Glucose tolerance in fibromyalgia

Zetterman, Teemu; Markkula, Ritva; Kalso, Eija

doi:10.1097/md.0000000000027803

Cited by 8 publications

(11 citation statements)

References 45 publications

(112 reference statements)

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“…Interestingly, our results indicate that the metabolic abnormalities previously reported in FM i.e. increased fasting glucose levels [6], higher BMI [8] and insulin resistance measured with HOMA-IR [7] were observed in a subgroup of responding to SNRI therapy. A logistic regression model revealed that HOMA-IR was a significant predictor of a lack of response to SNRI treatment, further analyses also highlighted the significance of depression, anxiety and personality disorders.…”

Section: Discussionsupporting

confidence: 67%

“…To the best of our knowledge this is the first study to assess the FM not only as a whole group but also in subgroups of FM [T+] and FM [T-] and describe the comparisons of the entire FM group as well as FM [T+] and FM [T-] to HC. Previous studies examined the FM as a homogenous group fulfilling diagnostic criteria [6][7][8], however based on clinical observation of significant differences among FM patients, we decided to assess subgroups of FM patients who responded to SNRI treatment and those who did not separately. Due to the above mentioned methodology our study was the first to reveal that insulin resistance is linked to the lack of response to SNRI in FM.…”

Section: Discussionmentioning

confidence: 99%

“…The model consisting of HOMA-IR together with anxiety showed the highest power in predicting the lack of response to SNRI treatment. In the paper by Zetterman et al [8] it was stated that patients with FM displayed alterations in glucose metabolism compared to healthy controls and that these were due to the higher BMI and smoking. However, in this work we observed that the relationship between BMI and lack of response to treatment with SNRI was fully mediated by the level of insulin resistance (HOMA-IR), which points out the importance of impaired glucose metabolism to the lack of response to SNRI in FM.…”

Section: Discussionmentioning

confidence: 99%

“…In a small cross-sectional study Pappola et al observed that FM is linked to insulin resistance [7]. Zetterman et al reported that FM patients showed higher glucose load after 1 hour and 2 hours of oral glucose tolerance test compared to healthy controls, however these differences were explained by patients higher body mass index (BMI) and percentage of smokers [8]. Furthermore Hassan et al used a reserpine-induced FM in a rat model to check the efficacy of an anti-diabetic drug pioglitazone on FM symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of treatment response to serotonin and noradrenaline reuptake inhibitors in fibromyalgia

Krupa¹,

Korkosz²,

Gorostowicz³

et al. 2023

Polish Archives of Internal Medicine

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What is new?Fibromyalgia (FM) patients are heterogenous in metabolic status. Contrary to the previously published data our study shows that only a subgroup of FM patients is characterized by insulin resistance. FM patients who are responsive to SNRI (serotonin and noradrenalin reuptake inhibitors) treatment have similar levels of fasting glucose, insulin, insulin resistance, BMI compared to healthy controls. However, FM patients who are not responsive to treatment with SNRI are characterized by higher fasting glucose, fasting insulin, insulin resistance, BMI compared to healthy controls and to FM patients responsive to SNRI. FM patients who are not responsive to treatment with SNRI present higher prevalence of depression, anxiety and personality disorders than those responsive to SNRI. Insulin resistance, depression, anxiety and personality disorders are predictors of the lack of response to treatment with SNRI in fibromyalgia.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predictors of treatment response to serotonin and noradrenaline reuptake inhibitors in fibromyalgia

Krupa¹,

Korkosz²,

Gorostowicz³

et al. 2023

Polish Archives of Internal Medicine

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“…During these sessions we collected medical histories and background, lifestyle and questionnaire data. Subjects were invited to participate in an oral glucose tolerance test, with 41 patients and 30 controls attending (reported previously) [ 25 ]. The diagnosis of FM was based on American College of Rheumatology 1990 criteria [ 3 ].…”

Section: Methodsmentioning

confidence: 99%

Elevated highly sensitive C-reactive protein in fibromyalgia associates with symptom severity

