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Gkouvi A, Tsiogkas SG, Bogdanos DP, Gika H, Goulis DG, Grammatikopoulou MG. Proteomics in Patients with Fibromyalgia Syndrome: A Systematic Review of Observational Studies. Curr Pain Headache Rep 2024; 28:565-586. [PMID: 38652420 PMCID: PMC11271354 DOI: 10.1007/s11916-024-01244-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE OF REVIEW Fibromyalgia syndrome (FMS) is a disease of unknown pathophysiology, with the diagnosis being based on a set of clinical criteria. Proteomic analysis can provide significant biological information for the pathophysiology of the disease but may also reveal biomarkers for diagnosis or therapeutic targets. The present systematic review aims to synthesize the evidence regarding the proteome of adult patients with FMS using data from observational studies. RECENT FINDINGS An extensive literature search was conducted in MEDLINE/PubMed, CENTRAL, and clinicaltrials.gov from inception until November 2022. The study protocol was published in OSF. Two independent reviewers evaluated the studies and extracted data. The quality of studies was assessed using the modified Newcastle-Ottawa scale adjusted for proteomic research. Ten studies fulfilled the protocol criteria, identifying 3328 proteins, 145 of which were differentially expressed among patients with FMS against controls. The proteins were identified in plasma, serum, cerebrospinal fluid, and saliva samples. The control groups included healthy individuals and patients with pain (inflammatory and non-inflammatory). The most important proteins identified involved transferrin, α-, β-, and γ-fibrinogen chains, profilin-1, transaldolase, PGAM1, apolipoprotein-C3, complement C4A and C1QC, immunoglobin parts, and acute phase reactants. Weak correlations were observed between proteins and pain sensation, or quality of life scales, apart from the association of transferrin and a2-macroglobulin with moderate-to-severe pain sensation. The quality of included studies was moderate-to-good. FMS appears to be related to protein dysregulation in the complement and coagulation cascades and the metabolism of iron. Several proteins may be dysregulated due to the excessive oxidative stress response.
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Affiliation(s)
- Arriana Gkouvi
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
| | - Sotirios G Tsiogkas
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
| | - Dimitrios P Bogdanos
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece.
| | - Helen Gika
- Center for Interdisciplinary Research and Innovation (CIRI-AUTH), Biomic_AUTh, Balkan Center Thermi B1.4, GR-57001, Thessaloniki, Greece
- Laboratory of Forensic Medicine and Toxicology, School of Medicine, Aristotle University of Thessaloniki, GR-54124, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria G Grammatikopoulou
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Tian J, Zhou Y, Lin X, Jones G, Pan F. Multisite Pain and Myocardial Infarction and Stroke: A Prospective Cohort and Mendelian Randomization Analysis. JACC. ADVANCES 2023; 2:100295. [PMID: 38939595 PMCID: PMC11198351 DOI: 10.1016/j.jacadv.2023.100295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/17/2023] [Accepted: 02/12/2023] [Indexed: 06/29/2024]
Abstract
Background Whether individuals with multisite pain had a higher risk of cardiovascular diseases is unclear. Objectives The purpose of this study was to investigate the longitudinal association of pain in multiple sites with incident myocardial infarction (MI) and stroke, and to disentangle the genetic causality of these associations. Methods A total of 281,760 participants (mean age: 56.3 years) who had no MI and stroke at baseline from UK Biobank study were included. Data on pain in the hip, knee, back and neck/shoulder, or 'all over the body' were collected. Chronic pain was defined if pain had lasted for ≥3 months. MI and stroke events were determined from hospital admission records and death registries. Cox regression and 2-sample Mendelian randomization were used for the analyses. Results During a median follow-up of 11.9 years, 4,854 had a first MI and 2,827 had a first stroke. In multivariable analyses, greater number of painful sites was dose-responsively associated with higher risks of incident MI and stroke, with a higher risk among participants with pain 'all over the body' (MI: HR: 1.65, 95% CI: 1.32-2.07; stroke: HR: 1.44, 95% CI: 1.13-1.85). Similar trends and associations were observed in those with chronic pain. Two-sample Mendelian randomization results supported a causal effect of multisite pain on MI risk, but not vice versa. No causal association was found between multisite pain and stroke risk. Conclusions Pain in multiple sites causally increases the risk of MI, highlighting that pain should be considered when assessing individuals' MI risk, and pain treatment and management may prevent MI risk.
