Background/Purpose: Fibromyalgia (FM) is characterized by chronic musculoskeletal widespread pain, fatigue, sleep disturbances and functional symptoms. The primary endpoint of our study aimed to determine whether FM could affect body composition of post-menopausal women. The secondary objectives investigated potential correlations between disease severity, measured subjectively by patient-compiled questionnaires, with body mass variables.

Methods: Thirty post-menopausal FM female patients (median age 58 years, BMI = 25.8) were diagnosed according to either ACR 1990 fibromyalgia classification criteria or ACR 2010 preliminary diagnostic criteria. They underwent Dual-energy X-ray absorptiometry (DEXA) for clinical purposes (i.e. screening for osteoporosis). The parameters analyzed by a dedicated software (GE Lunar, USA) were the spine and femoral bone mineral density (BMD), the total lean mass and the total body fat (TBF), quantitative variables of bone, muscle and fat composition. Additionally, qualitative analysis of the bone was indexed by the trabecular bone score (TBS). All the variables were compared with the parameters of 30 healthy controls (median age 59 years, BMI = 24.4) matched for sex and age. For each patient, data on disease duration, comorbidities, current treatment and disease severity self-reported scores were collected. The last ones derived from the Italian Fibromyalgia Impact Questionnaire Revised version that each patient independently compiled before the medical visit: widespread pain index (WPI), symptom severity scale (SSS), polysymptomatic distress scale (PDS), modified fibromyalgia assessment status (modFAS) and FIQR total score (FIQ-R).

Results: The clinical features of the patients included in our cohort are reported in table 1. No statistically significant differences were observed between femoral/spine BMD, TBS and muscle mass between patients and controls (p = 0.3, p = 0.06, p = 0.16, p = 0.8 respectively). Conversely, both total and central body fat were significantly higher in patients compared with healthy controls (29.4 kg vs 25.2 kg, 15.7 kg vs 13.2 kg, p = 0.006 and p = 0.01 respectively). No significant correlations were observed between body mass composition indexes with scores of disease severity. Body mass composition variables did not statistically differ when patients were sub-analyzed according to pharmacological treatment and comorbidities.

Conclusion: Our preliminary results suggest that FM does not significantly impair bone mass and quality in post-menopausal women, a conclusion in line with the majority of literature evidences [1]. Interestingly, total and central adipose tissue mass resulted higher in our cohort of patients compared with controls despite these findings did not correlate with disease severity. This might be due to a disease-induced sedentary lifestyle and reinforces the concept that physical activity not only should be the mainstay of treatment but also represents the best preventive method of overweight and obesity, one of most reported comorbidities of FM patients.

References: 1. Mateos F, Valero C, Olmos JM, et al. Bone mass and vitamin D levels in women with a diagnosis of fibromyalgia. Osteoporos Int. 2014;25(2):525-33.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/body-mass-composition-in-post-menopausal-women-with-fibromyalgia-preliminary-results-from-a-cross-sectional-monocentric-study/