Esma DEMİRHAN, Sevgi ATAR, Nur FERHATLAR, Ömer KURU

Fibromiyalji metabolik sendromlu hastalarda uyku ve yaşam kalitesini nasıl etkiler?

Amaç: Bu çalışmada metabolik sendrom (MetS) hastalarında fibromiyalji sendromu (FMS) prevalansını ve fibromiyalji varlığının uyku kalitesi ve yaşam kalitesi üzerindeki etkilerini araştırmak amaçlanmıştır.Yöntem: Çalışma ortalama yaşı 57,9±10,8 yıl ve ortalama vücut kitle indeksi 33,0±5,3 kg/m2 olan 84 (56 kadın, 28 erkek) MetS’li hasta ile gerçekleştirildi. MetS, Ulusal Kolesterol Eğitim Programı Yetişkin Tedavi Paneli III kriterlerine göre tanımlandı. FMS tanısı Amerikan Romatoloji Koleji’nin 2013 tarihli Alternatif Kriterler’ine göre kondu. Yaşam kalitesi Kısa Form 36 (KF-36), uyku kalitesi Pittsburgh Uyku Kalitesi İndeksi ile değerlendirildi.Bulgular: Tüm hastalar diabetes mellitus hastasıydı ve de obez ya da aşırı kiloluydu. Hastaların %73,8’inde uyku bozukluğu, %51,2’sinde FMS mevcuttu. Hem MetS’li hem FMS’li hastalarda kadınlar istatistiksel olarak anlamlı biçimde çoğunluktaydı (p<0,001). Hem MetS’li hem FMS’li hastaların %62,9’unda, yalnızca MetS’li hastaların ise %37,1’inde uyku bozukluğu mevcuttu (p<0,001). Tüm KF-36 alan puanları MetS grubuna kıyasla MetS+FMS grubunda daha düşüktü (p<0,001).Sonuç: MetS’li hastalarda FMS sıklığı yüksektir. MetS varlığı da FMS varlığı da tek başına uyku kalitesini ve yaşam kalitesini bozmaktadır. Bu iki durumun bir arada olması ise daha düşük uyku ve yaşam kalitesine neden olmaktadır. MetS’li hastaların tedavi ve takibinde FMS de göz önünde bulundurulmalıdır.

Anahtar Kelimeler:

fibromiyalji sendromu, metabolik sendrom, uyku kalitesi, yaşam kalitesi

How does fibromyalgia affect sleep quality and quality of life in patients with metabolic syndrome?

Aim: In this study, we aimed to investigate the prevalence of fibromyalgia syndrome (FMS) in patients with metabolic syndrome (MetS) and its effects on sleep quality and quality of life (QoL).Methods: The study included a total of 84 (56 females, 28 males) patients with MetS, with a mean age of 57.5 (34–74) years and mean body mass index of 32.5 (25–48.9) kg/m2. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. The FMS diagnosis was made based on the 2013 American College of Rheumatology Alternative Criteria. QoL and sleep quality were evaluated by the Short Form 36 (SF-36) and the Pittsburgh Sleep Quality Index, respectively.Results: All patients had diabetes mellitus and were obese or overweight. Of all patients, 73.8% had poor sleep quality and 51.2% had FMS. Patients with both MetS and FMS had a statistically significant female predominance (p<0.001). Impaired sleep was present in 62.9% of patients with both MetS and FMS and 37.1% of patients with MetS only (p<0.001). All SF-36 domain scores were statistically significantly lower in the MetS+FMS group than in the MetS group (p<0.001)Conclusion: The frequency of FMS is high in patients with MetS. Sleep quality and QoL are impaired in the presence of FMS or MetS alone. The co-presence of these conditions causes poorer sleep quality and worse QoL. FMS should be considered in the treatment and followup of patients with MetS.

