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Proietti E, Rapallo F, Molinari E, Mucci V, Marinelli L, Borgarelli C, Burlando B, Pisciotta L, Demori I. Online Questionnaire with Fibromyalgia Patients Shows Negative Correlations between Disease Severity and Adherence to Mediterranean Diet. Nutrients 2024; 16:1078. [PMID: 38613111 PMCID: PMC11013287 DOI: 10.3390/nu16071078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
Fibromyalgia (FM) is a multidimensional disorder in which intense chronic pain is accompanied by a variety of psychophysical symptoms that impose a burden on the patients' quality of life. Despite the efforts and the recent advancement in research, FM pathogenesis and effective treatment remain unknown. Recently, the possible role of dietary patterns and/or components has been gaining attention. The current study aimed to investigate a potential correlation between adherence to the Mediterranean diet (MedDiet) and FM severity in a sample of Italian FM patients. An online survey was designed, composed of customized questions and validated questionnaires with the aim of investigating the intensity and type of pain, the presence of other psychophysical symptoms, the overall impact of FM, general food and lifestyle habits, and adherence to the MedDiet. The collected responses were analyzed for descriptive statistics, linear regression, and propensity score analyses. The results show that, despite considerable use of pharmaceuticals and supplements, FM participants suffered from a high-severity grade disease. However, those with good adherence to the MedDiet experienced a lower pain intensity and overall FM impact. A propensity score analysis indicates a positive influence of the MedDiet against FM severity, thus unveiling the need for well-designed intervention studies to evaluate the therapeutic potential of different dietary patterns.
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Affiliation(s)
- Elisa Proietti
- Department of Internal Medicine (DIMI), University of Genova, Viale Benedetto XV, 6, 16132 Genova, Italy; (E.P.); (C.B.); (L.P.)
| | - Fabio Rapallo
- Department of Economics (DIEC), University of Genova, Via Vivaldi, 5, 16126 Genova, Italy;
| | - Elena Molinari
- Clincal Psychology Center, Division of Neurology, E.O. Ospedali Galliera, Via Mura delle Cappuccine 14, 16128 Genova, Italy;
| | - Viviana Mucci
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia;
| | - Lucio Marinelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Largo P. Daneo 3, 16132 Genova, Italy;
- IRCCS Ospedale Policlinico San Martino, Department of Neuroscience, Division of Clinical Neurophysiology, Largo R. Benzi 10, 16132 Genova, Italy
| | - Consuelo Borgarelli
- Department of Internal Medicine (DIMI), University of Genova, Viale Benedetto XV, 6, 16132 Genova, Italy; (E.P.); (C.B.); (L.P.)
| | - Bruno Burlando
- Department of Pharmacy (DIFAR), University of Genova, Viale Benedetto XV 3, 16132 Genova, Italy;
| | - Livia Pisciotta
- Department of Internal Medicine (DIMI), University of Genova, Viale Benedetto XV, 6, 16132 Genova, Italy; (E.P.); (C.B.); (L.P.)
- IRCCS Ospedale Policlinico San Martino, Department of Internal Medicine, Operative Unit of Dietetics and Clinical Nutrition, Largo R. Benzi 10, 16132 Genova, Italy
| | - Ilaria Demori
- Department of Pharmacy (DIFAR), University of Genova, Viale Benedetto XV 3, 16132 Genova, Italy;
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Fibromyalgia in women: association of inflammatory plasma proteins, muscle blood flow, and metabolism with body mass index and pain characteristics. Pain Rep 2022; 7:e1042. [PMID: 36213597 PMCID: PMC9534367 DOI: 10.1097/pr9.0000000000001042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/25/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. Metabolism and inflammation interact in fibromyalgia with obesity that can lead to chronic low-grade inflammation. Introduction: Obesity is a common comorbidity in fibromyalgia (FM). Both FM and obesity have been connected to low-grade inflammation, although it is possible that previously reported inflammatory alterations in FM primarily may be linked to increased body mass index (BMI). Objective: This study aimed to investigate whether the inflammatory plasma protein profile, muscle blood flow, and metabolism and pain characteristics (clinical parameters and patient-reported outcome measurements) differed between female patients with FM with and without obesity. Methods: Patients with FM underwent clinical examinations, physical tests, and answered questionnaires. They were dichotomized according to BMI (<30 kg/m2 [n = 14]; ≥30 kg/m2 [n = 13]). Blood samples were collected and analyzed using a panel of 71 inflammatory plasma proteins. Results: There were significant (P < 0.05) differences in blood pressure, pulse, max VO2, pain intensity, physical capacity, and Fibromyalgia Impact Questionnaire between the groups; the obese group had higher blood pressure, pulse, pain intensity, and Fibromyalgia Impact Questionnaire. There were 14 proteins that contributed to the group belonging. The 4 most important proteins for the group discrimination were MIP1β, MCP4, IL1RA, and IL6, which showed higher concentrations in obese patients with FM. Significantly decreased blood flow and increased concentration of pyruvate were detected in obese patients compared with nonobese patients. There was significant correlation between inflammatory proteins and sedentary behavior and health status in obese patients with FM. Conclusions: These findings suggest that metabolism and inflammation interact in female patients with FM with obesity and might cause chronic low-grade inflammation. Screening for obesity and monitoring of BMI changes should be considered in the treatment of patients with FM.
