组：无或极少 (23%)、仅中度周期性 (28%)、仅重度周期性 (20%)、中度或重度非周期性加中度周期性 (9%)、以及重度非周期性加严重周期性 (21%) ）。在这 5 个 LCA 盆腔疼痛定义的亚组中，子宫内膜异位症的患病率范围从“无或轻微盆腔疼痛”的 4% 到 4 个疼痛亚组的 24%、72%、70% 和 94%。仅后 3 个亚组的成员资格的可能性很大。与无骨盆疼痛的患者相比，偏头痛与所有 4 个骨盆疼痛亚组的显着几率相关（调整后的比值比 = 2.92-7.78），而背部、关节或腿部疼痛分别在后 3 个亚组中的几率显着更高亚组。最严重疼痛组中患有哮喘或过敏的几率是其三倍。周期性或非周期性疼痛水平升高的亚组与慢性重叠疼痛状况的频率较高相关，这表明中枢炎症和免疫机制发挥着重要作用。