Association between fibromyalgia syndrome clinical severity and body composition. A principal component analysis / Asociación entre las manifestaciones clínicas del síndrome de fibromialgia y la composición corporal. Un análisis de componentes principales

Introduction: The type of body composition modulates the severity of some musculoskeletal conditions, in fibromyalgia syndrome (FMS), this type of association remains relatively unexplored. Objective: To analyze the association between the type of body composition and FMS using Principal Component Analysis (PCA). The FMS clinical outcome measures were: Symptom Severity Scale (SSS), Widespread Pain Index (WPI; and Fibromyalgia Impact Questionnaire (FIQ). Methods: Forty-three women with FMS (ACR 2010 criteria) were clinically and anthropometrically evaluated. The anthropometric data were integrated into two indicators using a PCA methodology (PCA-Fat and PCA-muscle). Additionally, the patients were classified into high and low categories for each clinical indicator, which were used as dependent variables in binomial logistic regression (BLR) models. Results: We found a positive correlation between PCA-Fat with WPI (r=0.326, P=.043) and FIQ (r=0.325, P=.044), and negative correlation (r=−0.384, P=.013) between PCA-muscle and SSS. In the BLR analysis, PCA-Fat was a significant predictor for high WPI (OR=2.477, P=.038); while for high SSS, PCA-muscle (OR=0.303, P=.009) was an inversely significant predictor. Conclusions: The results suggest that the volume of fat mass can negatively modulate the severity of FMS. We propose that the evaluation of body composition should be a basic element for the clinical approach of patients with FMS.(AU)

Introducción: El tipo de composición corporal modula la gravedad de algunos padecimientos musculoesqueléticos; en el síndrome de fibromialgia (SFM) este tipo de asociación permanece relativamente inexplorado. Objetivo: Mediante análisis de componentes principales (PCA), analizar la asociación entre el tipo de composición corporal y medidas de desenlace clínico del SFM, como la Escala de Gravedad de Síntomas, el Índice de Dolor Generalizado y el Cuestionario de Impacto de la Fibromialgia. Métodos: Cuarenta y tres mujeres con SFM (criterios ACR 2010) fueron evaluadas clínica y antropométricamente. Los datos antropométricos se integraron en 2 indicadores mediante una metodología de PCA (PCA-Fat y PCA-Muscle). Adicionalmente, las pacientes se clasificaron en categorías alta y baja para cada indicador clínico, los cuales se utilizaron como variables dependientes en modelos de regresión logística binomial. Resultados: Encontramos correlación positiva entre PCA-Fat, el Índice de Dolor Generalizado (r=0,326, p=0,043) y el Cuestionario de Impacto de la Fibromialgia (r=0,325, p=0,044), y correlación negativa (r=−0,384, p=0,013) entre PCA-Muscle y la Escala de Gravedad de Síntomas. En el modelo de regresión logística binomial, PCA-Fat fue un predictor significativo para un Índice de Dolor Generalizado alto (OR=2,477, p=0,038), mientras que para una Escala de Gravedad de Síntomas alta, PCA-Muscle (OR=0,303, p=0,009) fue un predictor inversamente significativo. Conclusiones: Los resultados evidencian que el volumen de masa grasa puede modular negativamente la gravedad del SFM. Proponemos que la evaluación de la composición corporal debe ser un elemento básico para el abordaje clínico de los pacientes con SFM.(AU)

Association between fibromyalgia syndrome clinical severity and body composition. A principal component analysis.

INTRODUCTION: The type of body composition modulates the severity of some musculoskeletal conditions, in fibromyalgia syndrome (FMS), this type of association remains relatively unexplored. OBJECTIVE: To analyze the association between the type of body composition and FMS using Principal Component Analysis (PCA). The FMS clinical outcome measures were: Symptom Severity Scale (SSS), Widespread Pain Index (WPI; and Fibromyalgia Impact Questionnaire (FIQ). METHODS: Forty-three women with FMS (ACR 2010 criteria) were clinically and anthropometrically evaluated. The anthropometric data were integrated into two indicators using a PCA methodology (PCA-Fat and PCA-muscle). Additionally, the patients were classified into high and low categories for each clinical indicator, which were used as dependent variables in binomial logistic regression (BLR) models. RESULTS: We found a positive correlation between PCA-Fat with WPI (r=0.326, P=.043) and FIQ (r=0.325, P=.044), and negative correlation (r=-0.384, P=.013) between PCA-muscle and SSS. In the BLR analysis, PCA-Fat was a significant predictor for high WPI (OR=2.477, P=.038); while for high SSS, PCA-muscle (OR=0.303, P=.009) was an inversely significant predictor. CONCLUSIONS: The results suggest that the volume of fat mass can negatively modulate the severity of FMS. We propose that the evaluation of body composition should be a basic element for the clinical approach of patients with FMS.

