Endocrinology, Fondazione UALSI, Catanzaro, 88100, Italy.
Metab Brain Dis. 2013 Dec;28(4):619-27. doi: 10.1007/s11011-013-9421-3. Epub 2013 Jul 28.
To evaluate glucose metabolism and/or insulin resistance (IR) in 96 patients with Fibromyalgia (FM), associated or not to cognitive impairment. We investigated glucose metabolism in 96 FM patients. Enrolled patients were divided into two groups: 48 patients with memory deficit (group A) and 48 without memory deficit (control group). We evaluated glucose and insulin levels after a 2 h-Oral-Glucose-Tolerance-Test (2 h-OGTT) and insulin resistance (IR) by the homeostasis model assessment formula (HOMA). Body Mass Index (BMI), waist-to-hip-ratio (WHR), anxiety level, fasting plasma insulin and Non-Steroidal Anti-Inflammatory agents use were higher in patients with FM with memory impairment; while age, sex, waist circumference, education level, fasting plasma glucose, glycate hemoglobin, triglycerides, blood lipid profile, C- Reactivity-Protein (CRP), blood pressure and smoking habits were similar in both groups. Following OGTT the prevalence of glucose metabolism abnormalities was significantly higher in group A. IR was present in 79% patients, of whom 23% had also impaired glucose tolerance, 4% newly diagnosed diabetes mellitus and 52% IR only. Obesity and overweight prevailed in group A. IR, but not BMI or WHR was associated to an increased risk of memory impairment (OR = 2,6; 95% CI: 1,22-3,7). The results of this study suggest that IR may represent a risk factor for memory impairment in fibromialgic patients.
评估 96 例纤维肌痛(FM)患者的葡萄糖代谢和/或胰岛素抵抗(IR),这些患者是否伴有认知障碍。我们研究了 96 例 FM 患者的葡萄糖代谢。入组患者分为两组:48 例有记忆障碍(A 组)和 48 例无记忆障碍(对照组)。我们评估了 2 小时口服葡萄糖耐量试验(2 h-OGTT)后葡萄糖和胰岛素水平,并通过稳态模型评估公式(HOMA)评估胰岛素抵抗(IR)。有记忆障碍的 FM 患者的体重指数(BMI)、腰臀比(WHR)、焦虑水平、空腹血浆胰岛素和非甾体抗炎药使用率较高;而年龄、性别、腰围、教育水平、空腹血糖、糖化血红蛋白、甘油三酯、血脂谱、C 反应蛋白(CRP)、血压和吸烟习惯在两组中相似。OGTT 后,A 组葡萄糖代谢异常的患病率明显更高。79%的患者存在 IR,其中 23%存在糖耐量受损,4%新诊断为糖尿病,52%仅存在 IR。A 组肥胖和超重更为普遍。IR 而不是 BMI 或 WHR 与记忆障碍的风险增加相关(OR = 2.6;95%CI:1.22-3.7)。这项研究的结果表明,IR 可能是纤维肌痛患者记忆障碍的一个危险因素。