Hilal ECESOY, Ruhusen KUTLU, Nur DEMİRBAS

Effects of Pain, Depression and Quality of Life on Bone Mineral Density in Patients with Fibromyalgia

Objective: In this study, we aimed to assess the effects of bone mineral density with fibromyalgia on pain, depression and quality of life. Methods: In this case-control study, 100 women who were diagnosed as FMS and 100 women who were not diagnosed as FMS were included. Visual Analog Scala (VAS), Fibromyalgia Impact Questionnaire (FIQ) and Hospital Anxiety and Depression Scala (HADS) were used for the patients. Bone mineral density (BMD) of the participants was measured with dual energy x ray absorptiometry (DXA) method. Results: The number of the tender points of the women with fibromyalgia and VAS, FIQ, HAD-A and HAD-D scores were found significantly higher than of the control group (p0.05). When BMD measurements and HAD-A and HAD-D scores of the fibromyalgia patients were compared; in the L1-L4 region of the patients with anxiety and depression; BMD (mass, T score and Z score) were found respectively lower than of those without anxiety and depression (p=0.011) (p=0.040). Conclusions: The FIQ scores of the patients with low L1-L4 T scores were found higher than of the patients with normal T scores. The L1-L4 region of the patients with anxiety and depression; BMD (mass, T score and Z score) were found respectively lower than of those without anxiety and depression. This study confirmed the concept that FMS is a risk factor for osteoporosis.

