Fibromyalgia and obesity: A comprehensive systematic review and meta-analysis

D’Onghia, Martina; Ciaffi, Jacopo; Lisi, Lucia; Mancarella, Luana; Ricci, Susanna; Stefanelli, Nicola; Melicòni, Riccardo; Ursini, Francesco

doi:10.1016/j.semarthrit.2021.02.007

Cited by 59 publications

(53 citation statements)

References 110 publications

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“…14 The second, perhaps strongest, predictor of FM in our cohort was obesity. The relationship between obesity and FM is mutual and bidirectional; in a recent systematic review and meta-analysis, 26 our group demonstrated that BMI can influence nearly all domains of the syndrome.…”

Section: Discussionmentioning

confidence: 92%

Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? Results from a web-based survey

et al. 2021

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ObjectivePostacute COVID-19 syndrome (PACS) is an emerging entity characterised by a large array of manifestations, including musculoskeletal complaints, fatigue and cognitive or sleep disturbances. Since similar symptoms are present also in patients with fibromyalgia (FM), we decided to perform a web-based cross-sectional survey aimed at investigating the prevalence and predictors of FM in patients who recovered from COVID-19.MethodsData were anonymously collected between 5 and 18 April 2021. The collection form consisted of 28 questions gathering demographic information, features and duration of acute COVID-19, comorbid diseases, and other individual’s attributes such as height and weight. The American College of Rheumatology (ACR) Survey Criteria and the Italian version of the Fibromyalgia Impact Questionnaire completed the survey.ResultsA final sample of 616 individuals (77.4% women) filled the form 6±3 months after the COVID-19 diagnosis. Of these, 189 (30.7%) satisfied the ACR survey criteria for FM (56.6% women). A multivariate logistic regression model including demographic and clinical factors showed that male gender (OR: 9.95, 95% CI 6.02 to 16.43, p<0.0001) and obesity (OR: 41.20, 95% CI 18.00 to 98.88, p<0.0001) were the strongest predictors of being classified as having post-COVID-19 FM. Hospital admission rate was significantly higher in men (15.8% vs 9.2%, p=0.001) and obese (19.2 vs 10.8%, p=0.016) respondents.ConclusionOur data suggest that clinical features of FM are common in patients who recovered from COVID-19 and that obesity and male gender affect the risk of developing post-COVID-19 FM.

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Section: Discussionmentioning

confidence: 92%

Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? Results from a web-based survey

et al. 2021

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“…In particular, obesity is associated with increased pain severity and decreased physical functioning in FM [ 13 , 14 , 16 , 17 , 18 ]. Individuals with FM and obesity experience severe functional limitations owing to the combination of two issues: persistent pain related to FM and restricted movement imposed by obesity [ 13 , 19 , 20 , 21 ]. Thus, both conditions can interact with and exacerbate each other.…”

Section: Introductionmentioning

confidence: 99%

The Role of Pain Catastrophizing and Pain Acceptance in Performance-Based and Self-Reported Physical Functioning in Individuals with Fibromyalgia and Obesity

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et al. 2021

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Impaired physical functioning is one of the most critical consequences associated with fibromyalgia, especially when there is comorbid obesity. Psychological factors are known to contribute to perceived (i.e., subjective) physical functioning. However, physical function is a multidimensional concept encompassing both subjective and objective functioning. The contribution of psychological factors to performance-based (i.e., objective) functioning is unclear. This study aims to investigate the contribution of pain catastrophizing and pain acceptance to both self-reported and performance-based physical functioning. In this cross-sectional study, 160 participants completed self-report measures of pain catastrophizing, pain acceptance, and pain severity. A self-report measure and a performance-based test were used to assess physical functioning. Higher pain catastrophizing and lower pain acceptance were associated with poorer physical functioning at both self-reported and performance-based levels. Our results are consistent with previous evidence on the association between pain catastrophizing and pain acceptance with self-reported physical functioning. This study contributes to the current literature by providing novel insights into the role of psychological factors in performance-based physical functioning. Multidisciplinary interventions that address pain catastrophizing and pain acceptance are recommended and might be effective to improve both perceived and performance-based functioning in women with FM and obesity.

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“…Weight loss improves outcomes in patients with RA ( 37 , 38 , 44 , 49 ), PsA ( 39 , 61 , 64 ) and AS ( 110 , 111 ). Besides inflammatory arthritis, metabolic, and eating disorders were suggested to facilitate the occurrence of early clues of connective tissue disorders ( 112 ) and obesity was shown to worsen musculoskeletal symptoms also in patients with fibromyalgia ( 113 ). Promoting weight loss strategies may be part of the treatment for overweight and obese patients with fibromyalgia but evidence regarding the efficacy of KD in this setting is lacking.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Ketogenic Diet on Inflammatory Arthritis and Cardiovascular Health in Rheumatic Conditions: A Mini Review

et al. 2021

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The principle of ketogenic diet (KD) is restriction of carbohydrates to a maximum of 5–10% of the total daily caloric intake, aiming at shifting body metabolism toward ketone bodies. Different studies suggested promising results of KD to help patients to lose weight, to reduce insulin requirements in diabetes, to supplement cancer protocols, to treat neurological conditions and to optimize control of metabolic and cardiovascular diseases. However, literature about the anti-inflammatory properties of KD in rheumatic diseases is still limited. The beneficial effects of weight loss in patients with inflammatory arthritis can be explained by biomechanical and biochemical factors. Obesity is associated with macrophage activation and production of pro-inflammatory cytokines including TNF-α, IL-1b, and IL-6. The clinical effect of KD may be primarily attributed to improvement of insulin sensitivity. Insulin resistance is associated with an increase of TNF-α, IL-1α, IL-1β, IL-6, and leptin. Moreover, reduction of body's adipose tissue and weight loss account for part of the anti-inflammatory effects and for the impact of KD on cardiovascular health. In rheumatoid arthritis, fasting was shown to be effective in reducing disease symptoms, possibly through the production of β-hydroxybutyrate (BHB), the main ketone body. BHB may exert inhibitory effects also on IL-17 and intermittent fasting improved the clinical manifestations of psoriatic arthritis. In ankylosing spondylitis, current literature doesn't allow to draw conclusion about the effects of KD. Future prospective studies will be needed to elucidate the potential beneficial effects of KD on specific domains and clinical outcomes in patients with inflammatory arthritis.

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Fibromyalgia and obesity: A comprehensive systematic review and meta-analysis

Cited by 59 publications

References 110 publications

Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? Results from a web-based survey

Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? Results from a web-based survey

The Role of Pain Catastrophizing and Pain Acceptance in Performance-Based and Self-Reported Physical Functioning in Individuals with Fibromyalgia and Obesity

The Effect of Ketogenic Diet on Inflammatory Arthritis and Cardiovascular Health in Rheumatic Conditions: A Mini Review

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