Higher Fibromyalgia Impact Questionnaire Research Articles

Prevalence and Clinical Significance of Metabolic Syndrome in Fibromyalgia Patients

ABSTRACT Background and Objective Fibromyalgia syndrome (FMS) is a distressing clinical condition. Metabolic syndrome (MetS) is a biochemical and clinical condition characterised by visceral obesity, dyslipidaemia, hyperglycaemia and hypertension. The relation between the two conditions is rarely discussed. This study aimed to determine the prevalence of MetS in FMS patients and to uncover its association with the clinical severity of FMS. Patients and Methods This cross-sectional study included 200 patients with newly diagnosed FMS. The diagnosis of FMS was established on the basis of the American College of Rheumatology (ACR) 2016 revised criteria. Patients were assessed using the validated Arabic version of Fibromyalgia Impact Questionnaire (FIQ). FMS severity was categorised according to FIQ scores into mild (≤45), moderate (>46 and≤65), and severe (>65). Results The study included 200 FMS patients. They comprised 180 females (90.0%) and 20 males (10.0%). Among the studied patients, there were 96 patients (48.0%) who fulfilled the criteria of MetS diagnosis. A comparison between FMS patients with MetS and patients without MetS revealed a significantly higher Widespread Pain Index (WPI) [median (IQR): 12.0 (10.0–17.0) vs. 9.0 (6.0–11.0), p<0.001], a higher Symptoms Severity Scale (SSS) (10.5±1.04 vs. 8.1±1.8, p<0.001) and a higher FIQ (58.8±20.7 vs. 45.4±16.6) in patients with MetS. Patients with MetS had a significantly higher frequency of severe FMS (31.2 vs. 10.6%, p<0.001). Using binary logistic regression analysis, significant predictors of severe FMS included WPI, SSS and MetS in a univariate analysis. However, in a multivariate analysis, only WPI and SSS remained significant. ConclusionsThis study found that MetS is prevalent in FMS patients and it may be associated with more severe forms of the disease.

Evaluation of affective temperament and anxiety-depression levels in fibromyalgia patients: a pilot study.

Objective:Fibromyalgia (FM) patients have higher rates of depression and anxiety disorders than healthy controls. Affective temperament features are subclinical manifestations of mood disorders. Our aim was to evaluate the affective temperaments of FM patients and investigate their association with depression and anxiety levels and clinical findings.Methods:This cross-sectional study included FM patients and healthy controls. The Hospital Anxiety and Depression Scale (HADS) was used to determine patient anxiety and depression levels, and the Temperament Scale of Memphis, Pisa and San Diego, self-administered version was applied to assess affective temperaments in all subjects. Disease severity was assessed in FM patients with the Fibromyalgia Criteria and Severity Scales and the Fibromyalgia Impact Questionnaire (FIQ). Differences between groups were evaluated using Student’s t-tests. Correlations among parameters were performed.Results:This study involved 38 patients with FM (30 female) and 30 healthy controls (25 female). Depressive, anxious and cyclothymic temperaments were significantly higher in FM patients than healthy controls. Statistically significant positive correlations were found between HADS depression score and all temperaments except hyperthymic, as well as between HADS anxiety score and cyclothymic and anxious temperaments. HADS depression and anxiety scores were correlated with symptom severity. We found a higher risk of depression and anxiety among FM patients with higher FIQ scores.Conclusion:This study is the first to evaluate affective temperament features of FM patients. Evaluating temperamental traits in FM patients may help clinicians determine which patients are at risk for depression and anxiety disorders.

The role of personality in patients with fibromyalgia.

Previous studies suggest personality, the multifaceted characteristics underlying a person's affect, cognition, and behavior, may influence fibromyalgia. We examined associations among personality, fibromyalgia impact, and health-related outcomes in patients with fibromyalgia. We further tested whether anxiety and depression mediated the effect of personality on fibromyalgia impact. We performed a secondary analysis using baseline data from a randomized trial on fibromyalgia. Personality was assessed using the NEO-Five Factor Inventory 3. Fibromyalgia impact was evaluated using the revised Fibromyalgia Impact Questionnaire (FIQR). We also measured symptom severity, anxiety, depression, stress, quality of life, social support, self-efficacy, outcome expectations, and mindfulness. Multivariable linear regression was performed to evaluate each association. Mediation analysis assessed whether anxiety and depression mediated the relationship between personality and FIQR. There were 92 participants, 95% female, mean age 52years, body mass index (BMI) 30kg/m2, 52% white, and mean duration of body pain 14years. Higher neuroticism was significantly associated with higher FIQR (P = 0.002) and symptom severity (P = 0.008), as well as higher levels of anxiety, depression and stress, worse mental component quality of life, and lower self-efficacy, mindfulness, and social support. Higher conscientiousness and extraversion were associated with better psychological health and health-related outcomes. The effect of neuroticism on fibromyalgia impact was mediated by anxiety and depression. Personality was associated with fibromyalgia impact and a variety of health outcomes. Identifying the factors that influence fibromyalgia will help us better understand the condition and provide insight for more effective treatment.

