Relationship between fibromyalgia clinical and laboratory parameters with obesity

Abstract

Purpose: Fibromyalgia syndrome (FMS) is a common disease characterized by diffuse pain. Obesity is also a common disease characterized by excessive fat accumulation in adipose tissue. Obese individuals are known to have more musculoskeletal pain than normal people. In this study, we aimed to evaluate the relationship between obesity and fibromyalgia clinical and laboratory parameters.

 

Materials and Methods: The study included 50 FMS patients and 35 healthy control groups. FMS patients were divided into two subgroups according to their BMI: obese (BMI≥30) and non-obese (BMI<30). Clinical comparisons were made with Visual Analogue Scale (VAS), Fibromyalgia Impact Questionnaire (FEA), Short Form-36 (SF-36), and Beck Depression Inventory (BDI). In addition, serum CRP, vitamin B12, folate, TSH levels were compared.

 

Results: BDI, SF-36 physical function score was significantly higher in the obese group compared to the non-obese and healthy control group (p<0.001). Paresthesia and restless sleep symptoms were also significantly higher in the obese group than the non-obese group (p<0.05). Serum vitamin B12 levels were significantly lower and serum CRP values were significantly higher in the obese FMS group than the non-obese FMS group (p<0.001 and p<0.05, respectively). There was no statistically significant difference between groups in terms of VAS, FIQ score, pain duration, tender point count, serum TSH and folate levels.

 

Conclusion: Obesity is thought to have an impact on the pathogenesis and prognosis of the disease in patients with FMS. The findings of our study support the FMS-obesity relationship in the literature. To clarify this relationship, prospective studies involving more patient groups and using better homogenized patients and control groups are needed.

 

Keywords

• Fibromyalgia,Obesity,Short Form 36,Beck Depression Inventory,Vitamin B12

Fibromyalji klinik ve laboratuar parametreleri ile obezite ilişkisi

Abstract

           

Amaç: Fibromiyalji sendromu (FMS) yaygın ağrı ile karakterize sık görülen bir hastalıktır. Obezite de sık görülen,  adipoz dokuda aşırı yağ birikimi ile karakterize kompleks bir hastalıktır. Obez bireylerde normal kişilere göre daha fazla kas iskelet sistemi ağrıları olduğu bilinmektedir. Biz de bu çalışmamızda obezite ile fibromyalji klinik ve laboratuar parametreleri arasındaki ilişkiyi değerlendirmeyi amaçladık.

Gereç ve Yöntemler: Çalışmaya 50 FMS hastası ve 35 sağlıklı kontrol grubu alındı. FMS hastaları VKİ’lerine göre obez (VKİ≥30) ve non-obez (VKİ<30) olarak iki alt gruba ayrıldı. Gruplar arasında Vizual Analog Skalası (VAS), Fibromyalji Etki Anketi (FEA), Kısa Form-36 (KF-36), Beck Depresyon ölçeği (BDÖ) ile klinik olarak, serum CRP, vitamin B12, folat, TSH düzeyleri ile laboratuar olarak karşılaştırmalar yapıldı.

Bulgular: BDÖ, KF-36’nın fiziksel fonksiyon skoru obez grupta non-obez ve sağlıklı kontrol grubuna göre anlamlı olarak daha yüksekti (p<0.001). Parestezi ve dinlendirmeyen uyku semptomları da obez grupta non-obez gruptan anlamlı derecede daha yüksekti (p<0.05). Obez FMS grupta serum vitamin B12 değerleri non-obez FMS gruptan anlamlı düzeyde düşük, serum CRP değerleri ise anlamlı düzeyde yüksek bulundu (sırasıyla p<0.001 ve p<0.05). VAS, ağrı süresi, hassas nokta sayısı, FEA, TSH, folat düzeyleri açısından gruplar arasında istatiksel anlamlı farklılık gözlenmedi.

Sonuç: Obezitenin, FMS’li hastalarda hastalığın patogenez ve prognozuna etkisi olabileceği düşüncesi hakimdir. Bizim çalışmamızdaki bulgular da kısmi olarak literatürdeki FMS-obezite ilişkisini destekler niteliktedir. Bu ilişkinin daha net ortaya konulabilmesi için daha geniş sayıda hasta gruplarını içeren ve daha iyi homojenize edilmiş hasta ve kontrol gruplarının kullanıldığı prospektif çalışmalara ihtiyaç vardır.

