Tishler Moshe, Smorodin Tatyana, Vazina-Amit Mirit, Ramot Yoram, Koffler Michael, Fishel Beno
Department of Medicine 'B' and the Rheumatology Service, Assaf Harofe Medical Center, Zerifin, Israel.
Rheumatol Int. 2003 Jul;23(4):171-3. doi: 10.1007/s00296-002-0279-7. Epub 2003 May 20.
The aim of this study was to evaluate the prevalence of fibromyalgia (FM) in patients with diabetes mellitus (DM).
The study included 100 consecutive unselected patients with DM attending our diabetes clinic. Patients were divided into two groups: 45 patients with type 1 diabetes and 55 patients with type 2 diabetes. A group of 50 healthy hospital staff members served as controls. The FM was diagnosed according to the 1990 American College of Rheumatology criteria. Counts of 18 tender points were performed by thumb palpation and assessed by dolorimeter. Routine biochemical tests and levels of HbA(1c) were recorded in each patient.
The main outcome measure was the association of FM with DM. Fibromyalgia was diagnosed in 17 patients (17%) with DM and in only one (2%) healthy control ( P=0.008). No differences in patients were noted in the prevalence of FM between type 1 and type 2 diabetes (18.5% vs 15.5%, respectively). Patients with both FM and DM had significantly higher levels of HbA(1c) than DM patients without FM (9.2+/-1.1% vs 6.4+/-1.5%) ( P<0.05). Similarly, the numbers of tender points, pain scores, and the prevalence of sleep disturbances, fatigue, and headaches were higher in this group of patients. A significant correlation was observed between the numbers of tender points and HbA(1c) levels in the DM patients with FM ( r=0.72, P=0.027).
Fibromyalgia is a common finding in patients with types 1 and 2 diabetes, and its prevalence could be related to control of the disease. As with other diabetes complications, FM might be prevented by improved control of blood glucose levels.
本研究旨在评估糖尿病(DM)患者中纤维肌痛(FM)的患病率。
该研究纳入了100例连续入选的在我们糖尿病门诊就诊的未经过挑选的DM患者。患者被分为两组:45例1型糖尿病患者和55例2型糖尿病患者。一组50名健康医院工作人员作为对照。FM根据1990年美国风湿病学会标准进行诊断。通过拇指触诊进行18个压痛点计数,并使用压痛计进行评估。记录每位患者的常规生化检查和糖化血红蛋白(HbA1c)水平。
主要观察指标是FM与DM的关联。17例(17%)DM患者被诊断为纤维肌痛,而健康对照中只有1例(2%)(P = 0.008)。1型和2型糖尿病患者中FM的患病率没有差异(分别为18.5%和15.5%)。同时患有FM和DM的患者的HbA1c水平显著高于无FM的DM患者(9.2±1.1%对6.4±1.5%)(P<0.05)。同样,该组患者的压痛点数量、疼痛评分以及睡眠障碍、疲劳和头痛的患病率更高。在患有FM的DM患者中,压痛点数量与HbA1c水平之间观察到显著相关性(r = 0.72,P = 0.027)。
纤维肌痛在1型和2型糖尿病患者中是常见发现,其患病率可能与疾病控制有关。与其他糖尿病并发症一样,通过改善血糖水平控制可能预防FM。