Effects of Pain, Depression and Quality of Life on Bone Mineral Density in Patients with Fibromyalgia

Year 2020, Volume: 4 Issue: 3, 280 - 287, 01.09.2020

Nur Demirbas Ruhusen Kutlu Hilal Ecesoy

https://doi.org/10.30621/jbachs.2020.1175

Abstract

Objective: In this study, we aimed to assess the effects of bone mineral density with fibromyalgia on pain, depression and quality of life. Methods: In this case-control study, 100 women who were diagnosed as FMS and 100 women who were not diagnosed as FMS were included. Visual Analog Scala VAS , Fibromyalgia Impact Questionnaire FIQ and Hospital Anxiety and Depression Scala HADS were used for the patients. Bone mineral density BMD of the participants was measured with dual energy x ray absorptiometry DXA method. Results: The number of the tender points of the women with fibromyalgia and VAS, FIQ, HAD-A and HAD-D scores were found significantly higher than of the control group p0.05 . When BMD measurements and HAD-A and HAD-D scores of the fibromyalgia patients were compared; in the L1-L4 region of the patients with anxiety and depression; BMD mass, T score and Z score were found respectively lower than of those without anxiety and depression p=0.011 p=0.040 . Conclusions: The FIQ scores of the patients with low L1-L4 T scores were found higher than of the patients with normal T scores. The L1-L4 region of the patients with anxiety and depression; BMD mass, T score and Z score were found respectively lower than of those without anxiety and depression. This study confirmed the concept that FMS is a risk factor for osteoporosis.