 

Anahtar Kelimeler: Fibromyalji, Obezite,Kısa Form-36, Beck Depresyon Ölçeği, Vitamin B12

 

 

Keywords

• Vitamin B12,Fibromyalji,Obezite,Kısa Form 36,Beck Depresyon Ölçeği,Vitamin B12

References

1. 1. Arranz L, Canela MA, Rafecas M. Relationship between body mass index, fat mass and lean mass with SF-36 quality of life scores in a group of fibromyalgia patients. Rheumatol Int 2012;32:3605-3611. https://doi.org/10.1007/s00296-011-2250-y
2. 2. Branco JC, Bannwarth B, Failde I, et al. Prevalence of fibromyalgia: a survey in five European countries. Semin Arthritis Rheum 2010;39:448-453.http://dx.doi.org/10.1016/j.semarthrit.2008.12.003
3. 3. Clauw DJ. Fibromyalgia: update on mechanisms and management. J Clin Rheumatol 2007;13:102-109.
4. 4.Yunus MB. The role of gender in fibromyalgia syndrome. Current Rheumatology Reports 2001;3:128-134.
5. 5. Mork PJ, Vasseljen O, Nilsen TI. Association between physical exercise, body mass index, and risk of fibromyalgia: longitudinal data from the Norwegian Nord-Trøndelag Health Study. Arthritis Care Res (Hoboken). 2010;62:611-617. https://doi.org/10.1002/acr.20118
6. 6. Walker EA, Keegan D, Gardner G, Sullivan M, Katon WJ, Bernstein D. Psychosocial factors in fibromyalgia compared with rheumatoid arthritis: I. Psychiatric diagnoses and functional disability. Psychosom Med 1997;59:565–571. http://dx.doi.org/10.1097/00006842-199711000-00002
7. 7. Garrow JS. Obesity and related diseases. Churchill Livingstone, London: 1988;pp 1-16.
8. 8. Peltonen M, Lindroos AK, Torgerson JS. Musculoskeletal pain in the obese: a comparison with a general population and longterm changes after conventional and surgical obesity treatment. Pain 2003;104:549–557. https://doi.org/10.1016/S0304-3959(03)00091-5

