Fibromyalgia: Associations Between Fat Infiltration, Physical Capacity, and Clinical Variables

Abstract

Background Obesity is a risk factor for the development of fibromyalgia (FM) and generally most studies report increased Body Mass Index (BMI) in FM. Obesity in FM is associated with a worse clinical presentation. FM patients have low physical conditioning and obesity further exacerbates these aspects. Hitherto studies of FM have focused upon a surrogate for overall measure of fat content, ie, BMI. This study is motivated by that ectopic fat and adipose tissues are rarely investigated in FM including their relationships to physical capacity variables. Moreover, their relationships to clinical variables including are not known. Aims were to 1) compare body composition between FM and healthy controls and 2) investigate if significant associations exist between body composition and physical capacity aspects and important clinical variables. Methods FM patients (n = 32) and healthy controls (CON; n = 30) underwent a clinical examination that included pressure pain thresholds and physical tests. They completed a health questionnaire and participated in whole-body magnetic resonance imaging (MRI) to determine body composition aspects. Results Abdominal adipose tissues, muscle fat, and BMI were significantly higher in FM, whereas muscle volumes of quadriceps were smaller. Physical capacity variables correlated negatively with body composition variables in FM. Both body composition and physical capacity variables were significant regressors of group belonging; the physical capacity variables alone showed stronger relationships with group membership. A mix of body composition variables and physical capacity variables were significant regressors of pain intensity and impact in FM. Body composition variables were the strongest regressors of blood pressures, which were increased in FM. Conclusion Obesity has a negative influence on FM symptomatology and increases the risk for other serious conditions. Hence, obesity, dietary habits, and physical activity should be considered when developing clinical management plans for patients with FM.

Nutritional Status, Dietary Intake, Quality of Life, and Dysphagia in Women With Fibromyalgia

“…In fact, it has been observed a higher incidence of food deficiency among people with excessive body weight than in people with average body weight (Kobylińska et al, 2022); therefore, we cannot discard that women with FMS who are overweight and obese may have an unbalanced diet. In addition, the high prevalence of overweight and obesity in persons with FMS may also be explained by low physical activity and high sedentary levels because of chronic pain and fatigue (Borges-Cosic et al, 2019; D’Onghia et al, 2021; Gerdle et al, 2022). To clarify this hypothesis, future studies are required to analyze the characteristics of the diet, including food choices of persons with FMS with dysphagia.…”

Interplay between chronic widespread pain and lifestyle factors on the risk of type 2 diabetes: longitudinal data from the Norwegian HUNT Study

“…Shared biological mechanisms might partly explain a link between chronic pain and adverse lifestyle factors. For example, musculoskeletal conditions characterized by chronic widespread pain (eg, fibromyalgia) have been associated with elevated blood pressure,30 as well as chronic systemic inflammation 31. Both high blood pressure and chronic systemic inflammation have been suggested to be independent risk factors for type 2 diabetes 32–34.…”

Pain and the biochemistry of fibromyalgia: patterns of peripheral cytokines and chemokines contribute to the differentiation between fibromyalgia and controls and are associated with pain, fat infiltration and content

“…Investigating peripheral and systemic alterations are now given increased attention. Hence, signs of mitochondrial dysfunction from muscles of patients with FM have been reported [e.g., increased muscle interstitial lactate, pyruvate and/or glutamate levels ( 19 – 22 ), decreased muscle concentrations of adenosine triphosphate (ATP) or nucleoside triphosphates (NTP) and phosphocreatine (PCr) ( 19 , 23 – 25 )], and alterations in metabolism of N-acylethanolamines ( 26 , 27 ), and high prevalence of small fibre pathology ( 18 , 28 ). Moreover, altered gut microbiome composition has been reported in FM ( 29 , 30 ).…”

“…Systemic alterations have also been found e.g., significant alterations in lipid mediators ( 31 , 32 ). Blood proteomic studies (generally proteins at nano- and micromolar levels) show significant signs of immunity and inflammation alterations, which may indicate systemic low-grade inflammation ( 28 , 33 – 36 ). However, the roles of commonly investigated blood cytokines and chemokines (typically found at picomolar levels) are unclear.…”