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Metyas S, Chen C, Joseph M, Hanna N, Basta J, Khalil A. Subcategories of Fibromyalgia: A New Concept. Curr Rheumatol Rev 2022; 18:18-25. [PMID: 35220935 DOI: 10.2174/2666255815666220225103234] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/03/2021] [Accepted: 11/24/2021] [Indexed: 02/08/2023]
Abstract
Fibromyalgia has previously been categorized as primary, secondary, and juvenile fibromyalgia. However, these definitions do not adequately explain the etiopathology of disease, nor do they help direct new specific therapies. Herein, we review the previously known categorizations of fibromyalgia. Based on common patient characteristics and previously studied pathophysiologies, we propose new subcategorizations of fibromyalgia that we have self-narrated, including hormonal fibromyalgia, neuroendocrine fibromyalgia, psychologic fibromyalgia, inflammatory fibromyalgia, and lastly, neuropathic fibromyalgia. Future research needs to be done to verify, add to, and fully describe these self-narrated categories of fibromyalgia that we have proposed.
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Affiliation(s)
- Samy Metyas
- Covina Arthritis Clinic, Covina, California, CA, USA
| | | | - Marina Joseph
- Covina Arthritis Clinic, Covina, California, CA, USA
| | | | - Joseph Basta
- Covina Arthritis Clinic, Covina, California, CA, USA
| | - Andrew Khalil
- Covina Arthritis Clinic, Covina, California, CA, USA
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Elkfury JL, Antunes LC, Dal Moro Angoleri L, Sipmann RB, de Souza A, da Silva Torres IL, Caumo W. Dysfunctional eating behavior in fibromyalgia and its association with serum biomarkers of brain plasticity (BDNF and S100B): an exploratory study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 65:713-722. [PMID: 34591410 PMCID: PMC10065384 DOI: 10.20945/2359-3997000000406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/19/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess disordered eating, hunger and satiety perceptions in women with fibromyalgia (FM) compared to healthy controls (HC) and their association with biomarkers of brain plasticity (brain-derived neurotrophic factor (BDNF) and S100 calcium-binding protein B (S100B)). METHODS Cross-sectional exploratory study. The sample included FM (n = 20) and HC (n = 19), matched to age and waist perimeter. Dysfunctional eating was assessed through the Three Factor Eating Questionnaire and Eating Disorders Examination with a questionnaire. Hunger and satiety levels were rated by a Numerical Scale. Serum leptin, S100B and BDNF were analyzed. RESULTS The MANCOVA analysis showed that the mean of Emotional Eating rates was 30.65% higher in FM compared to HC (p = 0.015). Eating, shape and weight concerns were 77.77%, 57.14% and 52.22% higher in FM (p = <0.001) compared to HC, respectively. Moreover, the FM group reported higher scores for feeling of hunger "[5.2 (±2.9) vs. 4.8 (±2.0); p = 0.042] and lower scores for satiety [7.0 (±1.7) vs. 8.3 (±1.0); p = 0.038]. In the FM group, serum BDNF was negatively associated with hunger (r = - 0.52; p = 0.02), while S100B was positively associated with hunger scores (r = 0.463; p = 0.004). CONCLUSION The present findings support the hypothesis that the association between FM and obesity can be mediated by a hedonistic pathway. Further research is needed.