Depresión, ansiedad, apoyo interpersonal y dolor autopercibido en pacientes con síndrome de fibromialgia / Depression, Anxiety, Interpersonal Support, and Self-Perceived Pain in Fibromyalgia Syndrome Patients

Resumen El síndrome de fibromialgia (sf) es una patología que genera gran dificultad en los movimientos, fatiga y dolor en partes del cuerpo, afectando severamente la calidad de vida. El objetivo de este estudio fue determinar los indicadores de depresión, ansiedad, apoyo interpersonal, dolor autopercibido y su relación, en una muestra de pacientes con sfen Colombia. A 100 pacientes se les aplicaron las siguientes pruebas: Inventario de Ansiedad Rasgo Estado, Escala de depresión de Zung, Cuestionario para evaluación del apoyo interpersonal, y la Escala analógica del dolor. Se reportaron niveles moderados de depresión y ansiedad, dificultades específicas en el apoyo social y niveles altos en dolor autopercibido. Las puntuaciones en la escala de depresión se asociaron positivamente con la ansiedad estado y rasgo, pero se asociaron negativamente con el apoyo social. En conclusión, la salud mental, el apoyo interpersonal y el dolor autopercibido se encuentran afectados en los pacientes. Se requiere ajustar los protocolos de atención clínica con el propósito de conservar y potenciar la salud integral en los afectados.

Abstract The fibromyalgia syndrome (fs) is a pathology that generates great difficulty in movements, fatigue, and pain in different parts of the body, affecting severely the quality of life. This study was aimed to determine the indicators of depression, anxiety, interpersonal support, self-perceived pain, and their relationship in a sample of patients with fsin Colombia. The following tests were applied to 100 patients: State Trait Anxiety Inventory, Zung's Depression Scale, Interpersonal Support Evaluation List, and Analogue Pain Scale. Moderate levels of depression and anxiety were reported, specific difficulties in social support, and high levels of self-perceived pain. Depression scores were positively associated with state and trait anxiety scores but negatively associated with social support. In conclusion, mental health, interpersonal support, and self-perceived pain are affected in fs patients. It is necessary to adjust the clinical care protocols to preserve and enhance the integral health of those affected.

The prevalence of fibromyalgia in Brazil - a population-based study with secondary data of the study on chronic pain prevalence in Brazil / A prevalência da fibromialgia no Brasil - estudo de base populacional com dados secundários da pesquisa de prevalência de dor crônica brasileira

ABSTRACT BACKGROUND AND OBJECTIVES: The prevalence of the fibromyalgia syndrome has been estimated in some Brazilian cities and regions, and previous population-based studies investigating this prevalence, as well as the profile of medical consultations are unknown. METHODS: This study used the database constructed by a previous study of authors to identify the prevalence of chronic pain in Brazil. The cases that reported pain for more than 6 months and with a diagnosis of fibromyalgia were selected. The studied descriptive variables were age, intensity and frequency of pain, pain interference in self-care, walking, working, social life, sexual life, sleep quality, if pain causes sadness or depression or influences the emotional aspects. The total sample was evaluated by rheumatologists and pain-expert doctors. RESULTS: Thirteen cases from the initial database were selected since they reported the diagnosis of the prevalence of the fibromyalgia syndrome representing 2% of the initial study population, average age 35.8 years (9.8). The predominance of the fibromyalgia syndrome was in females (n=11). Pain intensity was 7.3 (2.4), the frequency and duration of pain were constant in the majority of the sample (n=9). Most of the cases report a serious pain interference with sleep (n=8), many said that pain interferes with the work (n=5), irritability (5) and finally, some report that pain has a moderate interference in self-care (n=5), walking (n=6), social life (n=6), sexual life (n=5) and causes moderate sadness or depression (n=5). CONCLUSION: The prevalence of the fibromyalgia syndrome was estimated in 2% of the Brazilian population, based on secondary data of a study on chronic pain prevalence in Brazil. The data was collected in 2015-2016. The most reported complaints were intense and daily pain that interferes with sleep.

