Volume of Fat Mass Negatively Impacts Severity of Fibromyalgia

The volume of fat mass, as analyzed by a Principal Component Analysis (PCA), was shown to negatively modulate the severity of fibromyalgia syndrome (FMS), according to a study published in Reumatología Clínica.¹ Investigators urge clinicians to evaluate body composition as part of the basic clinical approach for the treatment of this patient population.

“Since at least part of the pathogenesis of FM appears to be influenced by impaired regulation of pain modulating cytokines,both centrally and peripherally, the hypothesis that body composition can modulate the symptomatic context of fibromyalgia syndrome is perfectly plausible, although the results coming from studies devoted to the topic are contradictory,” investigators stated.

In this observational, quantitative, cross-sectional study, the association between type of body composition and FMS was evaluated using 43 women with clinically diagnosed FMS, per the American College of Rheumatology (ACR) 2010 criteria.

Clinical outcome measures included the Fibromyalgia Impact Questionnaire (FIQ), Symptom Severity Scale (SSS), and the Widespread Pain Index (WPI). Anthropometric data was categorized into PCA-Fat and PCA-muscle. Patients were also classified into high and low categories for each clinical indicator, which were used in the binomial logistic regression (BLR) models. Inclusion criteria included female sex, aged 18 years or older, with a clinical diagnosis of fibromyalgia (FM). Patients were selected through the Rheumatology outpatient clinic at the Yucatán Peninsula’s High Specialties Regional Hospital.

The median age of patients was 52.7 (± 11.3 years) years and had an average disease duration of 53.6 ± 54 months. Most patients were currently receiving some form of medication, including nonsteroidal anti-inflammatory drugs (NSAIDs) (65%, n = 30), opioids (28%, n = 13), and benzodiazepines or antidepressants (62%, n = 27, combined). Nearly all patients were classified as overweight or obese (90.7%), and most had 1 or more comorbidity (62.7%).

A positive correlation was shown between PCA-Fat and both WPI (r = 0.326, P = .043) and FIQ (r = 0.325, P = .044). There was a negative correlation between PCA-muscle and SSS (r = −0.384, P = .013). In the BLR analysis, PCA-Fat was a significant predictor of high WPI (OR = 2.477, P = .038). PCA-muscle was an inversely significant predictor of high SSS (OR = 0.303, P = .009).

“Our results strongly suggest that hyper-adiposity states may negatively modulate the clinical severity in FM,” investigators concluded. “Thus, body composition appraisal must be part of the global assessment of FM patients, with mandatory nutritional counseling, and special emphasis in the diet, from which patients can see benefits ranging from reduced anxiety symptoms, mood disturbance, and even disappointment with body image.”

Reference:

Álvarez-Nemegyei J, Pacheco-Pantoja EL, Olán-Centeno LJ, Angulo-Ramírez A, Rodríguez-Magaña FE, Aranda-Muiña JF. Association between fibromyalgia syndrome clinical severity and body composition. A principal component analysis. Reumatol Clin (Engl Ed). 2022;18(9):538-545. doi:10.1016/j.reumae.2021.09.008