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Effects of overweight and obesity on symptoms, overall condition and quality of life in patients with fibromyalgia syndrome
Received date: 2024-08-01
Online published: 2024-12-18
Supported by
China Academy of Chinese Medical Sciences Innovation Project Innovation Team Project(CI2021B007)
Copyright
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
Meijuan LONG , Yidan WANG , Shiya WU , Zihao LI , Yanting LI , Yang LI , Juan JIAO . Effects of overweight and obesity on symptoms, overall condition and quality of life in patients with fibromyalgia syndrome[J]. Journal of Peking University(Health Sciences), 2024 , 56(6) : 1001 -1008 . DOI: 10.19723/j.issn.1671-167X.2024.06.009
| 1 | Siracusa R , Paola RD , Cuzzocrea S , et al. Fibromyalgia: Pathogenesis, mechanisms, diagnosis and treatment options update[J]. Int J Mol Sci, 2021, 22 (8): 3891. |
| 2 | Sarzi-Puttini P , Giorgi V , Marotto D , et al. Fibromyalgia: An update on clinical characteristics, aetiopathogenesis and treatment[J]. Nat Rev Rheumatol, 2020, 16 (11): 645- 660. |
| 3 | 张哲浩. 纤维肌痛综合征临床药物治疗研究进展[J]. 临床药物治疗杂志, 2018, 16 (5): 26- 30. |
| 4 | World Health Organization, 2024. Obesity and overweight. World Health Organization. URL[EB/OL]. (2024-03-01)[2024-07-01]. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight# . |
| 5 | Chen K , Shen Z , Gu W , et al. Prevalence of obesity and asso-ciated complications in China: A cross-sectional, real-world study in 15.8 million adults[J]. Diabetes Obes Metab, 2023, 25 (11): 3390- 3399. |
| 6 | Institute of Medicine of the National Academes . Board on Health Sciences Policy, Committee on Advancing Pain Research, Care and Education. Relieving pain in America: A blueprint for transforming prevention, care, education, and research[M]. Washingten D.C.: National Academies Press, 2011: 62- 63. |
| 7 | Mork PJ , Vasseljen O , Nilsen TI . Association between physical exercise, body mass index, and risk of fibromyalgia: Longitudinal data from the Norwegian Nord-Tr?ndelag Health Study[J]. Arthritis Care Res (Hoboken), 2010, 62 (5): 611- 617. |
| 8 | 中华中医药学会风湿病分会, 海峡两岸医药卫生交流协会风湿免疫病学专业委员会纤维肌痛综合征中西医研究学组, 首都中西医结合风湿免疫病研究所. 中国纤维肌痛综合征诊疗指南[J]. 中华内科杂志, 2023, 62 (2): 129- 146. |
| 9 | Atzeni F , Alciati A , Salaffi F , et al. The association between body mass index and fibromyalgia severity: Data from a cross-sectional survey of 2 339 patients[J]. Rheumatol Adv Pract, 2021, 5 (1): rkab015. |
| 10 | Ko?yi?it BF , Okyay RA . The relationship between body mass index and pain, disease activity, depression and anxiety in women with fibromyalgia[J]. Peer J, 2018, 6, e4917. |
| 11 | Senna MK , Ahmad HS , Fathi W . Depression in obese patients with primary fibromyalgia: The mediating role of poor sleep and eating disorder features[J]. Clin Rheumatol, 2013, 32 (3): 369- 375. |
| 12 | Kim CH , Luedtke CA , Vincent A , et al. Association of body mass index with symptom severity and quality of life in patients with fibromyalgia[J]. Arthritis Care Res (Hoboken), 2012, 64 (2): 222- 228. |
| 13 | Kang JH , Park DJ , Kim SH , et al. Severity of fibromyalgia symptoms is associated with socioeconomic status and not obesity in Korean patients[J]. Clin Exp Rheumatol, 2016, 34 (2 Suppl 96): S83- S88. |
| 14 | Correa-Rodríguez M , Mansouri-Yachou JE , Casas-Barragán A , et al. The association of body mass index and body composition with pain, disease activity, fatigue, sleep and anxiety in women with fibromyalgia[J]. Nutrients, 2019, 11 (5): 1193. |
| 15 | 赵纬, 何建群, 郑艳峰. 肥胖对纤维肌痛综合征妇女症状及生活质量的影响[J]. 中国妇幼保健, 2021, 36 (10): 2239- 2241. |
| 16 | Wolfe F , Smythe HA , Yunus MB , et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee[J]. Arthritis Rheum, 1990, 33 (2): 160- 172. |
| 17 | Wolfe F , Clauw DJ , Fitzcharles MA , et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity[J]. Arthritis Care Res (Hoboken), 2010, 62 (5): 600- 610. |
| 18 | Wolfe F , Clauw DJ , Fitzcharles MA , et al. Fibromyalgia criteria and severity scales for clinical and epidemiological studies: A modification of the ACR preliminary diagnostic criteria for fibromyalgia[J]. J Rheumatol, 2011, 38 (6): 1113- 1122. |
| 19 | Jiao J , Cheng ZY , Xiao YY , et al. Validation of the 2011 and 2016 American College of Rheumatology diagnostic criteria for fibromyalgia in a Chinese population[J]. Ann Med, 2023, 55 (2): 2249921. |
| 20 | Huskisson EC . Measurement of pain[J]. Lancet, 1974, 304 (7889): 1127- 1131. |
| 21 | 郑洪波, 郑延平. 抑郁自评问卷(BDI)在抑郁患者中的应用[J]. 中国神经精神疾病杂志, 1987, 13 (4): 236- 237. |
