Frequency of Iron Deficiency and Iron Deficiency Anemia in Fibromyalgia Syndrome

Year 2020, Volume: 27 Issue: 1, 113 - 118, 01.03.2020

Fatih Baygutalp , Duygu Altıntaş Ayhan Kul

https://doi.org/10.17343/sdutfd.634438

Abstract

Objective

Fibromyalgia syndrome (FMS), which is a chronic pain condition of unknown etiology, is mainly
characterized by widespread pain,
sleep disturbances, memory problems, and fatigue, which seriously impair quality of life. Decreased
production of biogenic amine neurotransmitters as a result of decreased iron
levels in the blood may play a role in the pathophysiology of FMS. This study
aimed to investigate the prevalence of iron-deficiency and iron-deficiency anemia
in patients with FMS and to draw attention to the prevalence of iron deficiency
in patients with FMS.

Material and Methods

The patients who
applied to the physical medicine and rehabilitation outpatient clinic of our
hospital in the last five years, who were diagnosed as FMS and whose serum
ferritin, total iron-binding capacity (TDBK), vitamin B12 concentrations and
plasma hemoglobin concentrations were determined were analyzed retrospectively.
Data were analyzed by using SPSS 23 package
program.

Results

In the independent group
comparisons between female and male patients with FMS, both plasma hemoglobin
and serum iron levels were significantly lower in female patients than in male
patients (p =0.009 and p = 0.002, respectively). There were no statistically
significant differences between serum vitamin B12 levels and serum ferritin
levels between male and female patients with FMS (p= 0.344, p=0,093
respectively). Besides, iron
deficiency and iron deficiency anemia were
observed in 28% and 12% of all FMS patients,
respectively.

Conclusion

Measuring serum ferritin levels in FMS
patients and treating iron deficiency when necessary is recommended to increase
the success of FMS treatment. 

Keywords

ferritin, fibromyalgia syndrome, frequency, iron-deficieny

Thanks

We would like to express our gratitude to Dr. Hulki Aşır (MD) Head of Buhara Hospital for sharing data with us, and Professor Abdulbaki Bilgic from Department of Agricultural Economics, College of Agriculture, Atatürk University for analyzing the data for us.

Fibromiyalji Sendromunda Demir Eksikliği ve Demir Eksikliği Anemisi Görülme Sıklığı

Abstract

Amaç

Etiyolojisi tam olarak bilinmeyen
kronik bir ağrı durumu olan fibromiyalji sendromu (FMS) temel olarak yaygın
ağrı, uyku bozuklukları, hafıza sorunları ve yaşam kalitesini ciddi şekilde
bozan yorgunluk ile karakterizedir. Kandaki azalmış demir seviyelerinin bir
sonucu olarak biyojenik amin nörotransmiterlerinin üretimindeki azalma FMS'nin
patofizyolojisinde rol oynayabilir. Bu çalışmada FMS'li hastalarda demir
eksikliği ve demir eksikliği anemisinin prevalansının araştırılması ve FMS'li
hastalarda demir eksikliği prevalansına dikkat çekilmesi amaçlanmıştır.

Gereç ve yöntem

Hastanemiz
fiziksel tip ve rehabilitasyon polikliniği’ne son beş yıl içinde  müracaat eden hastalardan FMS tanısı alan ve
serum ferritin, total demir bağlama kapasitesi (TDBK),vitamin B12
konstantrasyonları ile plazma hemoglobin konstantrasyonları belirlenmiş olan
hastalar retrospektif olarak analiz edilmiştir. 
Veriler SPSS 23 paket programı kullanılarak analiz edilmiştir.

Bulgular

FMS'li kadın ve erkek hastalar
arasındaki bağımsız grup karşılaştırmalarında, plazma hemoglobin ve serum demir
düzeylerinin kadın hastalarda erkek hastalara göre anlamlı derecede düşük
olduğu görülmüştür (sırasıyla, p = 0.009 ve p = 0.002). FMS'li erkek ve kadın
hastalar arasında serum B12 düzeyleri ile serum ferritin düzeyleri arasında
istatistiksel olarak anlamlı bir fark yoktu (sırasıyla p = 0.344, p = 0,093).
Ayrıca, tüm FMS hastalarının % 28’inde demir eksikliği ve% 12'sinde demir
eksikliği anemisi olduğu belirlenmiştir.

Sonuç

FMS
tedavisinde başarının artırılması için FMS hastalarında serum ferritin
seviyelerinin ölçülmesi ve gerektiğinde demir eksikliğinin tedavi edilmesi
önerilmektedir. 

