Bone Mineral Density and Depression in Premenopausal Women with Primary Fibromyalgia Syndrome

Abstract

Objective: Sedentary lifestyle, depression and lack of physical activity may lead to a decrease in bone mineral density (BMD) in patients with fibromyalgia syndrome (FMS). The aim of this study was to evaluate the role of FMS in the development of osteoporosis and the impact of depression on the BMD. Materials and Methods: Fifty premenopausal women with a diagnosis of FMS according to the American College of Rheumatology (ACR) criteria and 40 premenopausal healthy controls were included in the study. A structured form was prepared covering demographic characteristics of the subjects. The severity of pain, disease activity and depression level were evaluated by Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire (FIQ) and Beck Depression Inventory (BDI), respectively. Lumbar spine and left femoral neck BMD values were determined by dual energy X-ray absorptiometry (DEXA). Results: There was no difference between patients and controls according to age, body mass index and duration of education (p>0.05). BMD values in the lumbar vertebrae were significantly lower in the FMS group than in the controls (p<0.05). The BMD score was not different between the patients with a depression score higher or lower than the cut-off point (p>0.05). There were no correlations among BMD, age, and BDI, VAS, and FIQ scores (p>0.05). Conclusion:We found that BMD of the lumbar vertebrae was lower in FMS patients than in the control group. We detected that depression has no significant impact on BMD. (Turk J Rheumatol 2010; 25: 105-9

Associations Between Bone Mass in Women With Fibromyalgia and Widespread Pressure Pain Hypersensitivity, Tenderness, Perceived Pain Level, and Disability

“…Our present findings are in concordance with previous research in which investigators assessed BMD by QUS at the distal radius that found that FMS was associated with osteopenia and osteoporosis (Babu et al, 2015). Similarly, researchers reported that BMD values at the lumbar spine (Olama et al, 2013;Tander et al, 2010) and femoral neck (Garip Cimen et al, 2015) were significantly lower in patients with FMS than in healthy controls. In a recent systematic review and metaanalysis, authors reported that BMD at the lumbar spine is decreased in patients with FMS compared with healthy individuals and recommended that patients with FMS should be assessed for risk of osteoporosis (Upala et al, 2017).…”

“…Because FMS is characterized by chronic widespread pain and tenderness, researchers have also examined the relationships between clinical features, including global pain, TPCs, and disease severity, and bone mass in FMS patients and have, again, reported conflicting results (Babu et al, 2015; Garip Cimen et al, 2015; Jensen et al, 2003; Olama et al, 2013; Tander et al, 2010). Although it is well-known that patients with FMS have decreased pain thresholds (Chinn et al, 2016), and PPT has proven to be a useful measure for evaluating the symptom of tenderness and pressure algometry (Chesterton et al, 2007), to date there has been no evidence of its relationship with bone status in FMS patients.…”

“…Like other rheumatic diseases, FMS is increasingly thought to be associated with osteoporosis (Upala, Yong, & Sanguankeo, 2017). Some studies have suggested that patients with FMS are at increased risk of developing osteoporosis (Babu, Ikbal, Noone, Joseph, & Danda, 2015; Garip Cimen, Eser, Sayin, Bodur, & Cavusoglu, 2015; Olama, Senna, Elarman, & Elhawary, 2013; Swezey & Adams, 1999; Tander et al, 2010), but others have had discrepant or conflicting results (Al-Allaf, Mole, Paterson, & Pullar, 2003; Jacobsen et al, 1993; Jensen, Wittrup, Bliddal, Danneskiold-Samsøe, & Faber, 2003; Zerahn, Bliddal, Møller, Borgwardt, & Danneskiold-Samsøe, 2001).…”

“…Some researchers have examined the relationships between bone mass and the clinical features of FMS including global pain, tender point count (TPC), and disease severity and have reported conflicting results (Babu et al, 2015; Garip Cimen et al, 2015; Jensen et al, 2003; Olama et al, 2013; Tander et al, 2010). Tander et al (2010) did not identify a correlation between BMD values and pain Visual Analogue Scale (VAS) scores or disease severity, whereas other studies have reported positive relationships between BMD and VAS and Fibromyalgia Impact Questionnaire (FIQ) scores (Babu et al, 2015; Garip Cimen et al, 2015; Jensen et al, 2003; Olama et al, 2013). Patients with FMS also have decreased pain thresholds (Chinn, Caldwell, & Gritsenko, 2016), commonly measured as pressure pain threshold (PPT), which evaluates tenderness symptoms and pressure algometry (Chesterton, Sim, Wright, & Foster, 2007).…”

Bone mass and bone turnover in premenopausal women with fibromyalgia syndrome

“…Menopause, aging, deficient calcium and vitamin D intake, smoking, alcohol use, immobility, drugs, hormonal and renal diseases have been suggested for the etiology of OP [4][5][6]. In recent years major depression has been also demonstrated as a risk factor in the development of OP [7][8][9][10][11].…”