| 22 | 王振, 苑成梅, 黄佳, 等. 贝克抑郁量表第2版中文版在抑郁症患者中的信效度[J]. 中国心理卫生杂志, 2011, 25 (6): 476- 480. |
| 23 | Huang F , Wang H , Wang Z , et al. Psychometric properties of the perceived stress scale in a community sample of Chinese[J]. BMC Psychiatry, 2020, 20 (1): 130. |
| 24 | 刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究[J]. 中华精神科杂志, 1996, (2): 103- 107. |
| 25 | Smets EM , Garssen B , Bonke B , et al. The multidimensional fatigue inventory (MFI) psychometric qualities of an instrument to assess fatigue[J]. J Psychosom Res, 1995, 39 (3): 315- 325. |
| 26 | Chuang LL , Chuang YF , Hsu MJ , et al. Validity and reliability of the traditional Chinese version of the multidimensional fatigue inventory in general population[J]. PLoS One, 2018, 13 (5): e0189850. |
| 27 | Li YT , Jiang Q , Jia Y , et al. A Chinese version of the revised fibromyalgia impact questionnaire: A validation study[J]. Int J Rheum Dis, 2023, 26 (2): 242- 249. |
| 28 | 李鲁, 王红妹, 沈毅. SF-36健康调查量表中文版的研制及其性能测试[J]. 中华预防医学杂志, 2002, (2): 38- 42. |
| 29 | Brazier JE , Harper R , Jones NM , et al. Validating the SF-36 health survey questionnaire: New outcome measure for primary care[J]. BMJ, 1992, 305 (6846): 160- 164. |
| 30 | Aparicio VA , Ortega FB , Carbonell-Baeza A , et al. Fibromyal-gia' s key symptoms in normal-weight, overweight, and obese female patients[J]. Pain Manag Nurs, 2013, 14 (4): 268- 276. |
| 31 | Okifuji A , Donaldson GW , Barck L , et al. Relationship between fibromyalgia and obesity in pain, function, mood, and sleep[J]. J Pain, 2010, 11 (12): 1329- 1337. |
| 32 | Gota CE , Kaouk S , Wilke WS . Fibromyalgia and obesity: The association between body mass index and disability, depression, history of abuse, medications, and comorbidities[J]. J Clin Rheumatol, 2015, 21 (6): 289- 295. |
| 33 | Okifuji A , Bradshaw DH , Olson C . Evaluating obesity in fibro-myalgia: Neuroendocrine biomarkers, symptoms, and functions[J]. Clin Rheumatol, 2009, 28 (4): 475- 478. |
| 34 | Neumann L , Lerner E , Glazer Y , et al. A cross-sectional study of the relationship between body mass index and clinical characteristics, tenderness measures, quality of life, and physical functioning in fibromyalgia patients[J]. Clin Rheumatol, 2008, 27 (12): 1543- 1547. |
| 35 | ?akit MO , ?akit BD , Gen? H , et al. The Association of skinfold anthropometric measures, body composition and disease severity in obese and non-obese fibromyalgia patients: A cross-sectional study[J]. Arch Rheumatol, 2018, 33 (1): 59- 65. |
| 36 | Cerón Lorente L , García Ríos MC , Navarro Ledesma S , et al. Functional status and body mass index in postmenopausal women with fibromyalgia: A case-control study[J]. Int J Environ Res Public Health, 2019, 16 (22): 4540. |
| 37 | Li S , Zhao JH , Luan J , et al. Cumulative effects and predictive value of common obesity-susceptibility variants identified by genome-wide association studies[J]. Am J Clin Nutr, 2010, 91 (1): 184- 190. |
| 38 | Jackson SE , Llewellyn CH , Smith L . The obesity epidemic-nature via nurture: A narrative review of high-income countries[J]. Sage Open Med, 2020, 8, 2050312120918265. |
| 39 | Wei L , Wu B . Racial and ethnic differences in obesity and overweight as predictors of the onset of functional impairment[J]. J Am Geriatr Soc, 2014, 62 (1): 61- 70. |
| 40 | Apovian CM . Obesity: Definition, comorbidities, causes, and burden[J]. Am J Manag Care, 2016, 22 (Suppl 7): S176- 185. |
| 41 | de Araújo TA , Mota MC , Crispim CA . Obesity and sleepiness in women with fibromyalgia[J]. Rheumatol Int, 2015, 35 (2): 281- 287. |
| 42 | Isasi CR , Parrinello CM , Jung MM , et al. Psychosocial stress is associated with obesity and diet quality in Hispanic/Latino adults[J]. Ann Epidemiol, 2015, 25 (2): 84- 89. |
| 43 | Beiner E , Brenner Miguel S , Friederich HC , et al. Elevated high sensitive C-reactive protein in fibromyalgia[J]. Front Psychiatry, 2023, 14, 1237518. |
| 44 | Ursini F , Naty S , Grembiale RD . Fibromyalgia and obesity: The hidden link[J]. Rheumatol Int, 2011, 31 (11): 1403- 1408. |
| 45 | D'Onghia M , Ciaffi J , Lisi L , et al. Fibromyalgia and obesity: A comprehensive systematic review and meta-analysis[J]. Semin Arthritis Rheum, 2021, 51 (2): 409- 424. |
| 46 | Prillaman M . Why BMI is flawed and how to redefine obesity[J]. Nature, 2023, 622 (7982): 232- 233. |
| 47 | Senna MK , Sallam RA , Ashour HS , et al. Effect of weight reduction on the quality of life in obese patients with fibromyalgia syndrome: A randomized controlled trial[J]. Clin Rheumatol, 2012, 31 (11): 1591- 1597. |
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