Keywords

demir eksikliği, ferritin, fibromiyalji sendromu, sıklık

References

• 1. Clauw DJ. Fibromyalgia: A Clinical Review. JAMA 2014;311(15):1547–55.
• 2. Bellato E, Marini E, Castoldi F, Barbasetti N, Mattei L, Bonasia DE et al. Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment. Pain Research and Treatment 2012; article ID 426130, doi:10.1155/2012/426130.
• 3. Yavne Y, Kabaha A, Rosen T, Avisar I, Orbach H, Amital D et al. The Powers of Flowers: Evaluating the Impact of Floral Therapy on Pain and Psychiatric Symptoms in Fibromyalgia. Isr Med Assoc J 2019;21(7):449-53.
• 4. Häuser W, Fitzcharles MA. Facts and myths pertaining to fibromyalgia. Dialogues Clin Neurosci 2018;20(1):53-62.
• 5. Fitzcharles MA, Ste-Marie PA, Pereira JX; Canadian Fibromyalgia Guidelines Committee. Fibromyalgia: evolving concepts over the past 2 decades. CMAJ 2013;185(13):E645–E651.
• 6. Furness PJ, Vogt K, Ashe S, Taylor S, Haywood-Small S, Lawson K. What causes fibromyalgia? An online survey of patient perspectives. Health Psychol Open. 2018;5(2):2055102918802683.
• 7. Cheng CA, Chiu YW, Wu D, Kuan YC, Chen SN, Tam KW. Effectiveness of Tai Chi on fibromyalgia patients: A meta-analysis of randomized controlled trials, Complementary Therapies in Medicine 2019; 46:1-8.
• 8. Pastor-Mira MA, López-Roig S, Martínez-Zaragoza F, León E, Abad E, Lledó A, et al. Goal Preferences, Affect, Activity Patterns and Health Outcomes in Women With Fibromyalgia. Front Psychol 2019;10:1912.
• 9. Pastor-Mira MA, López-Roig S, Peñacoba C, Sanz-Baños Y, Lledó A, Velasco L Predicting walking as exercise in women with fibromyalgia from the perspective of the theory of planned behavior. Women Health 2019:1-14.
• 10. Aloush V. Fibromyalgia, obesity and all that lies in between. Harefuah 2019;158(9):587-588.
• 11. Blokh Kerpel A, Tiosano S, Amital D, Comaneshter D, Cohen AD, Amital H. Association of obesity, smoking and socioeconomic strata with the fibromyalgia syndrome, Harefuah 2019;158(9):583-6.
• 12. Kösehasanoğullari M, Erdinç Gündüz N, Akalin E. Is Fibromyalgia Syndrome a Neuropathic Pain Syndrome? Arch Rheumatol 2018;34(2):196-203.
• 13. Gunduz N, Uşen A, Aydin Atar E. The Impact of Perceived Social Support on Anxiety, Depression and Severity of Pain and Burnout Among Turkish Females With Fibromyalgia. Arch Rheumatol 2018;34(2):186-95.
• 14. Kutu FC, Ozdolap S, Sarikaya S. Pro-inflammatory Cytokines and Oxidized Low-Density-Lipoprotein in Patients With Fibromyalgia. Arch Rheumatol 2018;34(2):123-129.
• 15. Ortancil O, Sanli A, Eryuksel R, Basaran A, Ankarali H. Association between serum ferritin level and fibromyalgia syndrome. Eur J Clin Nutr 2010;64(3):308-12.
• 16. Wang W, Knovich MA, Coffman LG, Torti FM, Torti SV. Serum ferritin: Past, present and future. Biochim Biophys Acta. 2010;1800(8):760–769.
• 17. Boomershine CS, Koch TA, Morris D. A Blinded, Randomized, Placebo-Controlled Study to Investigate the Efficacy and Safety of Ferric Carboxymaltose in Iron-Deficient Patients with Fibromyalgia. Rheumatol Ther 2018;5(1):271–281.
• 18. Mader R, Koton Y, Buskila D, Herer P, Elias M. Serum iron and iron stores in non-anemic patients with fibromyalgia. Clin Rheumatol. 2012;31(4):595-9.
• 19. WHO. Serum ferritin concentrations for the assessment of iron status and iron-deficiency in populations. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization 2011; WHO/NMH/NHD/MNM/11.2.
• 20. Sukumar N, Saravanan P. Investigating vitamin B12 deficiency. BMJ 2019;365:l1865.
• 21. Jahan F, Nanji K, Qidwai W, Qasim R. Fibromyalgia syndrome: an overview of pathophysiology, diagnosis and management. Oman Med J 2012;27(3):192–195. 22. Pamuk GE, Pamuk ÖN, Set T, Harmandar O, Yesil N. An increased prevalence of fibromyalgia in iron deficiency anemia and thalassemia minor and associated factors. Clin Rheumatol 2008; 27: 1103.
• 23. Soppi ET. Iron deficiency without anemia - a clinical challenge. Clin Case Rep 2018;6(6):1082-6.