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Affiliation(s)
- Jéssica Lorenzzi Elkfury
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Luciana C Antunes
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Centro de Ciências da Saúde, Divisão de Nutrição, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Letícia Dal Moro Angoleri
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Raquel Busanello Sipmann
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Andressa de Souza
- Programa de Pós-graduação em Saúde e Desenvolvimento Humano, LaSalle, Canoas, RS, Brasil
- Programa de Pós-graduação em Ciências Biológicas: Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Iraci Lucena da Silva Torres
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Wolnei Caumo
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Laboratório de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil,
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Fibromyalgia and obesity: A comprehensive systematic review and meta-analysis. Semin Arthritis Rheum 2021; 51:409-424. [PMID: 33676126 DOI: 10.1016/j.semarthrit.2021.02.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/30/2021] [Accepted: 02/15/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Obesity has been associated with several complications, including musculoskeletal disorders. Aim of the present systematic review was to identify all available evidence on the relationship between fibromyalgia (FM) and obesity, including epidemiological association, impact of obesity on FM severity and effect of weight loss strategies on FM symptoms. METHODS MedLine, Cochrane Central Register of Controlled Trials and Web of Science databases were searched up to September 2020 to identify eligible articles. Data from studies reporting the prevalence of obesity in FM patients were pooled using a random-effects model. RESULTS After removal of duplicate records, 393 studies proceeded to review. A total of 41 articles were deemed eligible for inclusion in final synthesis. Quality assessment revealed that the overall risk of bias was high. The overall prevalence of obesity in FM was 35.7% (95% CI: 31.8 - 39.9%), with higher figures reported for USA. The majority of studies included demonstrated that obesity is associated with different domains of the disorder, including composite measures of activity, pain severity, tender point count, stiffness, fatigue, physical functioning/disability, sleep, cognitive dysfunction, and quality of life; the strength of correlation was weak on average. Inconsistent data were available regarding the correlation with depression and anxiety. Only few studies addressed the effect of therapeutic weight loss in FM, either by bariatric surgery, diet/exercise combination or behavioral weight loss, providing preliminary evidence for a potential benefit of weight loss in ameliorating FM symptoms. CONCLUSIONS Available data support a potential interplay between obesity and FM-related symptoms. Weight management should be encouraged in patients with FM.
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Prevalence of Juvenile Fibromyalgia Syndrome Among Children and Adolescents and its Relationship With Academic Success, Depression and Quality of Life, Çorum Province, Turkey. Arch Rheumatol 2020; 35:68-77. [PMID: 32637922 DOI: 10.5606/archrheumatol.2020.7458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/08/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to determine the frequency of juvenile fibromyalgia syndrome (JFMS) among children and adolescents in Çorum Province, Turkey, and its impact by comparing the levels of academic success, depression and quality of life (QoL) in individuals with and without JFMS. Patients and methods This was a cross-sectional study on 476 children and adolescents (245 boys, 231 girls; mean age 13.81±2.3 years; range, 9 to 17 years). The control group (non-JFMS group) consisted of 105 age- and sex-matched healthy participants (75 girls, 30 boys; mean age 14.1±1.8 years; range; 9 to 17 years). Participants' sociodemographic data, parental information, and school achievement in addition to data on chronic illness and drug use were collected via questionnaires (depression and QoL). A tender point (TP) examination was performed on each participant. Results Thirty-five (7.35%) of the participants (girls, n=25; boys, n=10) were diagnosed with JFMS. The number of minor JFMS diagnostic criteria, number of TPs, depression level and number of days the participants were absent from school were significantly higher in the JFMS group compared with the non-JFMS group (p<0.05). The mean grade point scores of the JFMS group were significantly lower than those of the non-JFMS group (p<0.05). The QoL subgroup scores as assessed by physical functioning, emotional functioning, social functioning and school-related problems of the JFMS group were significantly lower than the non-JFMS group (p<0.05). Age had a statistically significant negative correlation with QoL and school-related problems (r= -0.421, r= -0.494; p<0.05, respectively). Depression was negatively correlated with QoL and school-related problems (r= -0.672, r= -0.731; p<0.05, respectively). Conclusion Juvenile fibromyalgia syndrome affects QoL and can lead to school absenteeism, poor academic performance, depression and anxiety among the school-age population. Early identification of JFMS and early intervention may be the most effective strategy for preventing problems in later life.
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Abstract
Binge eating disorder (BED) is the most common eating disorder and is accompanied by multiple medical comorbidities, many of which are associated with obesity-related diseases. However, the BED itself is likely to confer additional risk factors. BED presents with medical symptoms in virtually every body system and can have devastating consequences on both quality and length of life. This review covers the major comorbidities of BED and highlights areas of ongoing research in this disorder.