Zetterman

Markkula

Kalso

2022

Rheumatology Advances in Practice

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OBJECTIVES Fibromyalgia, a common pain syndrome, is thought to be a non-inflammatory, nociplastic condition but evidence implicating neuroinflammation has been increasing. Systemic inflammation may be associated with more severe symptoms in some fibromyalgia patients. We studied healthy controls and fibromyalgia patients with and without systemic inflammation detectable using high-sensitivity C-reactive protein (hsCRP) measurement. METHODS We measured hsCRP levels, and gathered clinical and questionnaire data (including Fibromyalgia Impact Questionnaire (FIQ)), from 40 female fibromyalgia patients and 30 age-matched healthy women: hsCRP > 3 mg/l was considered elevated. RESULTS Fibromyalgia patients had significantly higher mean hsCRP levels than controls, explained by overweight and lower leisure-time physical activity. Eight fibromyalgia patients had elevated, and 29 normal, hsCRP. Levels of hsCRP were significantly correlated with FIQ scores. Patients with elevated hsCRP had higher FIQ scores, with worse physical functioning and greater pain, and were less likely to be in work, than patients with normal hsCRP. These patient groups did not differ by blood count, liver function, or lipid profiles, nor by education, psychological measures, sleep disturbance, smoking, or comorbidities. CONCLUSION Some fibromyalgia patients have elevated hsCRP, mostly due to overweight and physical inactivity. They have worse symptoms and their ability to work is impaired. Measurement of hsCRP may help to identify fibromyalgia patients in greatest need of interventions supporting working ability. TRIAL REGISTRATION ClinicalTrials.gov, https://clinicaltrials.gov, NCT03300635 Lay summary What does this mean for patients? People with fibromyalgia suffer from persistent pain and reduced physical functioning. Severity of fibromyalgia symptoms varies greatly between patients. Laboratory tests have not been able to confirm fibromyalgia or gauge its severity. C-reactive protein (CRP) is a commonly used indicator of inflammation; even low levels of inflammation are known to predict worse health outcomes. In our study, we measured the CRP levels of 40 female patients with fibromyalgia and collected data on their medical history and lifestyle factors. We found that patients with above normal levels of CRP had worse symptoms, lower physical functioning and were less likely to be able to work. This increased inflammation was mostly explained by being overweight and having reduced physical activity, and not by, for example, other medical conditions. Although some patients had severe symptoms without inflammation, our results suggest that a simple and widely available blood test could be useful for identifying patients with severe fibromyalgia. CRP measurements could also be used to monitor the effectiveness of lifestyle changes such as exercise and weight-loss in these individuals. Using medication to alleviate fibromyalgia symptoms through reduction of inflammation should also be studied in the future.

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Risk of fibromyalgia following antibiotic prescriptions: A population‐based case–control study

Armstrong,

Dregan,

Ashworth

et al. 2024

European Journal of Pain

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BackgroundThe health of the gut microbiome is now recognized to be an important component of the gut–brain axis which itself appears to be implicated in pain perception. Antibiotics are known to create dysbiosis in the microbiome, so whether fibromyalgia is more commonly diagnosed after antibiotic prescriptions provides a means of exploring the role of the microbiome in the experience of chronic pain.MethodsA case–control study was carried out using electronic health records collected in the UK's Clinical Practice Research Datalink (CPRD), a comprehensive database of primary care consultations. For each case of diagnosed fibromyalgia, three controls were identified and matched by age, gender and GP practice. The exposure variable was the number and timing of antibiotic prescriptions over previous years. The analysis involved adjusting for a wide range of co‐variates that might be possible confounders.ResultsA total of 44,674 cases of fibromyalgia were identified together with 133,513 controls. After adjusting for co‐variates, it was found that both the total number of prescriptions and their timing was associated with an FM diagnosis. For example, the quartile with the highest number of prescriptions and that with the longest exposure had a greater than three‐fold increase in FM diagnoses (number of prescriptions: odds ratio 3.92; 95% CIs: 3.71–4.13; exposure odds ratio 3.28; CIs: 3.13–3.43). Some antibiotics (such as tetracyclines and metronidazole) seemed to confer greater risk than others.ConclusionsThe results lend support for prior antibiotics being an important risk factor for a diagnosis of FM.SignificanceThis study shows an association between the volume as well as timing of prior antibiotic prescriptions and of a subsequent diagnosis of fibromyalgia in primary care.

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Glucose tolerance in fibromyalgia

Cited by 8 publications

References 45 publications

Predictors of treatment response to serotonin and noradrenaline reuptake inhibitors in fibromyalgia

Predictors of treatment response to serotonin and noradrenaline reuptake inhibitors in fibromyalgia

Elevated highly sensitive C-reactive protein in fibromyalgia associates with symptom severity

Risk of fibromyalgia following antibiotic prescriptions: A population‐based case–control study

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