Gerdle Björn, Dahlqvist Leinhard Olof, Lund Eva, Bengtsson Ann, Lundberg Peter, Ghafouri Bijar, Forsgren Mikael Fredrik
Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SE 581 83, Sweden.
Centre for Medical Image Science and Visualization (CMIV), Linköping, SE 581 83, Sweden.
J Pain Res. 2022 Aug 27;15:2517-2535. doi: 10.2147/JPR.S376590. eCollection 2022.
Obesity is a risk factor for the development of fibromyalgia (FM) and generally most studies report increased Body Mass Index (BMI) in FM. Obesity in FM is associated with a worse clinical presentation. FM patients have low physical conditioning and obesity further exacerbates these aspects. Hitherto studies of FM have focused upon a surrogate for overall measure of fat content, ie, BMI. This study is motivated by that ectopic fat and adipose tissues are rarely investigated in FM including their relationships to physical capacity variables. Moreover, their relationships to clinical variables including are not known. Aims were to 1) compare body composition between FM and healthy controls and 2) investigate if significant associations exist between body composition and physical capacity aspects and important clinical variables.
FM patients (n = 32) and healthy controls (CON; n = 30) underwent a clinical examination that included pressure pain thresholds and physical tests. They completed a health questionnaire and participated in whole-body magnetic resonance imaging (MRI) to determine body composition aspects.
Abdominal adipose tissues, muscle fat, and BMI were significantly higher in FM, whereas muscle volumes of quadriceps were smaller. Physical capacity variables correlated negatively with body composition variables in FM. Both body composition and physical capacity variables were significant regressors of group belonging; the physical capacity variables alone showed stronger relationships with group membership. A mix of body composition variables and physical capacity variables were significant regressors of pain intensity and impact in FM. Body composition variables were the strongest regressors of blood pressures, which were increased in FM.
Obesity has a negative influence on FM symptomatology and increases the risk for other serious conditions. Hence, obesity, dietary habits, and physical activity should be considered when developing clinical management plans for patients with FM.
肥胖是纤维肌痛（FM）发生的一个风险因素，并且大多数研究普遍报告FM患者的体重指数（BMI）升高。FM患者的肥胖与更差的临床表现相关。FM患者身体机能较差，而肥胖会进一步加剧这些方面。迄今为止，FM的研究主要集中在脂肪含量总体测量的一个替代指标，即BMI。本研究的动机在于，在FM中很少研究异位脂肪和脂肪组织，包括它们与身体机能变量的关系。此外，它们与包括……在内的临床变量的关系尚不清楚。目的是：1）比较FM患者与健康对照者的身体成分；2）研究身体成分与身体机能方面及重要临床变量之间是否存在显著关联。
FM患者（n = 32）和健康对照者（CON；n = 30）接受了包括压痛阈值和身体测试在内的临床检查。他们完成了一份健康问卷，并参与全身磁共振成像（MRI）以确定身体成分方面。
FM患者的腹部脂肪组织、肌肉脂肪和BMI显著更高，而股四头肌的肌肉体积更小。FM患者的身体机能变量与身体成分变量呈负相关。身体成分和身体机能变量都是分组归属的显著预测因素；仅身体机能变量与分组归属的关系更强。身体成分变量和身体机能变量的组合是FM患者疼痛强度和影响的显著预测因素。身体成分变量是血压的最强预测因素，FM患者的血压升高。
肥胖对FM症状有负面影响，并增加了患其他严重疾病的风险。因此，在为FM患者制定临床管理计划时，应考虑肥胖、饮食习惯和身体活动。