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Affiliation(s)
- Jing Tian
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Yuan Zhou
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Xin Lin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Feng Pan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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Coexistence of fibromyalgia syndrome and inflammatory rheumatic diseases, and autonomic cardiovascular system involvement in fibromyalgia syndrome. Clin Rheumatol 2023; 42:645-652. [PMID: 36151442 DOI: 10.1007/s10067-022-06385-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 11/03/2022]
Abstract
The spectrum of symptoms represented by fibromyalgia syndrome (FMS) has a profound effect on daily activities and impairs the quality of life. A considerable proportion of patients with inflammatory rheumatic diseases (IRDs) fulfill the FMS criteria, which can complicate the diagnosis, treatment, and follow-ups of IRD. In addition, the coexistence of FMS may cause unnecessary laboratory and radiological assessments. Several mechanisms have been proposed that may have a role in the etiopathogenesis of FMS, one of which is autonomic dysregulation. In studies evaluating cardiac autonomic dysfunction based on heart rate variability (HRV), there has been found to be a decrease in HRV and dominance of the sympathetic nervous system. Autonomic reactivity reflects modulations of several functions to overcome the existing state and conditions. Blunted autonomic reactivity has been found in some FMS patients, which makes it difficult for these patients to respond appropriately to unexpected stress sources that occur during daily living activities. Baroreceptor signals have an inhibitory influence on the central nervous system, and these impulses cause pain suppression. From this perspective, there are studies that have suggested the involvement of diminished baroreflex sensitivity in the etiology of FMS. The risk of endothelial dysfunction and increased arterial stiffness have been shown to occur in FMS patients due to autonomic dysfunction, sympathetic nervous system dominance, chronic stress, and pain. There is also evidence linking FMS with the risk of atrial and ventricular arrhythmias. Considering all these cardiovascular autonomic dysfunctions, tests that can confirm abnormalities should be performed when suspicion arises. There is a need for specific pharmacological and non-pharmacological treatment alternatives to be identified for subgroups of patients with cardiovascular system abnormalities. Key points • The frequency of FMS accompanying inflammatory rheumatic diseases is considerable and this coexistence leads to troubles in evaluating treatment response and determining appropriate medical treatment options in inflammatory rheumatic diseases. • Various cardiovascular autonomic abnormalities have been described in FMS patients. Among these, the most emphasized are autonomic dysfunction, the disruption of the balance between the sympathetic-parasympathetic nervous systems, blunted autonomic reactivity to acute stress, changes in baroreflex sensitivity, increased arterial stiffness, and electrophysiological alterations. • Autonomic cardiovascular dysfunction may be involved in the complex etiopathogenesis of the fibromyalgia syndrome and may trigger at least some symptoms.
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Rönnegård AS, Nowak C, Äng B, Ärnlöv J. The association between short-term, chronic localized and chronic widespread pain and risk for cardiovascular disease in the UK Biobank. Eur J Prev Cardiol 2022; 29:1994-2002. [PMID: 35727954 DOI: 10.1093/eurjpc/zwac127] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 12/30/2022]
Abstract
AIMS The interplay between pain of different chronicity and cardiovascular disease (CVD) is incompletely understood. We aimed to investigate the association between different levels of chronic or nonchronic pain and risk of CVD. METHODS AND RESULTS Participants in the UK Biobank who reported pain at baseline were divided into three groups according to pain duration and widespreadness. Participants reporting no pain were controls. Multivariable Cox regression was used to investigate the association between pain and incidence of myocardial infarction, heart failure, stroke, cardiovascular mortality, and composite CVD (defined as any of the before-mentioned cardiovascular events). Of 475 171 participants, 189 289 reported no pain, 87 830 reported short-term pain, 191 716 chronic localized pain, and 6336 chronic widespread pain (CWP). During a median of 7.0 years' follow-up, participants with chronic localized pain and CWP had, after adjustment for age, sex, established cardiovascular risk factors, physical activity, anxiety, depression, cancer, chronic inflammatory/painful disease, pain/anti-inflammatory medication, socioeconomic status, a significantly increased risk for composite CVD [hazard ratio (HR) 1.14, confidence interval (CI) 1.08-1.21, P < 0.001; and HR 1.48, CI 1.28-1.73, P < 0.001, respectively] compared with controls, with similar results when using the different specific CVDs as outcomes. Population attributable risk proportion for chronic pain as a risk factor for composite CVD was comparable with that of diabetes (8.6 vs. 7.3%, respectively). CONCLUSION Chronic pain is associated with an increased risk for myocardial infarction, stroke, heart failure, and cardiovascular death independent of established cardiovascular risk factors, socioeconomic factors, comorbidities and medication. Our study, the largest to date, confirms and extends our understanding of chronic pain as an underestimated cardiovascular risk factor with important public health implications.
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Affiliation(s)
- Ann-Sofie Rönnegård
- Department of Health and Social Studies, Dalarna University, Falun, Sweden.,Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun, Sweden
| | - Christoph Nowak
- Department of Neurobiology, Care Sciences and Society (NVS), Family Medicine and Primary Care Unit, Karolinska Institutet, Huddinge, Sweden
| | - Björn Äng
- Department of Health and Social Studies, Dalarna University, Falun, Sweden.,Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun, Sweden.,Department of Neurobiology, Care Sciences and Society (NVS), Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
| | - Johan Ärnlöv
- Department of Health and Social Studies, Dalarna University, Falun, Sweden.,Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun, Sweden.,Department of Neurobiology, Care Sciences and Society (NVS), Family Medicine and Primary Care Unit, Karolinska Institutet, Huddinge, Sweden
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Ghoneim FM, Abo-Elkhair SM, Elsamanoudy AZ, Shabaan DA. Evaluation of Endothelial Dysfunction and Autophagy in Fibromyalgia-Related Vascular and Cerebral Cortical Changes and the Ameliorative Effect of Fisetin. Cells 2021; 11:48. [PMID: 35011610 PMCID: PMC8750434 DOI: 10.3390/cells11010048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 11/17/2022] Open
Abstract
Fibromyalgia (FM) is a common chronic pain syndrome that affects 1% to 5% of the population. We aimed to investigate the role of endothelial dysfunction and autophagy in fibromyalgia-related vascular and cerebral cortical changes in a reserpine-induced rat model of fibromyalgia at the histological and molecular levels and to study the ameliorative effect of fisetin. Forty adult female albino rats were divided into four groups (10 each): two control groups, the reserpine-induced fibromyalgia group, and the fisetin-treated group. The carotid arteries and brains of the animals were dissected. Frozen tissue samples were used for total RNA extraction and qPCR analysis of eNOS, caspase-3, Bcl-2, LC-3, BECN-1, CHOP, and TNF-α expression. Histological, immunohistochemical (eNOS), and ultrastructure studies were conducted. The carotid arteries revealed excessive autophagy and endothelial, vascular, and apoptotic changes. The cerebral cortex showed similar findings apart from endoplasmic reticulum stress. Additionally, there was decreased gene expression of eNOS and Bcl-2 and increased expression of caspase-3, LC-3, BECN-1, CHOP, and TNF-α. In the fisetin-treated rats, improvements in the histological and molecular results were detected. In conclusion, oxidative stress, enhanced apoptosis, and excessive autophagy are fundamental pathophysiologic mechanisms of reserpine-induced fibromyalgia. Moreover, fisetin has an ameliorative effect against fibromyalgia.