Free amino acids in fibromyalgia syndrome: relationship with clinical picture

The objectives of our study were to evaluate free amino acid (FAA) concentrations in the serum of patients affected by fibromyalgia syndrome (FMS) and to determine the relationships between FAA levels and FMS clinical parameters. Thus, serum amino acid concentrations were quantified (HPLC analysis) in 23 females with fibromyalgia (according to the American College of Rheumatology classification criteria) and 20 healthy females. The results showed significantly higher serum concentrations of aspartate, cysteine, glutamate, glycine, isoleucine, leucine, methionine, ornithine, phenylalanine, sarcosine, serine, taurine, tyrosine and valine in FMS patients vs. healthy controls. Patients with higher Fibromyalgia Impact Questionnaire (FIQ) scores showed increased levels of alanine, glutamine, isoleucine, leucine, phenylalanine, proline and valine. In conclusion, our results indicate an imbalance in some FAAs in FMS patients. Increased Glu is particularly interesting, as it could explain the deficit in monoaminergic transmission involved in pain.

Fibromyalgia and Its Clinical Relevance in Renal Transplant Recipients

ObjectiveRecent evidence suggests that fibromyalgia syndrome (FS) is associated with inflammation and endothelial dysfunction. Our aim was to determine the prevalence of FS in renal transplant recipients and to identify possible links between FS and clinical and laboratory parameters. MethodsNinety-nine kidney transplant recipients with normal graft functions (37.15 ± 10.83 years old, 67 male) were enrolled in the study. All subjects completed the Fibromyalgia Impact Questionnaire (FIQ). The biochemical and clinical parameters in the 1st post-transplantation year were retrospectively recorded. Cardiovascular parameters, including body composition analyses (Tanita), ambulatory blood pressure monitoring data, and pulse-wave velocity, were cross-sectionally analyzed. ResultsMean FIQ score for the whole group was 21.4 ± 14.7. Eight patients had FIQ score >50, and these patients had significantly higher left ventricular mass index than patients with lower FIQ score (P = .048). Patients were divided according to their physical impairment score (PIS): PIS ≥5 (n = 50) and PIS <5 (n = 49). Patients with higher PIS had significantly higher serum creatinine (P = .047) and lower eGFR values (P = .008) than patients with lower PIS. Patients were also evaluated with the use of the stiffness score (SS): patients with (n = 41) and without (n = 58) stiffness. Patients with stiffness had significantly higher office systolic (P = .027) and diastolic (P = .044) blood pressure, body mass index (P = .033), and sagittal abdominal diameter (P = .05) than patients without stiffness. Decline in estimated glomerular filtration rate levels were significantly higher in patients with higher FIQ (7.6% vs 9.4%; P = .0001) than in other patients. ConclusionsFS in renal transplant recipients was strongly associated with hypertension, arterial stiffness, obesity, and renal allograft dysfunction.

Fibromyalgia and Its Clinical Relevance in Renal Transplant Recipients.

Objective: Fibromyalgia (FM) syndrome was associated with various pathophysiologic mechanisms including oxidative stress, inflammation, coronary heart disease, left ventricular function and endothelial dysfunction. Our aim was to determine the prevalence of FM in renal transplant recipients and to identify possible links between FS and various clinical and laboratory parameters. Methods:Ninety nine kidney transplant recipients with normal graft functions (37.1±10.8 yrs, 67 male, 51.98±16.3 months post-transplantation period) were enrolled. All subjects completed the Fibromyalgia Impact Questionnaire (FIQ) and patients were evaluated with the total FIQ score and their physical impairmant score (PIS:0-10) and stiffness subscales. The biochemical and clinical parameters in the first year of post transplantation period were retrospectively recorded and graft function is evaluated with the yearly decline in eGFR. Cardiovascular parameters including body composition analyses, ambulatory blood pressure monitoring data(ABPM), pulse wave velocity (Pwv) were cross-sectionally analyzed. Results: Mean FIQ score for the whole group was 21.4±14.7. Eight patients had FIQ score >50 and these patients had significantly higher LVMI than patients with lower FIQ score (p:0.048). Patients were divided into two groups;Group 1 PIS ≥5, n:50 and group 2 PIS<5, n:49. Patients with higher PIS had significantly higher serum creatinine (p:0.047) and lower eGFR values (p:0.008) than group 2 patients. In ABPM, group 1 patients had significantly higher overall diastolic (p:0.015) and mean arterial BP (p:0.048) than group 2. Physical impairment score was positively correlated with serum CRP levels (p:0.024, r:.227). Patients were also evaluated with the stiffness score (SS) as group1 patients with (n:41) or group 2 patients without (n:58) stiffness. Patients with stiffness had significantly higher office sistolic (p:0.027) and diastolic BP (p:0.044) levels than patients without stiffness. BMI (p:0.033) and saggittal abdominal diameter (p:0.05) were significantly higher in patients with stiffness. Yearly decline in eGFR levels were significantly higher in patients with higher FIQ (7.6% vs. 9.4%, p:.0001) than other patients. Conclusion: FM in renal transplant recipients was closely related with adverse clinical outcome like hypertension, arterial stiffness, obesity and renal graft dysfunction.

