Department of Endocrinology, Ankara City Hospital, Ankara, 06000, Turkey.
Faculty of Medicine, Department of Endocrinology, Ankara Yildirim Beyazit University, Ankara, Turkey.
Reprod Sci. 2024 Jan;31(1):239-247. doi: 10.1007/s43032-023-01347-0. Epub 2023 Sep 15.
This study aims to investigate the frequency of fibromyalgia and its predictors in women with polycystic ovary syndrome (PCOS) and its relationship with insulin resistance, and to assess the effect of fibromyalgia on the anxiety and depressive symptoms in PCOS patients, and how the quality of life was affected by this combination.
The study was conducted with 74 women with PCOS according to the Rotterdam criteria, which applied to our tertiary care clinic between January 2021 and January 2022, and 51 controls. Endocrinologic and rheumatologic examinations, biochemical and hormonal analyses, and radiologic imaging are made. Hospital anxiety and depression scale (HADs) and Short Form 36 (SF-36) quality of life scale were applied.
There was no statistical difference between patients (n = 74 (23%)) and controls (n = 51 (13.7%)) in terms of fibromyalgia frequency. This frequency was 41.4% in PCOS patients with insulin resistance. The presence of insulin resistance was significantly higher in patients with PCOS and fibromyalgia (70.4%, 12 of 17 patients with fibromyalgia for the PCOS group; 8.3%, 1 of 7 patients with fibromyalgia for the control group) (χ = 9.130, p=0.003). Higher HOMA-IR levels (B = 1.278, p = 0.034) and age (B = 1.134, p = 0.022) were significant predictors of fibromyalgia in PCOS patients. Physical functioning (U = 1.960, P = 0.050), bodily pain subscales (U = 2.765, p = 0.006), and physical health summary measure (U = 2.296, p = 0.022) were significantly lower, VAS pain (U = 5.145, p < 0.0001) and fatigue (U = 5.997, p < 0.0001) scale scores were higher in PCOS patients with fibromyalgia.
Our results show that fibromyalgia is frequent in PCOS patients with insulin resistance.
本研究旨在调查多囊卵巢综合征（PCOS）女性中纤维肌痛的发生频率及其预测因素，及其与胰岛素抵抗的关系，并评估纤维肌痛对 PCOS 患者焦虑和抑郁症状的影响，以及这种组合如何影响生活质量。
本研究纳入了 2021 年 1 月至 2022 年 1 月期间在我们的三级保健诊所就诊的 74 名符合罗得岛标准的 PCOS 女性患者和 51 名对照者，进行了内分泌和风湿病学检查、生化和激素分析以及影像学检查。应用医院焦虑抑郁量表（HADs）和 36 项简短健康调查量表（SF-36）进行生活质量评估。
在患者（n=74（23%））和对照组（n=51（13.7%））中，纤维肌痛的发生频率无统计学差异。在伴有胰岛素抵抗的 PCOS 患者中，纤维肌痛的发生率为 41.4%。PCOS 合并纤维肌痛患者的胰岛素抵抗发生率显著高于 PCOS 对照组（70.4%，17 例纤维肌痛患者中有 12 例；8.3%，7 例纤维肌痛患者中有 1 例）（χ=9.130，p=0.003）。较高的 HOMA-IR 水平（B=1.278，p=0.034）和年龄（B=1.134，p=0.022）是 PCOS 患者发生纤维肌痛的显著预测因素。躯体功能（U=1.960，P=0.050）、躯体疼痛亚量表（U=2.765，p=0.006）和生理健康综合测量（U=2.296，p=0.022）明显降低，疼痛视觉模拟评分（U=5.145，p<0.0001）和疲劳评分（U=5.997，p<0.0001）升高。
我们的结果表明，纤维肌痛在伴有胰岛素抵抗的 PCOS 患者中较为常见。