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Affiliation(s)
- Fatma Mohamed Ghoneim
- Histology and Cell Biology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt; (F.M.G.); (D.A.S.)
| | - Salwa Mohamed Abo-Elkhair
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt;
| | - Ayman Zaky Elsamanoudy
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt;
- Clinical Biochemistry Department, Faculty of Medicine, King Abdulaziz University, Jeddah 21465, Saudi Arabia
| | - Dalia A. Shabaan
- Histology and Cell Biology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt; (F.M.G.); (D.A.S.)
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Carotid Arterial Stiffness and Cardiometabolic Profiles in Women with Fibromyalgia. Biomedicines 2021; 9:biomedicines9121786. [PMID: 34944602 PMCID: PMC8698753 DOI: 10.3390/biomedicines9121786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/17/2021] [Accepted: 11/26/2021] [Indexed: 11/17/2022] Open
Abstract
Background: The present study aimed to evaluate the association between FM and cardiometabolic risk factors and carotid arterial stiffness in FM patients. Methods: The cardiometabolic risk profile was defined based on the Adult Treatment Panel III panel. Carotid intimal media thickness (cIMT) and arterial stiffness were assessed using high-resolution ultrasonography. Multivariate logistic analysis was performed to estimate the association between FM and cardiometabolic risk factors. We used a general linear regression to compare the cIMT and carotid beta-index between the participants with and without FM. Pearson’s coefficient was calculated to evaluate the potential correlation between cardiometabolic risk profiles, cIMT, and arterial stiffening in FM. Results: FM participants showed a higher risk of central obesity (odds ratio [OR] = 3.21, 95% confidence interval [CI] 1.49, 6.91), high triglyceride (OR = 4.73, 95% CI 2.29, 9.79), and impaired fasting glucose (IFG) (OR = 4.27, 95% CI 2.07, 8.81) compared to the control group. The FM group exhibited higher beta-index values than the control group (p = 0.003). Although IFG and triglyceride glucose index showed a tendency to correlate with the beta-index, statistical significance was not observed. Conclusions: FM was associated with an increased risk of central obesity, high triglyceride levels, and IFG. Furthermore, advanced arterial stiffness of the carotid artery was observed in FM, which might be correlated with insulin resistance.
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Aksu E, Berk E, Sökmen A, Sökmen G, Çelik E. Subclinical cardiac structural and electrical abnormalities in fibromyalgia syndrome. Turk J Med Sci 2020; 50:885-893. [PMID: 32283905 PMCID: PMC7379451 DOI: 10.3906/sag-1912-228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 04/11/2020] [Indexed: 12/19/2022] Open
Abstract
Background/aim In the literature, there is a paucity of data about the effects of fibromyalgia syndrome (FMS) on myocardial function and electrophysiological properties of atrium and ventricles. In this study, we investigated cardiac functions and noninvasive predictors of arrhythmias in patients with FMS. Materials and methods The study included 43 female patients diagnosed with FMS and 30 age- and sex-matched healthy subjects. The presence of fragmented QRS (fQRS) morphology, P dispersion, QT dispersion, inter- and intraatrial electromechanical delay was evaluated in the groups with 12-lead ECG and standard and tissue Doppler echocardiography. Results Among electrocardiographic parameters, P dispersion, QT dispersion, and the ratio of presence of fQRS morphology were found to be significantly higher in the study group as compared to the control group. In lateral and septal, the ratio of the early transmitral flow velocity to the early diastolic tissue velocity (E/Em) was significantly higher in the study group. Additionally, intra- and interatrial electromechanical delay was found significantly prolonged in the study group. Conclusion FMS is found to be associated with significant cardiac electrical alterations that may indicate the increased risk of atrial and ventricular arrhythmias in this group of patients.