PDF

___

1. Bellato E, Marini E, Castoldi F, et al. Fibromyalgia Syndrome: Etiology, pathogenesis, diagnosis, and treatment. Pain Res Treat 2012;2012:426130. [CrossRef]
2. Jones GT, Atzeni F, Beasley M, Flüß E, Sarzi-Puttini P, Macfarlane GJ. The prevalence of fibromyalgia in the general population - a comparison of the American College of Rheumatology 1990, 2010 and modified 2010 classification criteria. Arthritis Rheumatol 2015;67:568–575. [CrossRef]
3. Verbunt JA, Pernot DH, Smeets RJ. Disability and quality of life in patients with fibromyalgia. Health Qual Life Outcomes 2008;22;6:8. [CrossRef]
4. Soran N, Altındağ O, Demirkol A. Depression level and relation with clinical parameters in fibromyalgia syndrome. Rheumatism 2008;23:1–4. https://archivesofrheumatology.org/abstract/243
5. Dessein PH, Stanwix AE. Why would fibromyalgia patients have osteoporosis? J Rheumatol 2000;27:1816–1817. https://pubmed.ncbi.nlm.nih.gov/10914876/
6. Upala S, Yong WC, Sanguankeo A. Bone mineral density is decreased in fibromyalgia syndrome: a systematic review and meta-analysis. Rheumatol Int 2017;37:617–622. [CrossRef]
7. Lee YH, Song GG. Association between low bone mineral density and fibromyalgia: a meta-analysis. Clin Rheumatol 2017;36:2573–2579. [CrossRef]
8. Topbas M, Cakırbay H, Gulec H, Akgol E, Ak I, Can G. The prevalance of fibromyalgia in women aged 20–64 in Turkey. Scand J Rheumatol 2005;34:140–144. https://pubmed.ncbi.nlm.nih.gov/16095011/
9. Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J Rheumatol 1991;18:728–733. https://pubmed.ncbi.nlm.nih.gov/1865419/
10. Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int 2000;20:9–12. [CrossRef]
11. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–370. [CrossRef]
12. Aydemir O, Güvenir T, Küey L, Kültür S. Reliability and Validity of the Turkish version of Hospital Anxiety and Depression Scale. Turk J Psychiatry 1997;8:280–287. http://www.turkpsikiyatri.com/en/default.aspx?modul=summary&id=191
13. International Society for Clinical Densitometry (ISCD). 2013 ISCD Official Positions - Adult; 2013. http://www.iscd.org/officialpositions/2013-iscd-official-positions-adult
14. Wolfe F, Clauw DJ, Fitzcharles MA, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 2010;62:600–610. [CrossRef]
15. Cobankara V, Unal UO, Kaya A, Bozkurt AI, Ozturk MA. The prevalence of fibromyalgia among textile workers in the city of Denizli in Turkey. Int J Rheum Dis 2011;14:390–394. [CrossRef]
16. Björkegren K, Wallander MA, Johansson S, Svärdsudd K. General symptom reporting in female fibromyalgia patients and referents: a population-based case-referent study. BMC Public Health 2009:31;9:402. [CrossRef]
17. Ozcan DS, Aras M, Koseoglu BF, Guven SS. Quality of life and associated conditions in women with fibromyalgia syndrome. Turk J Osteoporos 2013;19:42–47.
18. Tander B, Akyol Y, Durmus D, et al. Bone mineral density and depression in premenopausal women with primary fibromyalgia syndrome. Turk J Rheumatol 2010;25:105–109. [CrossRef]
19. Ubago Linares M del C, Ruiz-Perez I, Bermejo Perez MJ, Olry de Labry-Lima A, Hernandez-Torres E, Plazaola-Castano J. Analysis of the impact of fibromyalgia on quality of life: associated factors. Clin Rheumatol 2008;27:613–619. [CrossRef]
20. Sonmez I, Kosger F, Karasel S, Tosun O. The relationship among pain, depression, and illness perception in female patients with fibromyalgia. Anatolian J Psychiatry 2015;16:329–336. [CrossRef]
21. Gelonch O, Garolera M, Valls J, Rosselló L, Pifarré J. Cognitive complaints in women with fibromyalgia: Are they due to depression or to objective cognitive dysfunction? J Clin Exp Neuropsychol 2017;39:1013–1025. [CrossRef]
22. Guven AZ, Kul Panza E, Gunduz OH. Depression and psychosocial factors in Turkish women with fibromyalgia syndrome. Eur Med Phys 2005;41:309–313. https://www.minervamedica.it/en/journals/europa-medicophysica/article.php?cod=R33Y2005N04A0309
23. Eggermont LH, Shmerling RH, Leveille SG. Tender point count, pain, and mobility in the older population: The mobilize Boston study. J Pain 2010;11:62–70. [CrossRef]
24. Zerahn B, Bliddal H, Moller P, Burgwardt A, Danneskiold-Samsoe B. Bone mass in the calcaneus in patients with fibromyalgia. J Musculoskeletal Pain 2001;9:17–23. [CrossRef]
25. Gómez-Cabello A, Vicente-Rodríguez G, Navarro-Vera I, MartinezRedondo D, Díez-Sánchez C, Casajús JA. Influences of physical fitness on bone mass in women with fibromyalgia. Adapt Phys Activ Q 2015;32:125–136. [CrossRef]
26. Turkyılmaz AK, Yılmaz Yalçınkaya E, Öneş K. The effects of bone mineral density and level of serum vitamin-D on pain and quality of life in fibromyalgia patients. Turk J Osteoporos 2010;16:53–57. http://cms.galenos.com.tr/Uploads/Article_5521/53-57.pdf
27. Onat SS, Delialioglu US, Demir O, Ozel S. The prevalence of fibromyalgia in postmenopausal osteoporotic women and to determination of related risk factors (preliminary study). Turk J Osteoporos 2014;20:1–5. [CrossRef]
28. Olama SM, Senna MK, Elarman MM, Elhawary G. Serum vitamin D level and bone mineral density in premenopausal Egyptian women with fibromyalgia. Rheumatol Int 2013;33:185–192. [CrossRef]
29. Jensen B, Wittrup IH, Bliddal H, Danneskiold–Samsøe B, Faber J. Bone mineral density in fibromialgia patients–correlation to disease activity. Scand J Rheumatol 2003;32:146–150. [CrossRef]