Prevalence of falls in fibromyalgia patients.

OBJECTIVE: To compare the risk of falls in fibromyalgia (FM) patients compared to rheumatoid arthritis (RA) patients and normal controls. METHODS: We studied 60 FM, 60 RA patients and 60 controls for fall frequency in one week, one month, six months and one year. Patients were submitted to body mass index determination and balance evaluation through the Berg scale. Data on disease impact and depression were collected in FM patients through the Fibromyalgia Impact Questionnaire (FIQ) and the Beck Questionnaire. RESULTS: FM patients had a higher frequency of falls than RA patients and control individuals in one month (p<0.0001), in six months (p<0.0001) and in one year (p<0.0001). No relationship was found between falls and body mass index, pain or depression scores. Falls in 12 months were associated with higher FIQ values. CONCLUSION: FM patients fall more often than RA patients and control individuals. Level of Evidence II, Investigation of the effect of a patient characteristic on the disease outcome.

Helicobacter pylori in Egyptian patients with fibromyalgia syndrome

Helicobacter pylori infection has been associated with digestive and rheumatic diseases. Aim of the work: to investigate the prevalence of H. pylori in fibromyalgia syndrome (FMS), to determine the relationship between these two diseases. Patients and methodsThe present study was a cross-sectional descriptive study, 100 female patients with primary FMS, and 100 healthy females to serve as control group were included. Serum samples were tested for the presence of anti-H. pylori antibodies by using the enzyme-linked immunosorbent assay technique. ResultsThe prevalence of H. Pylori IgG antibody of the patients was significantly higher than the control group (68 PFMS, 32 controls p<0.001). Also there were 50 PFMS cases and 24 controls of positive IgA antibody (p<0.001). Patients who were H. pylori IgG antibody positive when compared to patients who were H. pylori negative, more frequently have post-exertion pain (p=0.0307), morning stiffness (p=0.0177), confusion (p=0.0139), depression (p=0.0015), mood disturbance (p=0.0093), anxiety (p=0.0388), tension headache (p=0.0088), sleep disturbance (p=0.0046), and changes in appetite (p=0.0301). Duration of FMS in patients who were H. pylori positive was 9.8±1.8years while in patients who were H. pylori negative it was 8±2years (p<0.001). Patients who were H. pylori positive when compared to patients who were H. pylori negative, had a higher visual analog scale (VAS) of fatigue (p<0.001), VAS of global severity (p=0.0017), VAS of anxiety (p<0.001), higher fibromyalgia impact questionnaire (FIQ) (p<0.001), and more tender points count (p<0.001). ConclusionSignificant increase existing in IgG and IgA antibody titer against H. pylori in FMS compared to control groups.

Fibromyalgia in primary antiphospholipid (Hughes) syndrome

Fibromyalgia (FM) is a syndrome that can be associated with several rheumatic diseases. However, no study has evaluated its frequency in patients with primary antiphospholipid syndrome (PAPS). The objective of this study was to analyze the frequency of FM in PAPS patients compared with healthy controls, to determine the possible associations between FM and PAPS features, and also to evaluate quality of life and depression in these patients. This case-control study included 30 PAPS patients (by the Sapporo criteria) and 40 healthy subjects. Demographic and clinical data, drug use, and antiphospholipid antibodies were analyzed. FM was diagnosed based on international criteria (ACR). Questionnaires on quality of life, including the Short Form 36 Health Survey (SF-36), Beck Depression Inventory (BDI), Fibromyalgia Impact Questionnaire (FIQ), and Visual Analog Scale (VAS), were also applied. PAPS patients and controls were similar in mean age as well as in distributions of gender and Caucasian race. Mean disease duration was 5.4 ± 4.2 years. A diagnosis of fibromyalgia was made in five (16.7%) PAPS patients and no controls (p = 0.012). PAPS patients had more diffuse pain (53% vs. 0%, respectively, p < 0.0001), ≥11 tender points (23% vs. 5%, respectively, p = 0.032), and a greater total number (175 vs. 57, respectively, p < 0.0001) as well as median number of tender points per patient than controls (5 [0-18] vs. 0 [0-11], respectively, p < 0.0001). PAPS patients had lower values in all dimensions of the SF-36, as well as higher FIQ scores, higher BDI scores, more depression diagnoses according to BDI results, and increased VAS in comparison with controls. Analysis of PAPS patients with FM compared with those subjects without FM revealed no significant differences regarding demographic features or thrombotic or clinical events; however, PAPS patients who also had FM had lower values in SF-36 dimensions as well as higher FIQ (82.6 ± 9.6 vs. 33.6 ± 29.8, respectively, p < 0.0001) and VAS scores (6.6 ± 2.97 vs. 3.25 ± 3.11, respectively, p = 0.03). BDI scores, in contrast, were similar in both groups. In conclusion, one-fifth of PAPS patients had fibromyalgia and a low quality of life when compared with healthy subjects.