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Affiliation(s)
- Ekrem Aksu
- Department of Cardiology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Ejder Berk
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Abdullah Sökmen
- Department of Cardiology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Gülizar Sökmen
- Department of Cardiology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Enes Çelik
- Department of Cardiology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
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Akkaya H, Güntürk EE, Kaydok E, Özdemir B. Determination of the increased risk of developing atrial fibrillation in fibromyalgia syndrome. Adv Rheumatol 2020; 60:14. [PMID: 32000854 DOI: 10.1186/s42358-020-0112-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/19/2020] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Atrial fibrillation (AF) is the leading cause of ischemic stroke and is one of the most common arrhythmias. Previous studies have shown that impaired diastolic functions, P wave dispersion (Pd), and prolonged atrial conduction times (ACT) are associated with increased incidence of atrial fibrillation (AF). The aim of this study was to evaluate diastolic functions, Pd, and ACT in fibromyalgia syndrome (FMS) patients to determine whether there is an increase in the risk of developing AF. METHODS The study included a total of 140 female patients (70 FMS group, 70 healthy control group). Pd was evaluated using 12 lead electrocardiography (ECG), and diastolic functions and ACT with echocardiography. The ECG and echocardiographic evaluations were performed by different cardiologists blinded to the clinical information of the subjects. RESULTS There was no difference between the two groups in laboratory and clinical parameters. Patients with FMS had significantly higher echocardiographic parameters of ACT known as left-sided intra-atrial (13.9 ± 5.9 vs. 8.1 ± 1.8, p < 0.001), right-sided intra-atrial (21.9 ± 8.2 vs. 10.4 ± 3.5, p < 0.001) and interatrial [40 (25-64) ms vs. 23 (14-27) ms p < 0.001] electromechanical interval (EMI) compared with the control group. Pd was significantly greater in the FMS group compared with the control group [46 (29-62) ms vs. 32 (25-37) ms, p < 0.001]. In the FMS group, there was no significant relationship of the echocardiographic parameters of ACT, Pmax and Pd with age, E/A ratio and deceleration time (DT); while all these five parameters were significantly correlated with left atrial dimension, isovolumetric relaxation time (IVRT), fibromyalgia impact questionnaire (FIQ) and visual analogue scale (VAS). There was a strong correlation between FIQ and VAS and echocardiographic parameters of ACT, Pmax and Pd. CONCLUSIONS Impaired diastolic functions, an increase in Pd, and prolongation of ACT were observed in FMS. Current disorders are thought to be associated with an increased risk of AF in FMS. The risk of developing AF increases with the severity of FMS and clinical progression.
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Affiliation(s)
- Hasan Akkaya
- Cardiology Department, Niğde Ömer Halisdemir University Medicine Faculty Education and Research Hospital, Niğde, Turkey.
| | - Ertuğrul Emre Güntürk
- Cardiology Department, Niğde Ömer Halisdemir University Medicine Faculty Education and Research Hospital, Niğde, Turkey
| | - Ercan Kaydok
- Physical Medicine and Rehabilitation Department, Niğde Ömer Halisdemir University Medicine Faculty Education and Research Hospital, Niğde, Turkey
| | - Betül Özdemir
- Cardiology Department, Niğde Ömer Halisdemir University Medicine Faculty Education and Research Hospital, Niğde, Turkey
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Gunturk EE, Ekiz T, Akkaya H. Evaluation of carotid-femoral pulse wave velocity, aortic stiffness index, and aortic distensibility in patients with fibromyalgia. Clin Rheumatol 2019; 38:1731-1735. [PMID: 30635854 DOI: 10.1007/s10067-019-04429-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/27/2018] [Accepted: 01/01/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The aim of this study was to compare the carotid-femoral pulse wave velocity (CFPWV), aortic stiffness index (ASI), and aortic distensibility values of fibromyalgia patients with those of healthy subjects. METHODS This study was conducted as a case-control study between September 2017 and March 2018. Echocardiographic evaluations were administered by the same cardiologist. ASI, aortic distensibility, CFPWV, and other echocardiographic parameters of fibromyalgia patients and healthy subjects were compared. In addition, all patients were assessed using the Fibromyalgia Impact Questionnaire (FIQ), number of tender points, and Visual Analogue Scale (VAS) pain score. RESULTS The fibromyalgia group consisted of 67 female patients with a mean age of 48.54 ± 3.1 years (range, 42-55 years) and the control group consisted of 50 healthy subjects with a mean age of 49.76 ± 3.1 years (range, 42-55 years). No significant difference was observed between the groups in respect of age and body mass index (p > 0.05). CFPWV and ASI values were significantly higher in the fibromyalgia group than in the control group. Aortic distensibility values were significantly lower in the fibromyalgia group compared to the control group (p < 0.05 for all). There was a very strong, positive correlation between the CFPWV values and number of tender points (r = 0.936, p < 0.001), VAS (r = 0.927, p < 0.001), FIQ (r = 0.941, p < 0.001), and ASI (r = 0.957, p < 0.001). CONCLUSION CFPWV and aortic stiffness seem to be increased and aortic distensibility seems to be decreased in patients with fibromyalgia. Alleviating pain and improving the disease severity may be helpful in preventing cardiovascular risk factors in patients with fibromyalgia.
