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D'Souza RS, Whipple MO, Vincent A. Statin Therapy and Symptom Burden in Patients With Fibromyalgia: A Prospective Questionnaire Study. Mayo Clin Proc Innov Qual Outcomes 2021; 5:1036-1041. [PMID: 34765886 PMCID: PMC8571478 DOI: 10.1016/j.mayocpiqo.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To evaluate the association between statin use and symptom severity, tender point count, fatigue, cognition, mood, and sleep issues in patients with fibromyalgia (FM). Methods Between May 2012 and November 2013, 668 patients with FM were surveyed. Patients were stratified into statin users and statin nonusers. Primary outcome was FM symptom severity (FIQ-R questionnaire) and tender point count. Secondary outcomes included fatigue (MFI-20), cognitive dysfunction (MASQ), anxiety (GAD-7), depression (PHQ-9), and sleep issues (SPI-II). Regression analysis assessed for differences in these clinical outcomes between statin users and statin nonusers and adjusted for age, sex, body mass index, ethnicity, tobacco use, opioid use, and neuropathic medication use. Results Of the FM patients, 79 (11.8%) were statin users, whereas 589 (88.2%) reported no current statin use. Compared with the control cohort, statin users were older (55.0±11.3 years vs 46.2±12.9 years; P<.001) and had a higher body mass index (33.0±7.0 kg/m2 vs 29.8±7.7 kg/m2; P=.001). Adjusted linear regression revealed no association between statin use and symptom severity (total FIQ-R scores, 57.7±18.3 vs 59.0±18.1; adjusted β coefficient, −0.4; 95% CI, −4.8 to 4.1; P=.871). There was also no association between statin use and tender point count (14.8±4.1 vs 14.5±4.2; adjusted β coefficient, 0.2; 95% CI, −0.8 to 1.2; P=.732). Secondary outcome analysis revealed no difference between statin users and statin nonusers in metrics measuring fatigue, cognition, anxiety, depression, and sleep problems. Conclusion Administration of statin therapy for at least 1 month is not a risk factor for worse symptom burden in patients with FM. Statin therapy should be offered to dyslipidemic FM patients with an appropriate medical indication to optimize their cardiovascular health.
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Affiliation(s)
- Ryan S D'Souza
- Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine
| | - Mary O Whipple
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Ann Vincent
- Department of Medicine, Mayo Clinic, Rochester, MN
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Jiang L, D’Souza RS, Oh T, Vincent A, Mohabbat AB, Ashmore Z, Mauck WD, Ge L, Whipple MO, McAllister SJ, Wang Z, Qu W. Sex-Related Differences in Symptoms and Psychosocial Outcomes in Patients With Fibromyalgia: A Prospective Questionnaire Study. Mayo Clin Proc Innov Qual Outcomes 2020; 4:767-774. [PMID: 33367213 PMCID: PMC7749234 DOI: 10.1016/j.mayocpiqo.2020.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective To investigate sex-related differences in patients with fibromyalgia (FM) in terms of demographic characteristics and clinical features, including tender point count (TPC), mood disorders, sleep problems, FM symptom severity, fatigue, cognitive dysfunction, and quality of life (QOL). Patients and Methods We studied 668 consecutive patients with FM (606 women) from May 1, 2012, to November 30, 2013. Validated questionnaires assessed outcomes of depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), sleep problems (Medical Outcomes Study Sleep Scale), FM symptom severity (Revised Fibromyalgia Impact Questionnaire), fatigue (Multidimensional Fatigue Inventory), cognitive dysfunction (Multiple Ability Self-report Questionnaire), and QOL (36-Item Short Form Health Survey). Nonparametric Mann-Whitney U and Pearson χ2 tests were used to compare continuous and categorical outcome measures, respectively, between men and women. Linear regression models were performed for all continuous dependent variables, adjusting for age, body mass index, ethnicity, marital status, and highest education level completed. P<.05 was considered statistically significant. The Benjamini-Hochberg procedure was used to adjust for multiple comparisons. Results Multiple linear regression analysis revealed a significant association of female sex and greater TPC (P<.001), lower overall FM symptom severity (lower overall Revised Fibromyalgia Impact Questionnaire score; P=.03), and higher QOL subscale score for vitality (36-Item Short Form Health Survey vitality subscale score; P=.02). After adjustment for multiple comparisons, only the association between female sex and greater TPC remained significant. There were no sex-related differences in demographic characteristics, depression, anxiety, sleep problems, FM symptom severity, cognitive dysfunction, and QOL. Conclusion A higher TPC may be associated with female sex in patients with FM. The assumption of other sex-based differences in the clinical presentation of FM was not supported in our study.