RESUMO JUSTIFICATIVA E OBJETIVOS: A prevalência de síndrome de fibromialgia já foi estimada em cidades e regiões pontuais do Brasil, desconhece-se estudos anteriores de base populacional que investiguem a prevalência, assim como o perfil de consultas médicas. MÉTODOS: Este estudo utilizou dados secundários ao banco de dados construído por uma pesquisa prévia para identificar a prevalência de dor crônica no Brasil. Foram selecionados os casos que responderam sentir dores há mais de 6 meses e com diagnóstico de fibromialgia. As variáveis analisadas de forma descritiva foram: idade, intensidade e frequência da dor, interferência da dor no autocuidado, na caminhada, no trabalho, na vida social, na vida sexual, na qualidade do sono, se dor causa tristeza ou deprime ou influencia os aspectos emocionais. A totalidade da amostra foi avaliada tanto por reumatologistas como por especialistas em dor. RESULTADOS: Treze casos do banco de dados inicial foram selecionados por afirmarem ter recebido o diagnóstico de síndrome de fibromialgia, representando 2% da população do estudo inicial, idade média de 35,8 anos (9,8). A predominância de síndrome de fibromialgia foi no gênero feminino (n=11). Intensidade de dor de 7,3 (2,4), a frequência e duração da dor é constante na maioria da amostra (n=9). A maioria dos casos relata muita interferência da dor no sono (n=8), alguns classificam que a dor interfere muito no trabalho (n=5), irritabilidade (5) e finalmente, alguns relatam que a dor interfere moderadamente no autocuidado (n=5), caminhada (n=6), vida social (n=6), vida sexual (n=5) e causa moderamente tristeza ou deprime (n=5). CONCLUSÃO: A prevalência da síndrome de fibromialgia foi estimada em 2% da população brasileira pelo viés de dados secundários de um estudo de prevalência de dor crônica no Brasil cujo dados foram coletados em 2015-2016. As queixas relatadas pela maioria dos casos foram de dor intensa e diária e com interferência da dor no sono.

Clinical significance of fibromyalgia syndrome in different rheumatic diseases: Relation to disease activity and quality of life.

OBJECTIVE: To describe the frequencies of fibromyalgia syndrome (FMS) in various rheumatic diseases; rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and Behçets disease (BD) patients and to study the relation to clinical manifestations and quality of life (QoL). PATIENTS AND METHODS: 160 patients (50 RA, 50 SLE, 30 SSc and 30 BD) and matched corresponding healthy controls were included. Disease activity was assessed using disease activity score in 28 joints (DAS28) for RA, SLE Disease Activity index (SLEDAI), modified Rodnan skin score for SSc and BD Current Activity Form (BDCAF). The QoL was also recorded. Severity in FMS cases was estimated using the revised Fibromyalgia Impact Questionnaire score. RESULTS: In the RA, SLE, SSc and BD patients, FMS was found in 14%, 18%, 6.67% and 3.33% respectively compared to 2.1%, 3%, 3.3% and 0% in their corresponding controls. In RA patients, DAS28 was significantly higher in those with FMS (p=0.009) and significantly correlated with both Widespread Pain Index (WPI) (p=0.011) and Symptom Severity (SS) scale (p=0.012). The QoL scale in those with FMS was significantly worse (62.3±7.9) compared to those without (71.7±14.4) (p=0.023). In SLE patients, The WPI and SS both significantly correlated with the presence of thrombosis (r=0.28, p=0.049 and r=0.43, p=0.002 respectively). The SS scale tended to correlate with the SLEDAI (r=0.28, p=0.05). In BD patients, BDCAF and WPI significantly correlated (p=0.03). CONCLUSION: Fibromyalgia syndrome is more frequent in rheumatic diseases, could be related to the disease activity in RA and BD patients and to thrombosis in SLE and affected the QoL in RA.

Cerebral magnetic resonance changes associated with fibromyalgia syndrome. / Cambios en la resonancia magnética cerebral asociados al síndrome de fibromialgia.

Fibromyalgia syndrome is a chronic disease, of unknown origin, whose diagnostic criteria were established in 1990 by the American College of Rheumatology. New criteria were proposed in 2010 that have not yet been validated. It is characterized by a generalized chronic musculoskeletal pain, accompanied by hyperalgesia and allodynia, as well as other motor, vegetative, cognitive and affective symptoms and signs. We have reviewed a set of studies with cerebral magnetic resonance (morphometry, connectivity and spectroscopy) that refer to changes in areas involved in pain processing. Modifications in gray and white matter volume, as well as in levels of N-acetylaspartate, choline or glutamate, among other metabolites, have been observed in the hippocampus, insula, prefrontal and cingular cortex. Neuroradiological findings are nonspecific and similar to those found in other examples of chronic pain. An increase in the sample size and a standardized methodology would facilitate comparison, allowing the drawing of general conclusions.