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Affiliation(s)
- Ertugrul Emre Gunturk
- Faculty of Medicine, Department of Cardiology, Nigde Omer Halisdemir University, Nigde, Turkey. .,Nigde Omer Halisdemir Universitesi Merkez Yerleşkesi, Tip Fakültesi Kardiyoloji Anabilim Dalı, Bor Yolu Uzeri, 51240, Merkez/Nigde, Turkey.
| | - Timur Ekiz
- Turkmenbası Medical Center, Department of Physical and Rehabilitation Medicine, Adana, Turkey
| | - Hasan Akkaya
- Faculty of Medicine, Department of Cardiology, Nigde Omer Halisdemir University, Nigde, Turkey
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Khoonsari PE, Musunri S, Herman S, Svensson CI, Tanum L, Gordh T, Kultima K. Systematic analysis of the cerebrospinal fluid proteome of fibromyalgia patients. J Proteomics 2019; 190:35-43. [DOI: 10.1016/j.jprot.2018.04.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/28/2018] [Accepted: 04/05/2018] [Indexed: 01/08/2023]
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Evaluation of Ventricular Diastolic Function in Patients With Fibromyalgia Syndrome. Arch Rheumatol 2018; 33:150-153. [PMID: 30207569 DOI: 10.5606/archrheumatol.2018.6541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/09/2017] [Indexed: 01/08/2023] Open
Abstract
Objectives This study aims to compare the diastolic functions between fibromyalgia (FM) patients and control subjects by using transthoracic echocardiography. Patients and methods This case-control and cross-sectional study included 34 female FM patients (mean age 43.6±8.2 years; range 28 to 57 years), who were diagnosed by The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia and defined as the FM group. A control group was defined consisting of 30 healthy females (mean age 41.2±9.1 years; range 22 to 54 years). Echocardiography findings of the groups were compared. Results The body mass index and mean disease duration of the FM group were 25.37±2.71 kg/m2 and 12.24 months, respectively. The body mass index of the control group was 25.58±1.49 kg/m2. There was no significant difference between the groups in terms of age and body mass index. Isovolumetric relaxation time and mitral E-wave deceleration time values were significantly higher in the FM group than in the control group (p=0.047, p=0.003, respectively). Conclusion Isovolumetric relaxation time and mitral valve deceleration time are significantly prolonged in FM patients compared with healthy subjects. Female patients with FM seem to be under risk of impaired relaxation and diastolic function of the left ventricle.
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Abstract
PURPOSE OF REVIEW Fibromyalgia syndrome (FMS) is defined as chronic, widespread musculoskeletal pain and tenderness with concomitant mood and cognitive dysfunction. Several comorbidities have been reported to be associated with FMS. We reviewed the literature concerning the most noteworthy chronic conditions associated with FMS. RECENT FINDINGS There is mounting evidence displaying the concurrence of fibromyalgia and coexisting medical and psychiatric conditions. Such comorbidities may blur the classical clinical presentations and erroneously lead to misinterpretation of disease activity. The recognition of this fact should be underlined, as misrecognition may lead to excessive therapy and avoidable side-effects of medications on the one hand and to a better handling of FMS on the other hand, leading to improved clinical outcomes. SUMMARY A greater proportion of psychiatric and rheumatologic disorders are associated with FMS patients than the population. Consequently, physicians treating patients with either condition should keep in mind that these patients may have such comorbidities and should be treated accordingly.
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Multanen J, Häkkinen A, Heikkinen P, Kautiainen H, Mustalampi S, Ylinen J. Pulsed electromagnetic field therapy in the treatment of pain and other symptoms in fibromyalgia: A randomized controlled study. Bioelectromagnetics 2018; 39:405-413. [PMID: 29709070 DOI: 10.1002/bem.22127] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 03/12/2018] [Indexed: 11/09/2022]
Abstract
Low-energy pulsed electromagnetic field (PEMF) therapy has been suggested as a promising therapy to increase microcirculation, which is of great concern in patients with fibromyalgia. This study evaluated the effectiveness of PEMF therapy on the treatment of fibromyalgia. A group of 108 women with fibromyalgia were allocated to a 12-week treatment period with an active Bio-Electro-Magnetic-Energy-Regulation (BEMER) device and a similar treatment period with an inactive device. Each patient received active and sham treatments in a random order. Pain and stiffness were assessed on a visual analog scale (VAS, scale 0-100 mm), and functional status was assessed by the Fibromyalgia Impact Questionnaire (FIQ). Mean VAS pain scores before the active and sham treatment periods were 66 (SD 22) and 63 (SD 22), respectively. After treatment periods, mean VAS pain scores had decreased significantly in active treatment, -12, 95% CI [-18, -6], and in sham treatment, -11, 95% CI [-17, -5]. Similarly, the decrease in stiffness and FIQ index after both treatments was statistically significant. However, per-protocol analysis showed no differences between active and sham treatments at any of the outcomes. This study demonstrated that low-energy PEMF therapy was not efficient in reducing pain and stiffness or in improving functioning in women with fibromyalgia. Bioelectromagnetics. 39:405-413, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Juhani Multanen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
| | - Arja Häkkinen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pauli Heikkinen
- Department of Physics, University of Jyväskylä, Jyväskylä, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Sirpa Mustalampi
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
| | - Jari Ylinen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
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Kim BJ, Cho IS, Cho KI. Impact of Mindfulness Based Stress Reduction Therapy on Myocardial Function and Endothelial Dysfunction in Female Patients with Microvascular Angina. J Cardiovasc Ultrasound 2018; 25:118-123. [PMID: 29333218 PMCID: PMC5762694 DOI: 10.4250/jcu.2017.25.4.118] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 11/06/2017] [Accepted: 11/14/2017] [Indexed: 01/18/2023] Open
Abstract
Background Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic, and psychiatric disorders. In this study, we investigate the impact of MBSR on left ventricular (LV) and endothelial function in female patients with microvascular angina. Methods A total of 34 female patients (mean age 52.2 ± 13.8 years) diagnosed with microvascular angina underwent a MBSR program with anti-anginal medication for 8 weeks. The global longitudinal strain (GLS) of the LV was used as a parameter to assess myocardial function and reactive brachial flow-mediated dilatation (FMD) was used to assess endothelial function. Symptoms were analyzed by the Symptom Checklist 90 Revised to determine emotional stress. Changes in GLS and FMD between baseline and post-MBSR were analyzed. Results After 8 weeks of programmed MBSR treatment, stress parameters were significantly decreased. In addition, GLS (−19.5 ± 2.1% vs. −16.6 ± 2.5%, p < 0.001) and reactive FMD significantly improved (8.9 ± 3.0% vs. 6.9 ± 2.6%, p = 0.005) after MBSR compared to baseline. The changes in GLS correlated to changes in FMD (r = 0.120, p = 0.340) and with the changes in most stress parameters. Conclusion MBSR has beneficial impacts on myocardial and endothelial function in female patients with microvascular angina.