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Affiliation(s)
| | - Julie Friedman
- Binge Eating Treatment and Recovery, Eating Recovery Center, Northwestern University Medical School, Department of Psychiatry, Eating Recovery Center Insight, 333 North Michigan Avenue, 19th Floor, Chicago, IL 60601, USA
| | - Philip S Mehler
- Eating Recovery Center, ACUTE @ Denver Health, Glassman Professor of Medicine, University of Colorado School of Medicine, 7351 East Lowry Boulevard, Suite 200, Denver, CO 80230, USA
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Prevalence of fibromyalgia in patients treated at the bariatric surgery outpatient clinic of Hospital de Clínicas do Paraná - Curitiba. REVISTA BRASILEIRA DE REUMATOLOGIA 2017; 57:425-430. [PMID: 29037315 DOI: 10.1016/j.rbre.2017.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 01/05/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Fibromyalgia (FM) is a chronic pain syndrome characterized by generalized pain. It is known that obese patients have more skeletal muscle pain and physical dysfunction than normal weight patients. Therefore, it is important that the early diagnosis of FM be attained in obese patients. OBJECTIVE To determine the prevalence of FM in a group of obese patients with indication of bariatric surgery. MATERIALS AND METHODS The patients were recruited from the Bariatric Surgery outpatient clinic of Hospital de Clínicas of UFPR (HC-UFPR) before being submitted to surgery. Patient assessment consisted in verifying the presence or absence of FM using the 1990 and 2011 ACR criteria, as well as the presence of comorbidities. RESULTS 98 patients were evaluated, of which 84 were females. The mean age was 42.07 years and the BMI was 45.39. The prevalence of FM was 34% (n=29) according to the 1990 criteria and 45% (n=38) according to the 2011 criteria. There was no difference in age, BMI, Epworth score and prevalence of other diseases among patients who met or not the 1990 criteria. Only depression was more common in patients with FM. (24.14% vs. 5.45%). The same findings were seen in patients that met the 2011 criteria. CONCLUSIONS The prevalence of FM in patients with morbid obesity is extremely high. However, BMI does not differ in patients with or without FM. The presence of depression may be a risk factor for the development of FM in these patients.
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Prevalência de fibromialgia em pacientes acompanhados no ambulatório de cirurgia bariátrica do Hospital de Clínicas do Paraná ‐ Curitiba. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2017.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Abstract
PURPOSE To gain further understanding of the general medical comorbidity of binge eating disorder (BED) beyond its association with obesity. METHOD We reviewed studies of general medical comorbidity in people with BED or clinically significant binge eating behavior beyond obesity. We also reviewed studies of BED in specific medical conditions. RESULTS Three broad study categories of medical comorbidity in BED were found: cross-sectional studies of medical conditions in BED; prospective studies of medical conditions in BED; and studies of BED in specific medical conditions. Cross-sectional epidemiologic data suggest that BED is associated with medical conditions related to obesity, including diabetes, hypertension, dyslipidemias, sleep problems/disorders, and pain conditions, and that BED may be related to these conditions independent of obesity and co-occurring psychiatric disorders. Prospective data suggest that BED may be associated with type 2 diabetes and metabolic syndrome. BED or binge eating behavior is also associated with asthma and gastrointestinal symptoms and disorders, and among women, menstrual dysfunction, pregnancy complications, intracranial hypertension, and polycystic ovary syndrome. CONCLUSIONS BED is associated with substantial medical comorbidity beyond obesity. Further study of the general medical comorbidity of BED and its relationship to obesity and co-occurring psychiatric disorders is greatly needed.
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de Araújo TA, Mota MC, Crispim CA. Obesity and sleepiness in women with fibromyalgia. Rheumatol Int 2014; 35:281-7. [PMID: 25056401 DOI: 10.1007/s00296-014-3091-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 07/07/2014] [Indexed: 11/28/2022]
Abstract
Fibromyalgia (FM) is associated with a number of comorbidities, including chronic widespread pain, fatigue and non-restorative sleep. Evidence has shown that FM is closely associated with overweight and obesity. The objective of the present study was to investigate the relationship between obesity and sleepiness in women with FM. A total of 100 adult female patients with a prior medical diagnosis of FM participated in the study. Body mass, height and waist circumference were measured, and body mass index (BMI) was calculated. The diet quality was evaluated by the Healthy Eating Index. Subjective analyses of daytime sleepiness [Epworth Sleepiness Scale (ESS)] and sleep quality (Pittsburgh Sleep Quality) were performed. An obesity rate of 41 % was found in all women (56.1 % were sleepy and 43.9 % were not, p = 0.04). Obese women showed a greater level of sleepiness when compared with non-obese (10.2 and 7.0, respectively, p = 0.004). Sleepy women showed a greater weight gain after the diagnosis of FM when compared with non-sleepy women (11.7 and 6.4 kg, respectively, p = 0.04). A positive and significant correlation between BMI and sleepiness (r = 0.35, p = 0.02) was also found. In multivariate logistic regression, moderate or severe sleepiness (ESS >12) was associated with obesity (odds ratio 3.44, 95 % CI 1.31-9.01, p = 0.04). These results demonstrate an important association between sleepiness and FM, suggesting that the occurrence of obesity may be involved with sleepiness in these patients.
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Affiliation(s)
- Tânia Aparecida de Araújo
- Post Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Av. Pará, 1720, Bloco 2U, Sala 20. Campus Umuarama, Uberlândia, MG, 38405-320, Brazil
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