Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (6): 1001-1008. doi: 10.19723/j.issn.1671-167X.2024.06.009

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Effects of overweight and obesity on symptoms, overall condition and quality of life in patients with fibromyalgia syndrome

Meijuan LONG, Yidan WANG, Shiya WU, Zihao LI, Yanting LI, Yang LI, Juan JIAO*()   

  1. Department of Rheumatology, Guang' anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
  • Received:2024-08-01 Online:2024-12-18 Published:2024-12-18
  • Contact: Juan JIAO E-mail:jiao.juan@hotmail.com
  • Supported by:
    China Academy of Chinese Medical Sciences Innovation Project Innovation Team Project(CI2021B007)

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Abstract:

Objective: To explore the effects of overweight and obesity (overweight/obesity) on symptom severity and quality of life in Chinese patients with fibromyalgia syndrome (FMS). Methods: A cross-sectional survey was used to collect general data on height, weight, gender and age of 435 FMS patients who visited the rheumatology clinic of Guang 'anmen Hospital from October 2018 to December 2021. The numbers of tender points, widespread pain index and symptom severity scale were used as diagnostic indicators of the disease. The pain visual analogue scale, Beck depression inventory, perceived stress scale (PSS), Pittsburgh sleep quality index (PSQI) and multidimensional fatigue scale were used to assess the severity of pain and negative emotions, stress perception, sleep quality, and fatigue symptoms of this disease. The revised fibromyalgia impact questionnaire, fibromyalgia symptom scale (FS) and quality of life assessment scale (36 item short-form health survey, SF-36) were used to evaluate the overall condition and quality of life of the FMS patients. At the same time, 50 healthy volunteers matched in gender and age were recruited as the control group. Covariance analysis was used to explore the effects of overweight/obesity on the FMS patients after adjusting for age and gender. Results: According to the Chinese body mass index (BMI) standard, there were 242 (59%) and 170 (41%) FMS patients in the normal weight group and overweight/obesity group, respectively, with average BMI of (21.66±1.42) kg/m2 and (26.25±1.83) kg/m2, respectively. Compared with the normal weight FMS patients, the overweight/obesity patients had higher PSS scores (P=0.010), PSQI sub-dimension sleep efficiency scores (P < 0.001) and FS scores (P=0.025), and lower SF-36 sub-dimension physical functioning scores (P=0.041). However, there were no statistical differences in the above indicators between normal weight and overweight/obesity patients in the healthy control group (P > 0.05). Conclusion: Compared with normal-weight FMS patients, overweight/obesity patients have higher levels of perceived stress, lower sleep efficiency, and more severe fibromyalgia symptoms, as well as a low quality of life characterized by decreased physiological function. It is important for overweight/obesity FMS patients to control BMI actively in order to improve sleep efficiency, psychological state, physical functioning, and the overall condition.

Key words: Fibromyalgia syndrome, Chronic pain, Weight, Weight loss

CLC Number: 

  • R593.2

Table 1

BMI standards"

Group Chinese BMI Asia BMI WHO BMI
Underweight/(kg/m2) < 18.5 < 18.5 < 18.5
Normal weight/(kg/m2) 18.5-23.9 18.5-22.9 18.5-24.9
Overweight/(kg/m2) 24.0-27.9 23.0-24.9 25.0-29.9
Obesity/(kg/m2) ≥28.0 ≥25.0 ≥30.0

Table 2

Distribution of Chinese, Asian, and WHO BMI standards in FMS patients and healthy volunteers"

Chinese BMI Asia BMI WHO BMI χ2 P P
China vs. Asia China vs.WHO Asia vs.WHO
Fibromyalgia (n=435) 167.609 <0.001 <0.001 <0.001 <0.001
   Underweight 23(5) 23(5) 23(5)
   Normal weight 242(56) 188(43) 296(68)
   Overweight 144(33) 108(25) 109(25)
   Obesity 26(6) 116(27) 7(2)
Health volunteers (n=50) 20.940 <0.001 0.037 0.048 <0.001
   Underweight 0(0) 0(0) 0(0)
   Normal weight 28(56) 24(48) 35(70)
   Overweight 17(34) 11(22) 15(30)
   Obesity 5(10) 15(30) 0(0)
   χ2 3.865 3.209 0.722
   P 0.262 0.361 0.354

