Article

Fibromyalgia and obesity: The hidden link

Rheumatology Research Unit, Clinical and Experimental Medicine Department, University of Catanzaro "Magna Graecia", University Campus "Salvatore Venuta", Viale Europa, Catanzaro, Italy.
Rheumatology International (Impact Factor: 1.63). 04/2011; 31(11):1403-8. DOI: 10.1007/s00296-011-1885-z
Source: PubMed

ABSTRACT Fibromyalgia is a chronic disorder of uncertain etiology, characterized by widespread pain, muscle tenderness, and decreased pain threshold to pressure and other stimuli. Obesity is a well-known aggravating factor for certain rheumatologic conditions, such as knee osteoarthritis. Emerging evidences are exploring the link between obesity and other rheumatic diseases, such as fibromyalgia. Epidemiological data show that fibromyalgia patients have higher prevalence of obesity (40%) and overweight (30%) in multiple studies compared with healthy patients. Several mechanisms have been proposed to explain "the hidden link", but at this time is not possible to ascertain whether obesity is cause or consequence of fibromyalgia. Among mechanisms proposed, there are the following: impaired physical activity, cognitive and sleep disturbances, psychiatric comorbidity and depression, dysfunction of thyroid gland, dysfunction of the GH/IGF-1 axis, impairment of the endogenous opioid system. In this article, we review the scientific evidence supporting a possible link between obesity and fibromyalgia, how obesity influences fibromyalgia symptoms and how fibromyalgia severity can be improved by weight loss. In addition, we analyze the possible mechanisms by which fibromyalgia and obesity interrelate.

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Available from: Rosa Daniela Grembiale, Sep 23, 2014
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    • "Intriguingly, recent studies highlighted the high prevalence rates of obesity in fibromyalgia patients (Ursini & Naty, 2011). "
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    • "Its diagnosis is based on multiple symptoms, including musculoskeletal pain, fatigue, non-restorative sleep, cognitive impairments and somatic symptoms (Wolfe et al., 2010). Although it is rarely discussed in the literature, a prominent comorbidity of fibromyalgia is a tendency to be overweight [body mass index (BMI) Ն 25 kg/m 2 ] (Ursini et al., 2011). Indeed, high rates of overweight patients with fibromyalgia (70–76%) have been reported (Bennett et al., 2007; Okifuji et al., 2010; Kim et al., 2012a). "
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    ABSTRACT: BACKGROUND: Fibromyalgia is characterized by chronic widespread pain and sleep disturbances. Overweight and obesity, which lead to metabolic changes, are additional comorbidities that are rarely explored, although they are highly prevalent in patients with fibromyalgia. METHODS: We compared the plasma levels of leptin and acylated ghrelin in 17 women with fibromyalgia (patients) and 16 healthy women (controls) with similar age, anthropometric measurements and levels of physical activity. We also investigated the relationships between these two neuropeptides and sleep and various pain characteristics in patients with fibromyalgia. Anthropometric measurements were recorded, and physical activity levels were assessed using a questionnaire. Pain intensity was measured using visual analogue scales (weekly general and mean pain scores). Sleep was assessed using an accelerometry technique. RESULTS: Compared to the control group, the patient group had increased leptin levels (patients: 22.4 ± 10.6 vs. controls: 13.3 ± 17.9 ng/mL; p < 0.01) and decreased acylated ghrelin levels (patients: 126.7 ± 47.8 vs. controls: 183.3 ± 102.2 pg/mL; p = 0.048). The leptin level was not significantly correlated with any of the variables. Acylated ghrelin level was inversely correlated with the weekly mean pain score (r = -0.67, p < 0.01) and the weekly general pain score (r = -0.67, p < 0.01). Multiple regression analysis revealed that the variations in acylated ghrelin levels accounted for 35% of the weekly general pain and 29% of the weekly mean pain variability. CONCLUSIONS: These findings indicate that the decreased acylated ghrelin levels in women with fibromyalgia are related to pain intensity.
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