Department of Rheumatology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Rheumatol Int. 2013 Jan;33(1):185-92. doi: 10.1007/s00296-012-2361-0. Epub 2012 Feb 4.
Patients with fibromyalgia syndrome (FMS) have impaired mobility and therefore get less sunlight exposure, we postulated that they may be at increased risk of developing osteoporosis (OP). The aim of this study was to assess and compare serum vitamin D level and bone mineral density (BMD) value in patients with primary FMS (PFMS) and healthy controls. A total of 50 patients with PFMS participated in this case-control study, and 50 healthy females who were age-matched to the patients were used as the control group. Venous blood samples collected from all subjects were used to evaluate serum 25-hydroxyvitamin D3 (25-OHD). BMD was measured at the lumbar spine (L2-L4) anteroposterior, femoral neck and forearm by dual-energy X-ray absorptiometry. Patients with PFMS had significantly lower serum 25-OHD than controls (15.1 ± 6.1 and 18.8 ± 5.4 ng/ml, respectively, p = 0.0018). Apart from the BMD in the lumbar spine, which was significantly lower in the PFMS patients compared with controls (p = 0.0012), no significant difference was found in other measures of BMD. Compared to PFMS patients who had serum level of the 25-OHD >20 ng/ml, the patients with 25-OHD ≤20 ng/ml are more likely to have impaired short memory (46.4 vs. 13.6%, respectively, p = 0.0136), confusion (50 vs. 18.2%, respectively, p = 0.0199), mood disturbance (60.7 vs. 27.3%, respectively, p = 0.0185), sleep disturbance (53.6 vs. 22.7%, respectively, p = 0.0271), restless leg syndrome (57.1 vs. 27.3%, respectively, p = 0.0346) and palpitation (67.9 vs. 36.4%, respectively, p = 0.0265). Serum level of the 25-OHD is inversely correlated with visual analogue scale (VAS) of pain (p = 0.016), Beck score for depression (p = 0.020) and BMD at lumbar spine (p = 0.012). The lumbar BMD inversely correlated with VAS of pain (p = 0.013) and Beck score for depression (p = 0.016). This study confirmed high prevalence of hypovitaminosis D among in patients with PFMS. This study confirmed the concept that FMS is a risk factor for OP. Based on this, an early nutrition program rich in calcium and vitamin D, appropriate exercise protocols, and medical treatment should be considered in these patients in terms of preventing OP development.
纤维肌痛综合征 (FMS) 患者的活动能力受损，因此阳光照射较少，我们推测他们可能患骨质疏松症 (OP) 的风险增加。本研究旨在评估和比较原发性纤维肌痛综合征 (PFMS) 患者和健康对照组的血清维生素 D 水平和骨密度 (BMD) 值。共有 50 名 PFMS 患者参与了这项病例对照研究，50 名年龄与患者匹配的健康女性被用作对照组。从所有受试者采集静脉血样，用于评估血清 25-羟维生素 D3 (25-OHD)。通过双能 X 射线吸收法测量腰椎 (L2-L4) 前后、股骨颈和前臂的 BMD。PFMS 患者的血清 25-OHD 明显低于对照组（分别为 15.1 ± 6.1 和 18.8 ± 5.4 ng/ml，p = 0.0018）。除了 PFMS 患者的腰椎 BMD 明显低于对照组（p = 0.0012）外，其他 BMD 测量值没有差异。与血清 25-OHD 水平 >20ng/ml 的 PFMS 患者相比，血清 25-OHD ≤20ng/ml 的患者更有可能出现短期记忆受损（分别为 46.4%和 13.6%，p = 0.0136）、意识混乱（分别为 50%和 18.2%，p = 0.0199）、情绪障碍（分别为 60.7%和 27.3%，p = 0.0185）、睡眠障碍（分别为 53.6%和 22.7%，p = 0.0271）、不宁腿综合征（分别为 57.1%和 27.3%，p = 0.0346）和心悸（分别为 67.9%和 36.4%，p = 0.0265）。血清 25-OHD 水平与疼痛视觉模拟量表 (VAS)（p = 0.016）、抑郁贝克评分（p = 0.020）和腰椎 BMD 呈负相关（p = 0.012）。腰椎 BMD 与疼痛 VAS（p = 0.013）和抑郁贝克评分（p = 0.016）呈负相关。本研究证实了 PFMS 患者中维生素 D 缺乏症的高患病率。本研究证实了 FMS 是 OP 的一个危险因素。基于此，应考虑在这些患者中早期进行富含钙和维生素 D 的营养计划、适当的运动方案和药物治疗，以预防 OP 的发生。