Table 3

Comparison of demographic and disease indicators between FMS patients and healthy volunteers"

Items Fibromyalgia syndrome (n=412) Health volunteers (n=50) t/Z/χ2 P
Women, n(%) 352 (85) 4 3(86) 0.011 0.915
Age/years 50.00 (40.00,58.00) 49.5 (35.00,58.50) -0.474 0.635
BMI/(kg/m2) 23.34 (21.45,25.39) 23.08 (21.47,25.81) -0.376 0.707
TPC score 12.00 (9.50,15.00) 0.00 (0.00,3.25) -10.900 < 0.001
WPI score 11.00 (7.00,15.00) 0.00 (0.00,1.00) -11.473 < 0.001
SSS score 7.00 (5.00,9.00) 1.00 (0.00,2.00) -10.938 < 0.001
Pain VAS score 6.00 (4.00,7.00) 0.00 (0.00,1.00) -11.464 < 0.001
BDI score 6.00 (3.00,12.00) 0.50 (0.00,2.25) -8.505 < 0.001
PSS score 27.00 (21.00,32.00) 26.50 (21.75,29.00) -1.160 0.246
PSQI total score 12.00 (9.00,14.00) 3.00 (2.00,6.00) -9.776 < 0.001
MFI-20 total score 68.00 (56.25,79.00) 35.5 (29.25,42.25) -10.799 < 0.001
FIQR total score 31.17 (19.00,48.42) 2.50 (0.75,6.88) -10.661 < 0.001
   Function 3.67 (0.00,10.33) 0.00 (0.00,0.00) -8.769 < 0.001
   Overall impact 5.00 (0.00, 10.00) 0.00 (0.00, 0.00) -8.677 < 0.001
   Symptoms 23.73±8.92 4.56±6.24 18.751 < 0.001
FS score 17.00 (13.00,22.00) 2.00 (0.00,0.25) -11.364 < 0.001
SF-36 score
   PCS 36.75 (26.50,53.25) 87.50 (74.63,91.75) -10.539 < 0.001
   MCS 46.92 (31.97,68.44) 86.63 (63.26,89.81) -8.823 < 0.001

Table 4

Comparison of core symptom indicators between normal weight subjects and overweight and obese subjects"

Items Fibromyalgia syndrome(n=412) Health volunteers(n=50)
BMI<24 kg/m2(n=242) BMI≥24 kg/m2(n=170) P BMI<24 kg/m2(n=28) BMI≥24 kg/m2(n=22) P
Pain VAS score 6.00 (5.00,7.00) 6.00 (4.75,7.00) 0.263 0.00 (0.00,0.88) 0.00 (0.00,1.00) 0.692
BDI score 7.00 (4.00,13.00) 6.50 (4.00,12.25) 0.377 0.50 (0.00,2.00) 0.50 (0.00,3.00) 0.206
PSS score 26.00 (20.00,31.00) 27.00 (22.00,33.00) 0.010 27.00 (22.50,29.00) 25.00 (21.00,28.25) 0.581
PSQI total score 12.00 (10.00,15.00) 12.00 (9.00,15.00) 0.774 3.00 (1.00,5.75) 3.00 (2.00,7.25) 0.647
   Subjective sleep quality 2.00 (1.00,2.50) 2.00 (1.00,2.00) 0.134 0.00 (0.00,1.00) 1.00 (0.00,1.00) 0.636
   Sleep latency 2.00 (1.00,3.00) 2.00 (1.00,3.00) 0.087 1.00 (0.00,1.00) 0.50 (0.00,1.00) 0.775
   Sleep duration 1.00 (1.00,2.00) 1.00 (1.00,2.00) 0.966 0.00 (0.00,1.00) 0.00 (0.00,1.00) 0.882
   Habitual sleep efficiency 2.00 (2.00,2.00) 3.00 (2.00,3.00) <0.001 0.00 (0.00,0.00) 0.00 (0.00,0.25) 0.652
   Sleep disturbances 2.00 (1.00,2.00) 2.00 (1.00,2.00) 0.948 1.00 (0.00,1.00) 1.00 (1.00,1.25) 0.206
   Use of sleep medication 0.00 (0.00,0.00) 0.00 (0.00,0.00) 0.807 0.00 (0.00,0.00) 0.00 (0.00,0.00) 1.000
   Daytime dysfunction 3.00 (2.00,3.00) 3.00 (2.00,3.00) 0.118 1.00 (0.00,1.75) 1.00 (0.00,1.25) 0.854
MFI-20 total score 72.00 (63.00,80.00) 71.00 (63.00,80.00) 0.976 33.21±7.73 39.05±9.19 0.060