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Affiliation(s)
- Bong Joon Kim
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.,Convergence Medicine & Exercise Science Research Institute, Kosin University College of Medicine, Busan, Korea
| | - In Suk Cho
- Convergence Medicine & Exercise Science Research Institute, Kosin University College of Medicine, Busan, Korea
| | - Kyoung Im Cho
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.,Convergence Medicine & Exercise Science Research Institute, Kosin University College of Medicine, Busan, Korea
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Cho KI. Women, Stress and Heart Health: Mindfulness-Based Stress Reduction and Cardiovascular Disease. KOSIN MEDICAL JOURNAL 2016. [DOI: 10.7180/kmj.2016.31.2.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Psychological stress including depression and anxiety are independent risk factors for cardiovascular disease morbidity and mortality, especially in women. Emotional regulation plays a mediating role in the development of depression and physical illness, and can alter resting physiologic responses associated with the stress response. Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic, and psychiatric disorders. MBSR was originally developed for the management of chronic pain, which is now used widely to reduce psychological morbidity associated with chronic illnesses and to treat emotional and behavioral disorders. In cardiovascular disease, MBSR may be helpful for controlling several risk factors for coronary heart disease such as hypertension, type 2 diabetes mellitus, dyslipidemia, oxidative and psychosocial stress, obesity, and smoking, and improvements in submaximal exercise responses and heart rate variability. Although the most effective mode of stress reduction therapy is yet to be established, increasing recognition is being given to MBSR therapy.
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Triantafyllias K, De Blasi M, Hoffmann I, Thomaidis T, Drees P, Schwarting A. The count of tender rather than swollen joints correlates with aortic stiffness in patients with rheumatoid arthritis. SPRINGERPLUS 2016; 5:428. [PMID: 27104116 PMCID: PMC4828367 DOI: 10.1186/s40064-016-2066-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 03/29/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND Patients with rheumatoid arthritis (RA) are at a higher cardiovascular (CV) risk in comparison to the general population. CV risk associates closely with aortic stiffness. Aim of this exploration was therefore to evaluate aortic stiffness in patients with RA and to examine its association with various RA associated parameters as well as with traditional CV risk factors. METHODS Measurements of carotid-femoral pulse wave velocity (cfPWV) were analyzed retrospectively in 38 RA patients and 25 controls. We investigated the statistical difference between cfPWV values in the two groups. Furthermore, we analyzed the associations of cfPWV with laboratory and clinical RA parameters including Disease Activity Score 28 and its components, rheumatoid factor, cyclic citrullinated peptide antibodies, antinuclear antibodies and RA duration. Finally, we explored the relationship of cfPWV with traditional CV risk factors in the RA group. RESULTS cfPWV was not significantly higher in RA patients in comparison to controls in an adjusted statistical model for confounding factors [-0.587 95 % CI (-1.38 to 0.201), p = 0.144]. Among RA patients there was a statistically significant correlation of cfPWV with age (rho = 0.544, p = 0.001) and the count of tender joints [0.051 95 % CI (0.008-0.207), p = 0.034]. Finally, C-reactive protein associated only marginally with cfPWV [0.105 95 % CI (-0.410 to 0.003), p = 0.053]. CONCLUSIONS In RA patients the number of tender, rather than swollen joints correlates with stiffness of the aorta, as measured through cfPWV. Therefore, RA associated joint pain might play a role in the development of aortic stiffness and thus increase CV risk.
