Division of Nephrology, Department of Internal Medicine, Konya Numune State Hospital, Konya, Turkey.
Rheumatol Int. 2013 Sep;33(9):2391-8. doi: 10.1007/s00296-013-2748-6. Epub 2013 Apr 16.
Recent evidence suggests that patients with fibromyalgia (FM) have increased oxidative stress, inflammation, endothelial dysfunction and autonomic dysfunction. These factors are also shown to be responsible for increased urinary albumin and protein excretion and deranged circadian blood pressure (BP). However, no study has examined the 24-h urinary albumin excretion (UAE), 24-h urinary protein excretion (UPE) and 24-h ambulatory BP measurements in FM patients. The sociodemographic, laboratory parameters, depressive symptoms, sleep problems and 24-h ambulatory BPs were measured for all patients. Diagnosis of FM was based on the criteria for the classification of FM by the American College of Rheumatology. After diagnosis of FM, these patients underwent to complete the Fibromyalgia Impact Questionnaire (FIQ). In total, 30 patients with FM and 61 patients without FM were included. Among FM patients, the average number of tender points was 13.1 ± 1.57 and the mean FIQ score was 57.9 ± 8.86. The number of tender points did not show any correlation with office and ambulatory BPs. There were also no correlations between the number of tender points, UPE and UAE. The stepwise linear regression did not show any relation between UPE and FM. However, 24-h UAE was independently correlated with office systolic BP (P 0.008) and the presence of FM (P 0.045). The logistic regression analysis revealed no association between FM and non-dipping status. We suggest that circadian blood pressure and UPE are not independently associated with FM. However, UAE was related with the presence of FM. Studies are needed to confirm our findings and to highlight pathophysiologic mechanisms.
最近的证据表明，纤维肌痛（FM）患者存在氧化应激增加、炎症、内皮功能障碍和自主神经功能障碍。这些因素也被证明与尿白蛋白和蛋白排泄增加以及昼夜节律血压（BP）紊乱有关。然而，尚无研究检查 FM 患者的 24 小时尿白蛋白排泄量（UAE）、24 小时尿蛋白排泄量（UPE）和 24 小时动态血压测量值。所有患者均测量了社会人口统计学、实验室参数、抑郁症状、睡眠问题和 24 小时动态血压。FM 的诊断基于美国风湿病学会的 FM 分类标准。FM 诊断后，这些患者接受了完整的纤维肌痛影响问卷（FIQ）评估。共纳入 30 例 FM 患者和 61 例非 FM 患者。在 FM 患者中，平均压痛点数为 13.1 ± 1.57，平均 FIQ 评分为 57.9 ± 8.86。压痛点数与诊室和动态血压均无相关性。压痛点数与 UPE 和 UAE 也无相关性。逐步线性回归未显示 UPE 与 FM 之间存在任何关系。然而，24 小时 UAE 与诊室收缩压独立相关（P 0.008），与 FM 的存在独立相关（P 0.045）。逻辑回归分析显示 FM 与非杓型血压无关联。我们认为昼夜节律血压和 UPE 与 FM 无独立关联。然而，UAE 与 FM 的存在有关。需要进一步研究来证实我们的发现，并强调病理生理机制。