9. 9. Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the multicenter Criteria Committee. Arthritis Rheum 1990;33: 160-172. https://doi.org/10.1002/art.1780330203
10. 10. Pi-Sunyer FX. Obesity: criteria and classification. Proc Nutr Soc 2000;59:505-509. https://doi.org/10.1017/S0029665100000732
11. 11.McCormack HM, Horne DJL, Sheather S. Clinical applications of visual analogue scales: a criticalreview. Psychol Med 1988;18:1007-1019. https://doi.org/10.1017/S0033291700009934
12. 12. Tastekin N, Birtane M, Uzunca K. Which of the three different tender points assessment methods is more useful for predicting the severity of fibromyalgiasyndrome? Rheumatol Int 2007;27:447-451. https://doi.org/10.1007/s00296-0060232-2
13. 13. Hisli N. Beck depresyon envanterinin geçerliliği üzerine bir çalışma. Psikoloji Dergisi 1988; 22:118-126.
14. 14. 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. https://doi.org/10.1007/s002960000077
15. 15. Koçyiğit H, Aydemir Ö, Fisek G,Ölmez N, Memiş AK. Kısa Form-36’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. İlaç ve Tedavi Dergisi 1999;12:102-106.
16. 16. Peres MF, Lerário DD, Garrido AB, Zukerman E. Primary headaches in obese patients. Arq Neuropsiquiatr 2005;63:931-933. http://dx.doi.org/10.1590/S0004-282X2005000600005
17. 17. Pradalier A, Willer JC, Boureau F, Dry J. Relationship between pain and obesity: an electrophysiological study. Physiol Behav 1981;27:961-964. https://doi.org/10.1016/0031-9384(81)90354-1
18. 18. McKendall MJ, Haier RJ. Pain sensitivity and obesity. Psychiatry Res 1983;8:119-125. https://doi.org/10.1016/0165-1781(83)90099-9
19. 19. Okifuji A, Bradshaw DH, Olson C. Evaluating obesity in fibromyalgia: neuroendocrine biomarkers, symptoms,and functions. Clin Rheumatol 2009;28:475-478.https://doi.org/10.1007/s10067-009-1094-2
20. 20. Yunus MB, Arslan S, Aldag JC. Relationship between body mass index and fibromyalgia features. Scand J Rheumatol 2002;31:27-31. https://doi.org/10.1080/030097402317255336
21. 21. Neumann L, Lerner E, Glazer Y, Bolotin A, Shefer A, Buskila D. A cross-sectional study of the relationship between body mass index and clinical characteristics, tenderness measures, quality of life, and physical functioning in fibromyalgia patients. Clin Rheumatol 2008;27: 1543-1547. https://doi.org/10.1007/s10067-008-0966-1
22. 22. Segura-Jimenez V, Castro-Pinero J, Soriano-Maldonado A, et al. The association of total and central body fat with pain, fatigue and the impact of fibromyalgia in women; role of physical fitness. Eur J Pain 2016;20:811-821. https://doi.org/10.1002/ejp.807
23. 23. de Carvalho JF, Silva DN. Serum levels of vitamin B12 (cobalamin) in fibromyalgia. Rheumatology Int 2016;36:741-742. https://doi.org/10.1007/s00296-016-3454-y
24. 24. Ortancil O, Sanli A, Eryuksel R, Basaran A, Ankarali H. Association between serum ferritin level and fibromyalgia syndrome. Eur J Clin Nutr 2010;64:308–312. https://doi.org/10.1038/ejcn.2009.149
25. 25. Sun Y, Sun M, Liu B, et al. Inverse association between serum vitamin b12 concentration and obesity among adults in the United States. Front Endocrinol (Lausanne) 2019;10:414. https://doi.org/10.3389/fendo.2019.00414
26. 26. Ozer S, Sonmezgoz E, Demir O. Negative correlation among vitamin B12 levels, obesity severity and metabolic syndrome in obese children: A case control study.J Pak Med Assoc 2017;67(11):1648-1653.
27. 27. Brooks GC, Blaha MJ, Blumenthal RS. Relation of C‐reactive protein to abdominal adiposity. Am J Cardiol 2010;106:56-61.https://doi.org/10.1016/j.amjcard.2010.02.017
28. 28. Choi J, Joseph L, Pilote L. Obesity and C-reactive protein in various populations: a systematic review and meta-analysis.Obes Rev 2013;14:232-244. https://doi.org/10.1111/obr.12003
29. 29. Ferrante AW. Obesity‐induced inflammation: a metabolic dialogue in the language of inflammation. J Intern Med 2007;262:408-414. https://doi.org/10.1111/j.1365-2796.2007.01852.x
30. 30. Rocha VZ, Libby P. Obesity, inflammation, and atherosclerosis. Nat Rev Cardiol 2009; 6: 399-409. https://doi.org/10.1038/nrcardio.2009.55
31. 31. Van Gaal LF, Mertens IL, De Block CE. Mechanisms linking obesity with cardiovascular disease. Nature 2006;444:875-880. https://doi.org/10.1038/nature05487
32. 32. Bucova M, Bernadic M, Buckingham T .C-reactive protein, cytokines and inflammation in cardiovascular diseases. Bratisl Lek Listy 2008;109:333-340.
33. 33.Xiao Y, Haynes WL, Michalek JE, Russell IJ. Elevated serum high-sensitivity C-reactive protein levels in fibromyalgia syndrome patients correlate with body mass index, interleukin-6, interleukin-8, erythrocyte sedimentation rate. Rheumatol Int 2013;33:1259-1264. https://doi.org/10.1007/s00296-012-2538-6
34. 34. Rus A, Molina F, Gasso M, Camacho MV, Peinado MÁ, del Moral ML. Nitric oxide, inflammation, lipid profile, and cortisol in normal- and overweight women with fibromyalgia. Biol Res Nurs 2016;18:138-146. https://doi.org/10.1177/1099800415591035
35. 35. Metyas SK, Solyman JS, Arkfeld DG. Inflammatory fibromyalgia: Is it Real? Curr Rheumatol Rev 2015;11:15-17. https://doi.org/10.2174/1573397111666150522095004