Table 5

Comparison of overall disease status and quality of life indicators between normal weight and overweight and obese patients with FMS and healthy volunteers"

Items Fibromyalgia syndrome(n=412) Health volunteers(n=50)
BMI<24 kg/m2(n=242) BMI≥24 kg/m2(n=170) P BMI<24 kg/m2(n=28) BMI≥24 kg/m2(n=22) P
FIQR total score 34.25 (24.38,50.17) 37.00 (24.33,52.33) 0.201 2.00 (0.00,5.00) 4.42 (1.00,10.00) 0.257
   Function 5.00 (1.00,10.33) 6.33 (1.67,11.83) 0.053 0.00 (0.00,0.00) 0.00 (0.00,0.00) 0.887
   Overall impact 6.50 (2.00,10.25) 7.00 (3.00,12.00) 0.309 0.00 (0.00,0.00) 0.00 (0.00,0.25) 0.435
   Symptoms 23.40±8.60 24.18±9.36 0.367 1.75 (0.00,4.75) 3.00 (0.88,9.25) 0.255
FS score 18.00 (15.00,22.00) 19.50 (15.00,24.00) 0.025 1.00 (0.00,2.00) 2.00 (1.00,3.50) 0.112
SF-36 score
   PF 65.00 (45.00,80.00) 55.00 (40.00,80.00) 0.041 100.00 (95.00,100.00) 95.00 (85.00,100.00) 0.164
   RP 0.00 (0.00,25.00) 0.00 (0.00,25.00) 0.061 100.00 (81.25,100.00) 100.00 (37.50,100.00) 0.792
   BP 41.00 (31.00,52.00) 41.00 (22.00,51.00) 0.175 90.00 (80.00,90.00) 84.00 (74.00,90.00) 0.502
   GH 30.00 (20.00,42.00) 30.00 (18.75,45.00) 0.674 74.79±19.94 62.14±17.40 0.098
   VT 40.00 (30.00,50.00) 40.00 (30.00,55.00) 0.344 75.00 (65.00,88.75) 70.00 (58.75,76.25) 0.077
   SF 62.5 (37.50,75.00) 62.50 (37.50,75.00) 0.867 100.00 (87.5,100.00) 100.00 (75.00,100.00) 0.080
   RE 33.33 (0.00,100.00) 33.00 (0.00,100.00) 0.566 100.00 (100,100.00) 100.00 (25.00,100.00) 0.243
   MH 44.00 (29.00,56.00) 44.00 (27.00,56.00) 0.381 80.00 (65.00,87.00) 78.00 (67.00,84.00) 0.542
   PCS 34.00 (27.75,47.25) 32.75 (21.75,44.25) 0.057 88.75 (84.19,94.81) 85.88 (68.94,89.50) 0.329
   MCS 43.69 (31.25,65.69) 42.63 (31.06,64.41) 0.507 87.25 (74.72,91.00) 84.38 (53.55,89.50) 0.114
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