Buyukbese M A, Pamuk O N, Yurekli O A, Yesil N
Department of Internal Medicine, KSU School of Medicine, Kahramanmaras, Turkey.
J Postgrad Med. 2013 Apr-Jun;59(2):106-9. doi: 10.4103/0022-3859.113825.
Fibromyalgia (FM) may t cause a decrease in bone mineral density (BMD) because of decreased mobility. The condition is relatively frequent in rheumatoid arthritis (RA) and RA patients with FM have more disability than those without FM. We evaluated the effect of FM on BMD and investigated the effect of FM on BMD in RA patients.
We included age-matched 56 FM, 52 RA patients, and 37 healthy females as controls. Twenty three of all RA subjects met 1990 ACR FM criteria. Patients using the antiresorptive drugs, those on hormone replacement therapy, patients with thyroid or parathyroid dysfunction were excluded. Self-reported pain and fatigue severity, functional items of FM impact questionnaire were questioned in FM and RA patients. In all subjects, BMD of the lumbar spine and femur neck were determined by dual X-ray absorptiometry, and T-scores were recorded.
Self-reported pain and fatigue scores in FM subjects were significantly higher than in RA patients (P<0.001). The mean lumbar spine and femur neck BMD and their T-scores in RA patients were significantly lower than in FM and control groups (P values<0.01). There was no difference in BMD between FM subjects and the control group. BMD in RA patients with and without FM were similar (P>0.05). There was a significant negative correlation between self-reported pain score and lumbar spine BMD in FM subjects (r=-0.41, P=0.006).
In spite of functional disability, FM does not cause a decrease in BMD. The presence of FM in RA patients does not result in a change in BMD.
纤维肌痛（FM）可能因活动减少导致骨矿物质密度（BMD）降低。这种情况在类风湿关节炎（RA）中相对常见，且患有FM的RA患者比未患FM的患者有更多残疾。我们评估了FM对BMD的影响，并研究了FM对RA患者BMD的影响。
我们纳入了年龄匹配的56例FM患者、52例RA患者以及37名健康女性作为对照。所有RA受试者中有23例符合1990年美国风湿病学会（ACR）FM标准。排除使用抗吸收药物的患者、接受激素替代疗法的患者、患有甲状腺或甲状旁腺功能障碍的患者。对FM和RA患者询问了自我报告的疼痛和疲劳严重程度、FM影响问卷的功能项目。对所有受试者，采用双能X线吸收法测定腰椎和股骨颈的BMD，并记录T值。
FM受试者自我报告的疼痛和疲劳评分显著高于RA患者（P<0.001）。RA患者腰椎和股骨颈的平均BMD及其T值显著低于FM组和对照组（P值<0.01）。FM受试者与对照组的BMD无差异。有FM和无FM的RA患者的BMD相似（P>0.05）。FM受试者自我报告的疼痛评分与腰椎BMD之间存在显著负相关（r=-0.41，P=0.006）。
尽管存在功能障碍，但FM不会导致BMD降低。RA患者中FM的存在不会导致BMD改变。