Keywords

fibromyalgia syndrome, bone mineral density, pain, depression

References

• 1. Bellato E, Marini E, Castoldi F, et al. Fibromyalgia Syndrome: Etiology, pathogenesis, diagnosis, and treatment. Pain Res Treat 2012;2012:426130. [CrossRef]
• 2. Jones GT, Atzeni F, Beasley M, Flüß E, Sarzi-Puttini P, Macfarlane GJ. The prevalence of fibromyalgia in the general population - a comparison of the American College of Rheumatology 1990, 2010 and modified 2010 classification criteria. Arthritis Rheumatol 2015;67:568–575. [CrossRef]
• 3. Verbunt JA, Pernot DH, Smeets RJ. Disability and quality of life in patients with fibromyalgia. Health Qual Life Outcomes 2008;22;6:8. [CrossRef]
• 4. Soran N, Altındağ O, Demirkol A. Depression level and relation with clinical parameters in fibromyalgia syndrome. Rheumatism 2008;23:1–4. https://archivesofrheumatology.org/abstract/243
• 5. Dessein PH, Stanwix AE. Why would fibromyalgia patients have osteoporosis? J Rheumatol 2000;27:1816–1817. https://pubmed. ncbi.nlm.nih.gov/10914876/
• 6. Upala S, Yong WC, Sanguankeo A. Bone mineral density is decreased in fibromyalgia syndrome: a systematic review and meta-analysis. Rheumatol Int 2017;37:617–622. [CrossRef]
• 7. Lee YH, Song GG. Association between low bone mineral density and fibromyalgia: a meta-analysis. Clin Rheumatol 2017;36:2573–2579. [CrossRef]
• 8. Topbas M, Cakırbay H, Gulec H, Akgol E, Ak I, Can G. The prevalance of fibromyalgia in women aged 20–64 in Turkey. Scand J Rheumatol 2005;34:140–144. https://pubmed.ncbi.nlm.nih. gov/16095011/
• 9. Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J Rheumatol 1991;18:728–733. https://pubmed.ncbi.nlm.nih.gov/1865419/
• 10. Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int 2000;20:9–12. [CrossRef]
• 11. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–370. [CrossRef]
• 12. Aydemir O, Güvenir T, Küey L, Kültür S. Reliability and Validity of the Turkish version of Hospital Anxiety and Depression Scale. Turk J Psychiatry 1997;8:280–287. http://www.turkpsikiyatri.com/en/ default.aspx?modul=summary&id=191
• 13. International Society for Clinical Densitometry (ISCD). 2013 ISCD Official Positions - Adult; 2013. http://www.iscd.org/ officialpositions/2013-iscd-official-positions-adult
• 14. Wolfe F, Clauw DJ, Fitzcharles MA, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 2010;62:600–610. [CrossRef]
• 15. Cobankara V, Unal UO, Kaya A, Bozkurt AI, Ozturk MA. The prevalence of fibromyalgia among textile workers in the city of Denizli in Turkey. Int J Rheum Dis 2011;14:390–394. [CrossRef]
• 16. Björkegren K, Wallander MA, Johansson S, Svärdsudd K. General symptom reporting in female fibromyalgia patients and referents: a population-based case-referent study. BMC Public Health 2009:31;9:402. [CrossRef]
• 17. Ozcan DS, Aras M, Koseoglu BF, Guven SS. Quality of life and associated conditions in women with fibromyalgia syndrome. Turk J Osteoporos 2013;19:42–47.
• 18. Tander B, Akyol Y, Durmus D, et al. Bone mineral density and depression in premenopausal women with primary fibromyalgia syndrome. Turk J Rheumatol 2010;25:105–109. [CrossRef]
• 19. Ubago Linares M del C, Ruiz-Perez I, Bermejo Perez MJ, Olry de Labry-Lima A, Hernandez-Torres E, Plazaola-Castano J. Analysis of the impact of fibromyalgia on quality of life: associated factors. Clin Rheumatol 2008;27:613–619. [CrossRef]
• 20. Sonmez I, Kosger F, Karasel S, Tosun O. The relationship among pain, depression, and illness perception in female patients with fibromyalgia. Anatolian J Psychiatry 2015;16:329–336. [CrossRef]
• 21. Gelonch O, Garolera M, Valls J, Rosselló L, Pifarré J. Cognitive complaints in women with fibromyalgia: Are they due to depression or to objective cognitive dysfunction? J Clin Exp Neuropsychol 2017;39:1013–1025. [CrossRef]
• 22. Guven AZ, Kul Panza E, Gunduz OH. Depression and psychosocial factors in Turkish women with fibromyalgia syndrome. Eur Med Phys 2005;41:309–313. https://www.minervamedica.it/en/journals/ europa-medicophysica/article.php?cod=R33Y2005N04A0309
• 23. Eggermont LH, Shmerling RH, Leveille SG. Tender point count, pain, and mobility in the older population: The mobilize Boston study. J Pain 2010;11:62–70. [CrossRef]
• 24. Zerahn B, Bliddal H, Moller P, Burgwardt A, Danneskiold-Samsoe B. Bone mass in the calcaneus in patients with fibromyalgia. J Musculoskeletal Pain 2001;9:17–23. [CrossRef]
• 25. Gómez-Cabello A, Vicente-Rodríguez G, Navarro-Vera I, MartinezRedondo D, Díez-Sánchez C, Casajús JA. Influences of physical fitness on bone mass in women with fibromyalgia. Adapt Phys Activ Q 2015;32:125–136. [CrossRef]
• 26. Turkyılmaz AK, Yılmaz Yalçınkaya E, Öneş K. The effects of bone mineral density and level of serum vitamin-D on pain and quality of life in fibromyalgia patients. Turk J Osteoporos 2010;16:53–57. http:// cms.galenos.com.tr/Uploads/Article_5521/53-57.pdf
• 27. Onat SS, Delialioglu US, Demir O, Ozel S. The prevalence of fibromyalgia in postmenopausal osteoporotic women and to determination of related risk factors (preliminary study). Turk J Osteoporos 2014;20:1–5. [CrossRef]
• 28. Olama SM, Senna MK, Elarman MM, Elhawary G. Serum vitamin D level and bone mineral density in premenopausal Egyptian women with fibromyalgia. Rheumatol Int 2013;33:185–192. [CrossRef]
• 29. Jensen B, Wittrup IH, Bliddal H, Danneskiold–Samsøe B, Faber J. Bone mineral density in fibromialgia patients–correlation to disease activity. Scand J Rheumatol 2003;32:146–150. [CrossRef]