Fibromyalgia and body mass composition in post-menopausal women: preliminary results from a cross-sectional monocentric study

BackgroundFibromyalgia (FM) is characterized by chronic musculoskeletal widespread pain, fatigue, sleep disturbances and functional symptoms.ObjectivesOur study aimed to determine if FM could affect body composition of post-menopausal women and to investigated potential correlations between disease severity and body mass variables.MethodsThirty post-menopausal FM female patients (median age 58 years, BMI = 25.8) were diagnosed according to either ACR 1990 fibromyalgia classification criteria or ACR 2010 preliminary diagnostic criteria. They underwent Dual-energy X-ray absorptiometry (DEXA) for clinical purposes (i.e. screening for osteoporosis). The parameters analyzed by a dedicated software (GE Lunar, USA) were the spine and femoral bone mineral density (BMD), the total lean mass and the total body fat (TBF), quantitative variables of bone, muscle and fat composition. Additionally, qualitative analysis of the bone was indexed by the trabecular bone score (TBS). All the variables were compared with the parameters of 30 healthy controls (median age 59 years, BMI = 24.4) matched for sex and age. For each patient, data on disease duration, comorbidities, current treatment and disease severity self-reported scores were collected. The last ones derived from the Italian Fibromyalgia Impact Questionnaire Revised (FIQ-R) version that each patient independently compiled before the medical visit: widespread pain index (WPI), symptom severity scale (SSS), polysymptomatic distress scale (PDS), modified fibromyalgia assessment status (modFAS) and the FIQ-R total score.ResultsThe clinical features of the FM patients included in our cohort are reported in Table 1. No statistically significant differences were observed between femoral/spine BMD, TBS and muscle mass between patients and controls (p = 0.3, p = 0.06, p = 0.16, p = 0.8 respectively). Conversely, both total and central body fat were significantly higher in patients compared with healthy controls (29.4 kg vs 25.2 kg, 15.7 kg vs 13.2 kg, p = 0.006 and p = 0.01 respectively). No significant correlations were observed between body mass composition indexes with scores of disease severity. Body mass composition variables did not statistically differ when patients were sub-analyzed according to pharmacological treatment and comorbidities.Table 1.Clinical features of FM patients included in present cohort (please see text for explanations of terminology)Patients,N = 30Age (range)58.0 [53.8, 69.2]BMI (range)25.8 [23.0, 28.4]Disease duration (years), Median [IQR]4.5 [2.2, 9.2]ModFAS, Median [IQR]24.5 [20.0, 29.2]PDS, Median [IQR]17.5 [16.0, 23.2]SSS, Median [IQR]8.0 [6.0, 9.0]WPI, Median [IQR]12.0 [7.8, 15.0]FIQ-R, Median [IQR]57.9 [32.4, 68.8]Current pharmacological treatment Cyclobenzaprine N (%)24 (80) Fluoxetine N (%)5 (16.6) Duloxetine N (%)4 (13.3) Gabapentinoids N (%)2 (6.6) Tizanidine N (%)2 (6.6) Benzodiazepines N (%)2 (6.6) Cannabinoids N (%)3 (10)Nson-pharmacological treatmentAerobic physical activity N (%)5 (16)Comorbidities Hypertension N (%)10 (33.3) Diabetes N (%)3 (10) Osteoarthritis N (%)10 (33.3) Anxiety/depression N (%)3 (10) Psoriasis N (%)3 (10)ConclusionOur preliminary results suggest that FM seems not associated with impaired bone mass and bone quality in post-menopausal women compared to matched healthy controls, in line with the majority of literature evidences [1]. However, total and central adipose tissue mass resulted higher in this cohort of FM patients compared with controls but not correlate with disease severity. This might be due to a disease-induced sedentary lifestyle and might reinforce the concept that physical activity represents the best preventive method of overweight and obesity, one of most reported comorbidities for FM patients[2].References[1]Mateos F et al. Osteoporos Int. 2014;25(2):525-33.[2]D’Onghia et al. Seminars in Arthritis and Rheumatism. 2021;51(2):409-24.Disclosure of InterestsNone declared