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Affiliation(s)
- Li Jiang
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - Ryan S. D’Souza
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
- Correspondence: Address to Ryan S. D’Souza, MD, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, 200 1st St SW, Rochester, MN 55905 @Ryan_S_DSouzaMD
| | - Terry Oh
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - Ann Vincent
- Department of Medicine, Mayo Clinic, Rochester, MN
| | | | - Zachary Ashmore
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - William D. Mauck
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Lin Ge
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | | | | | - Zhen Wang
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN
| | - Wenchun Qu
- Department of Pain Medicine, Mayo Clinic, Jacksonville, FL
- Wenchun Qu, MD, MS, PhD, 4500 San Pablo Rd S, Jacksonville, FL 32224.
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Ge L, D'Souza RS, Oh T, Vincent A, Mohabbat AB, Eldrige J, Jiang L, Whipple MO, McAllister SJ, Wang Z, Qu W, Mauck WD. Tobacco Use in Fibromyalgia Is Associated With Cognitive Dysfunction: A Prospective Questionnaire Study. Mayo Clin Proc Innov Qual Outcomes 2019; 3:78-85. [PMID: 30899911 PMCID: PMC6408684 DOI: 10.1016/j.mayocpiqo.2018.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 12/12/2022] Open
Abstract
Objective To evaluate the association between smoking and cognitive function in patients with fibromyalgia. Patients and Methods We surveyed 668 patients with fibromyalgia from May 1, 2012 through November 30, 2013 at a major tertiary referral center. Patients were categorized by smoking status. Primary outcome of interest was cognitive function (MASQ questionnaire), and secondary outcomes included fibromyalgia symptom severity (FIQ-R questionnaire), quality of life (SF-36 questionnaire), fatigue (MFI-20 questionnaire), sleep (MOS-sleep scale), anxiety (GAD-7 questionnaire), and depression (PHQ-9 questionnaire). Independent Students' t-tests and χ2 tests were performed for continuous and categorical variables, respectively. Univariate regression analysis identified variables predictive of outcomes, adjusting for age, gender, body mass index, marital status, and educational level. Results Ninety-four (14.07%) patients self-identified as smokers. There was an association of lower education level, unmarried status, and younger age in smokers compared with nonsmokers. In the adjusted univariate regression analysis, fibromyalgia smokers reported greater perceived total cognitive dysfunction (P=.009) and greater subscale scores of perceived difficulty in language (P=.03), verbal memory (P=.003), visual-spatial memory (P=.02), and attention (P=.04) compared with nonsmokers with fibromyalgia. For secondary outcomes, smokers with fibromyalgia reported greater severity of fibromyalgia-related symptoms (P=.006), worse quality-of-life index in the mental component scale (P=.02), greater sleep problems (P=.01), and increased anxiety (P=.001) compared with nonsmokers who had fibromyalgia. Conclusion In patients with fibromyalgia, smoking is a risk factor for cognitive dysfunction. Moreover, smokers with fibromyalgia were more likely to report increased severity of fibromyalgia symptoms, worse quality of life, more sleep problems, and increased anxiety compared with nonsmokers with fibromyalgia.
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Key Words
- BMI, body mass index
- FIQ-R, Revised Fibromyalgia Impact Questionnaire
- FM, fibromyalgia
- GAD-7, 7-item Generalized Anxiety Scale
- MASQ, Multiple Ability Self-Report Questionnaire
- MFI-20, Multidimensional Fatigue Inventory
- MOS-Sleep, Medical Outcomes Study Sleep Scale
- PHQ-9, 9-item Patient Health Questionnaire Depression Scale
- QOL, quality of life
- SF-36, 36-item Short Form Health Survey
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Affiliation(s)
- Lin Ge
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.,Department of Rheumatology, Guang An Men Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Ryan S D'Souza
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Terry Oh
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - Ann Vincent
- Department of Medicine, Mayo Clinic, Rochester, MN
| | | | - Jason Eldrige
- Department of Anesthesiology, Pain Division, Mayo Clinic, Rochester, MN
| | - Li Jiang
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | | | | | - Zhen Wang
- Department of Nursing, Mayo Clinic, Rochester, MN
| | - Wenchun Qu
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.,Department of Anesthesiology, Pain Division, Mayo Clinic, Rochester, MN
| | - William D Mauck
- Department of Anesthesiology, Pain Division, Mayo Clinic, Rochester, MN
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