Keywords:

fibromiyalgia syndrome, metabolic syndrome, quality of life, sleep quality,

PDF

___

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112(17):2735–52.
Moore JX, Chaudhary N, Akinyemiju T. Metabolic syndrome prevalence by race/ethnicity and sex in the United States, National Health and Nutrition Examination Survey, 1988–2012. Prev Chronic Dis. 2017;14:e24.
Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640–5.
Miettola J, Niskanen LK, Viinamäki H, Sintonen H, Kumpusalo E. Metabolic syndrome is associated with impaired health-related quality of life: Lapinlahti 2005 study. Qual Life Res. 2008;17(8):1055–62.
Han JH, Park HS, Shin CI, Chang HM, Yun KE, Cho SH, et al. Metabolic syndrome and quality of life (QoL) using generalised and obesity-specific QoL scales. Int J Clin Pract. 2009;63(5):735–41.
Hung HC, Yang YC, Ou HY, Wu JS, Lu FH, Chang CJ. The association between self-reported sleep quality and metabolic syndrome. PloS One. 2013;8(1):e54304.
Jahangiry L, Shojaeezadeh D, Montazeri A, Najafi M, Mohammad K. Health-related quality of life among people participating in a metabolic syndrome e-screening program: a web-based study. Int J Prev Med. 2016;7:27.
Roohafza H, Sadeghi M, Talaei M, Pourmoghaddas Z, Sarrafzadegan N. Psychological status and quality of life in relation to the metabolic syndrome: Isfahan Cohort Study. Int J Endocrinol. 2012;2012:380902.
Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. 1995;38(1):19–28.
Queiroz LP. Worldwide epidemiology of fibromyalgia. Curr Pain Headache Rep. 2013;17(8):356.
Munguía-Izquierdo D, Legaz-Arrese A. Determinants of sleep quality in middle-aged women with fibromyalgia syndrome. J Sleep Res. 2012;21(1):73–9.
Hoffman DL, Dukes EM. The health status burden of people with fibromyalgia: a review of studies that assessed health status with the SF-36 or the SF-12. Int J Clin Pract. 2008;62(1):115–26.
Bennett RM, Friend R, Marcus D, Bernstein C, Han BK, Yachoui R, et al. Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria. Arthritis Care Res. 2014;66(9):1364–73.
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiat Res. 1989;28(2):193–213.
Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.
Tishler M, Smorodin T, Vazina-Amit M, Ramot Y, Koffler M, Fishel B. Fibromyalgia in diabetes mellitus. Rheumatol Int. 2003;23(4):171–3.
Yanmaz MN, Mert M, Korkmaz M. The prevalence of fibromyalgia syndrome in a group of patients with diabetes mellitus. Rheumatol Int. 2012;32(4):871–4.
Mirghani HO, Elbadawi AS. Are diabetes mellitus, restless syndrome, and fibromyalgia related? IJBAMR. 2016;5(3):208–15.
Fatima J, Jain V, Priya S, Karoli R, Shukla V, Siddiqi Z, et al. Fibromyalgia linked to uncontrolled diabetes mellitus and hypomagnesemia. J Intern Med India. 2018;12:19–25.
Loevinger BL, Muller D, Alonso C, Coe CL. Metabolic syndrome in women with chronic pain. Metabolism. 2007;56(1):87–93.
Mork PJ, Vasseljen O, Nilsen TI. Association between physical exercise, body mass index, and risk of fibromyalgia: longitudinal data from the Norwegian Nord-Trøndelag Health Study. Arthritis Care Res. 2010;62(5):611–7.
Okifuji A, Donaldson GW, Barck L, Fine PG. Relationship between fibromyalgia and obesity in pain, function, mood, and sleep. J Pain. 2010;11(12):1329–37.
Jennings JR, Muldoon MF, Hall M, Buysse DJ, Manuck SB. Self-reported sleep quality is associated with the metabolic syndrome. Sleep. 2007;30(2):219–23.
Okubo N, Matsuzaka M, Takahashi I, Sawada K, Sato S, Akimoto N, et al. Relationship between self-reported sleep quality and metabolic syndrome in general population. BMC Public Health. 2014;14:562.
Demiral Y, Ergor G, Unal B, Semin S, Akvardar Y, Kıvırcık B, et al. Normative data and discriminative properties of Short Form 36 (SF-36) in Turkish urban population. BMC Public Health. 2006;6(1):247.
Corica F, Corsonello A, Apolone G, Mannucci E, Lucchetti M, Bonfiglio C, et al. Metabolic syndrome, psychological status and quality of life in obesity: the QUOVADIS Study. Int J Obes. 2008;32(1):185–91.
Wagner JS, DiBonaventura MD, Chandran AB, Cappelleri JC. The association of sleep difficulties with health-related quality of life among patients with fibromyalgia. BMC Musculoskelet Disord. 2012;13(1):199.
Arranz LI, Rafecas M, Alegre C. Effects of obesity on function and quality of life in chronic pain conditions. Curr Rheumatol Rep. 2014;16(1):390.