Xie, Fangfang, You, Yanli, Ma, Jianwen et al. · Journal of translational medicine · 2026 · DOI
This study compared 956 people with ME/CFS to 865 healthy people to understand what factors might contribute to the illness. Researchers measured fatigue, sleep problems, and digestive discomfort using standard questionnaires. They found that people with ME/CFS experienced all types of fatigue at roughly twice the severity of healthy controls, and that sleep and digestive problems often occurred together with ME/CFS.
Understanding which symptoms cluster together in ME/CFS and identifying associated demographic factors can help clinicians recognize the condition earlier and tailor support to address the interconnected fatigue, sleep, and digestive problems that significantly impact quality of life. This research highlights that ME/CFS is not simply tiredness but a complex multisystem condition requiring comprehensive symptom assessment.
This cross-sectional design cannot establish causation—it cannot determine whether insomnia and gastrointestinal symptoms cause ME/CFS fatigue or result from it. The study does not investigate underlying biological mechanisms or validate whether these symptom clusters represent distinct ME/CFS subtypes. Generalizability may be limited to the Chinese population studied.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Xie, Fangfang, You, Yanli, Ma, Jianwen, Han, Haotian, Fang, Min, Xu, Jiatuo, et al. (2026). Associated factors and assessment of clinical symptoms including fatigue, insomnia, and gastrointestinal discomfort of chronic fatigue syndrome: a cross-sectional case-control study.. Journal of translational medicine. https://doi.org/10.1186/s12967-026-07740-y
BibTeX
@article{mecfsatlas-xie-2026-associated-factors,
author = {Xie, Fangfang and You, Yanli and Ma, Jianwen and Han, Haotian and Fang, Min and Xu, Jiatuo and Yao, Fei},
title = {Associated factors and assessment of clinical symptoms including fatigue, insomnia, and gastrointestinal discomfort of chronic fatigue syndrome: a cross-sectional case-control study.},
journal = {Journal of translational medicine},
year = {2026},
doi = {10.1186/s12967-026-07740-y},
note = {PubMed: 41654906},
url = {https://www.mecfsatlas.com/evidence/xie-2026-associated-factors},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/xie-2026-associated-factors
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