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: 1.52). 04/2011; 31(11):1403-8. DOI: 10.1007/s00296-011-1885-z
Source: PubMed


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
    • "Furthermore , the prior studies evaluating the link between obesity and fibromyalgia-related symptoms have based their results in correlation coefficients and have not provided the predictive capacity of body fat with respect to fibromyalgia symptomatology. It is noteworthy that correlation coefficients between body composition and fibromyalgia symptomatology are usually r ~ 0.25, which indicates a low correlation (Ursini et al., 2011). This lead to the hypothesis that other factors might be involved in the relationship between obesity and pain in fibromyalgia. "
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    ABSTRACT: BACKGROUND: The relationship between estimates of total and central body fat with fibromyalgia pain, fatigue and overall impact has not been fully described. We aimed to assess the individual and combined association of body fat (total and central) with pain, fatigue and the overall impact in fibromyalgia women; and to study the possible mediation role of physical fitness in these associations. METHODS: A total of 486 fibromyalgia women with a mean (standard deviation) age of 52.2 (8.0) years participated. Pain was measured with self-reported measures and algometry, whereas fatigue with the Multidimensional Fatigue Inventory. The impact of fibromyalgia was measured with the Revised Fibromyalgia Impact Questionnaire (FIQR) total score. Total and central body fat were assessed by means of bioelectrical impedance and waist circumference, respectively. The Functional Senior Fitness Test battery and the handgrip strength test were used to assess physical fitness. RESULTS: Total and central body fat were positively associated with pain- and fatigue-related measures and the FIQR total score (β from 0.10 to 0.25; all, p < 0.05). A combined effect of total and central body fat was observed on pain (FIQR and 36-item Short-Form Health Survey), general and physical-related fatigue and FIQR total score (all, overall p < 0.05), so that the group with no total and central obesity had more favourable results than those with total and central obesity. Cardiorespiratory fitness partially mediated (between 22-40% of the total effect) the associations between total and central body fat with pain, general fatigue, physical fatigue and reduced activity, and largely mediated (80%) the association of central body fat with the FIQR total score. CONCLUSIONS: Physical fitness might potentially explain the association between obesity and fibromyalgia symptoms
    European Journal of Pain 10/2015; DOI:10.1002/ejp.807 · 2.93 Impact Factor
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    • "Intriguingly, recent studies highlighted the high prevalence rates of obesity in fibromyalgia patients (Ursini & Naty, 2011). "
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    ABSTRACT: Background: Investigations on the relationship between obesity, binge eating and the function of hypothalamic-pituitary-adrenal (HPA) axis have led to inconsistent results. General psychopathology affects HPA axis function. The present study aims to examine correlations between binge eating, general psychopathology and HPA axis function in obese binge eaters. Methods: Twenty-four hour urinary free cortisol (UFC/24 h) was measured in 71 obese binge eating women. The patients were administered psychometric tests investigating binge eating, psychopathology and clinical variables. The relationship between binge eating, psychopathology and urinary cortisol was investigated, controlling for age and BMI. Results: We found an inverse correlation between UFC/24 h and binge eating, depression, obsessive-compusive symptoms, somatization and sensitivity. In a regression model a significant inverse correlation between urinary cortisol and psychopathology was confirmed. Conclusions: Urinary cortisol levels in obese patients with binge eating disorder show an inverse correlation with several dimensions of psychopathology which are considered to be typical of a cluster of psychiatric disorders characterized by low HPA axis function, and are very common in obese binge eating patients. If these results are confirmed, UFC/24 h might be considered a biomarker of psychopathology in obese binge eaters.
    Appetite 08/2014; 83. DOI:10.1016/j.appet.2014.08.020 · 2.69 Impact Factor
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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.
    European journal of pain (London, England) 09/2013; 17(8). DOI:10.1002/j.1532-2149.2013.00296.x · 2.93 Impact Factor
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