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Affiliation(s)
| | - Michele De Blasi
- />ACURA Rheumatology Clinics, Kaiser-Wilhelm-Str. 9-11, 55543 Bad Kreuznach, Germany
| | - Isabell Hoffmann
- />Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg University, Mainz, Germany
| | - Thomas Thomaidis
- />First Department of Medicine, Johannes Gutenberg University, Mainz, Germany
| | - Philipp Drees
- />Department of Orthopaedics and Trauma Surgery, Johannes Gutenberg University, Mainz, Germany
| | - Andreas Schwarting
- />ACURA Rheumatology Clinics, Kaiser-Wilhelm-Str. 9-11, 55543 Bad Kreuznach, Germany
- />First Department of Medicine, Johannes Gutenberg University, Mainz, Germany
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Erkmen Uyar M, Sezer S, Bal Z, Guliyev O, Tutal E, Genctoy G, Kulah E, Ozdemir Acar N, Haberal M. Fibromyalgia and its clinical relevance in renal transplant recipients. Transplant Proc 2015; 47:1105-9. [PMID: 26036530 DOI: 10.1016/j.transproceed.2015.01.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/30/2014] [Accepted: 01/28/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Recent 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. METHODS Ninety-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. 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 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. CONCLUSIONS FS in renal transplant recipients was strongly associated with hypertension, arterial stiffness, obesity, and renal allograft dysfunction.
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Affiliation(s)
- M Erkmen Uyar
- Department of Nephrology, Baskent University, Ankara, Turkey.
| | - S Sezer
- Department of Nephrology, Baskent University, Ankara, Turkey
| | - Z Bal
- Department of Nephrology, Baskent University, Ankara, Turkey
| | - O Guliyev
- Department of Nephrology, Baskent University, Ankara, Turkey
| | - E Tutal
- Department of Nephrology, Baskent University, Ankara, Turkey
| | - G Genctoy
- Department of Nephrology, Baskent University, Antalya, Turkey
| | - E Kulah
- Department of Nephrology, Baskent University, Istanbul, Turkey
| | - N Ozdemir Acar
- Department of Nephrology, Baskent University, Istanbul, Turkey
| | - M Haberal
- Department of Nephrology, Baskent University, Istanbul, Turkey; Department of General Surgery, Baskent University, Ankara, Turkey
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Hesler BD, Dalton JE, Singh H, Chahar P, Saager L, Sessler DI, Turan A. Association between fibromyalgia and adverse perioperative outcomes. Br J Anaesth 2014; 113:792-9. [PMID: 24966151 DOI: 10.1093/bja/aeu164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Fibromyalgia, the classic non-inflammatory pain syndrome, has been associated with chronic inflammatory makers which are linked with increased morbidity and mortality. We tested the primary hypothesis that patients with fibromyalgia undergoing hospital procedures have a high risk of cardiovascular complications. Our secondary goals were to evaluate the association of fibromyalgia with: (i) in-hospital thromboembolic events, (ii) in-hospital mortality, and (iii) in-hospital microvascular complications. METHODS We obtained 21.78 million discharge records from 2009 to 2010 from the US Agency for Healthcare Research and Quality censuses across the seven states. We matched fibromyalgia records and compared records with controls based on age, gender, state of discharge, principal procedure, and a propensity score developed from the set of diagnosis-related predictors. A multivariable logistic regression was used to compare matched fibromyalgia patients and controls on the primary and secondary outcomes. RESULTS We matched 89 589 pairs for a total sample size of 179 178 discharge records. The adjusted odds ratio for in-hospital cardiovascular complications was 1.04 [99% confidence interval (CI): 0.90-1.19, P=0.51], for thromboembolic events was 1.03 (99% CI: 0.93-1.15, P=0.46), for in-hospital mortality was 0.81 (99% CI: 0.73-0.89, P<0.001), and for microvascular complications was 0.96 (99% CI: 0.88, 1.04, P=0.18). Two separate sensitivity analyses produced results similar to that of the primary analysis for all three complication outcomes. CONCLUSIONS We found no evidence that the diagnosis of fibromyalgia increased the risk of in-hospital complications. Fibromyalgia seems to be associated with a reduction in in-hospital mortality, but this requires confirmation with a large prospective controlled study.
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Affiliation(s)
| | - J E Dalton
- Department of Outcomes Research Department of Quantitative Health Sciences
| | - H Singh
- Anesthesiology Institute and
| | | | - L Saager
- Department of Outcomes Research Department of General Anesthesiology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | | | - A Turan
- Department of Outcomes Research Department of General Anesthesiology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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Cho KI, Lee JH. The impact of thyroid autoimmunity on arterial stiffness in postmenopausal patients with fibromyalgia. Int J Rheum Dis 2014; 20:1978-1986. [PMID: 24410753 DOI: 10.1111/1756-185x.12257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The exact mechanism of arterial stiffness in fibromyalgia (FM) remains unclear. The present study aimed to evaluate the association between thyroid function and markers of arterial function in postmenopausal FM patients. METHODS This study included 163 postmenopausal FM patients without any known cardiovascular diseases and within a normal reference range of thyroid-stimulating hormone (TSH) level. Clinical parameters including the Fibromyalgia Impact Questionnaire (FIQ), the pain visual analogical scale (VAS) and tender point counts were measured. Vascular function was assessed by brachial-ankle pulse wave velocity (baPWV) and flow-mediated dilation (FMD). We evaluated the associations between arterial markers and serum TSH, free thyroxin, as well as serum thyroidperoxidase autoantibody (TPO Ab). RESULTS Patients with a high baPWV (≥ 1490 cm/s) showed more positive TPO Ab (65% vs. 10%, P = 0.006) than those with a normal baPWV. Additionally, the baPWV values of patients with positive TPO Ab were significantly different from those with negative TPO Ab. Age, FIQ and TPO Ab were significantly correlated with baPWV and FMD (all P < 0.05). Multiple linear regression analysis revealed that the only significant predictors of baPWV were age, FIQ and the presence of TPO Ab after adjustment for traditional risk factors. A significant association was also found between FMD and positive TPO Ab. CONCLUSION Age, functional status and presence of TPO Ab were significantly associated with increased arterial stiffness in postmenopausal FM patients. Given the combined thyroid autoimmunity in FM patients, a re-evaluation of the effects on the vasculature may be necessary.
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Affiliation(s)
- Kyoung Im Cho
- Cardiovascular Research Institute, Kosin University School of Medicine, Busan, Korea
| | - Ji Hyun Lee
- Division of Rheumatology, Maryknoll Medical Center, Busan, Korea
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Sung KC, Lim YH, Park S, Kang SM, Park JB, Kim BJ, Shin JH. Arterial stiffness, fatty liver and the presence of coronary artery calcium in a large population cohort. Cardiovasc Diabetol 2013; 12:162. [PMID: 24191863 PMCID: PMC3826844 DOI: 10.1186/1475-2840-12-162] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/02/2013] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND We tested whether fatty liver, brachial-ankle pulse wave velocity (baPWV) and conventional cardiovascular risk factors were associated with a coronary artery calcium (CAC) score > 0 (as a marker of the presence of early atherosclerosis) in a cohort of healthy Korean adults. METHOD The study population consisted of individuals who underwent a comprehensive health examination in 2010 at Kangbuk Samsung Hospital, College of Medicine, Sungkyunkwan University in South Korea. The 6009 subjects of total 7371 participants who had an assigned CAC score following coronary computed tomography (CT) scanning and baPWV were analyzed. RESULTS Among the study subjects, 39.2% of the population had evidence of fatty liver by ultrasound and 4.6% of the population had evidence of CAC score > 0. Among individuals with a CAC score = 0, 38% of the individuals had fatty liver compared with 58% of the individuals with a CAC score > 0. The individuals with a CAC score > 0 also had higher blood pressure and had more metabolic abnormalities. The prevalence of CAC score > 0 was increased according to baPWV quartiles and was higher in the fatty liver group in comparison with those without fatty liver. The odds ratio for CAC score > 0, after adjusting for clinical risk factors, showed a significant elevation with increasing quartiles of baPWV and the presence of fatty liver. CONCLUSION We showed that both fatty liver and baPWV are independently associated with the presence of CAC, a marker of preclinical atherosclerosis. These associations are independent of conventional risk factors and medical history.
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Affiliation(s)
- Ki-Chul Sung
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, #108, Pyung Dong, Jongro-Ku, Seoul 110-746, Republic of Korea.
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Afsar B, Burucu R. Urinary albumin, protein excretion and circadian blood pressure in patients with fibromyalgia. Rheumatol Int 2013; 33:2391-8. [PMID: 23588409 DOI: 10.1007/s00296-013-2748-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 04/03/2013] [Indexed: 11/25/2022]
Abstract
Recent evidence suggests that patients with fibromyalgia (FM) have increased oxidative stress, inflammation, endothelial dysfunction and autonomic dysfunction. These factors are also shown to be responsible for increased urinary albumin and protein excretion and deranged circadian blood pressure (BP). However, no study has examined the 24-h urinary albumin excretion (UAE), 24-h urinary protein excretion (UPE) and 24-h ambulatory BP measurements in FM patients. The sociodemographic, laboratory parameters, depressive symptoms, sleep problems and 24-h ambulatory BPs were measured for all patients. Diagnosis of FM was based on the criteria for the classification of FM by the American College of Rheumatology. After diagnosis of FM, these patients underwent to complete the Fibromyalgia Impact Questionnaire (FIQ). In total, 30 patients with FM and 61 patients without FM were included. Among FM patients, the average number of tender points was 13.1 ± 1.57 and the mean FIQ score was 57.9 ± 8.86. The number of tender points did not show any correlation with office and ambulatory BPs. There were also no correlations between the number of tender points, UPE and UAE. The stepwise linear regression did not show any relation between UPE and FM. However, 24-h UAE was independently correlated with office systolic BP (P 0.008) and the presence of FM (P 0.045). The logistic regression analysis revealed no association between FM and non-dipping status. We suggest that circadian blood pressure and UPE are not independently associated with FM. However, UAE was related with the presence of FM. Studies are needed to confirm our findings and to highlight pathophysiologic mechanisms.
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Affiliation(s)
- Baris Afsar
- Division of Nephrology, Department of Internal Medicine, Konya Numune State Hospital, Konya, Turkey.
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Kulshreshtha P, Deepak KK. Autonomic nervous system profile in fibromyalgia patients and its modulation by exercise: a mini review. Clin Physiol Funct Imaging 2012; 33:83-91. [DOI: 10.1111/cpf.12000] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 08/20/2012] [Indexed: 01/24/2023]
Affiliation(s)
- Poorvi Kulshreshtha
- Department of Physiology; Kalinga Institute of Medical Sciences; KIIT University; Bhubaneswar; Odisha; India
| | - Kishore K. Deepak
- Department of Physiology; All India Institute of Medical Sciences; New Delhi; India
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