Are Patients With Fibromyalgia in a Prothrombotic State?

OBJECTIVES: The aim of this study was to investigate thrombosis-related parameters (blood coagulation parameters, platelet indices, red blood cell [RBC] count, and inflammatory markers) in patients with fibromyalgia (FM). METHOD: We carried out a case-control study with 35 women with FM and 12 age-matched healthy volunteers to analyze fibrinogen levels, prothrombin time, cephaline time, platelet count, platelet distribution width (PDW), mean platelet volume (MPV), RBC count, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (PLR). RESULTS: The results showed significantly increased fibrinogen levels ( p < .05), platelet count ( p < .05), PDW ( p = .059), RBC count ( p < .05), and PLR ( p < .05) in women with FM versus the healthy volunteers. Prothrombin time ( p < .05) and MPV ( p < .05) were significantly lower in patients with FM than in the controls. CONCLUSIONS: Elevated platelet and RBC counts, PDW values, and fibrinogen levels as well as decreased prothrombin time are all indicative of a prothrombotic state in FM patients, which may be enhanced by an increased inflammatory tone. This prothrombotic state may increase the risk of thrombosis-related cardiovascular disease in patients with FM.

Is fibromyalgia-related oxidative stress implicated in the decline of physical and mental health status?

OBJECTIVES: Fibromyalgia (FM) is a form of non-articular rheumatism characterised by chronic widespread musculoskeletal aching. Although some works have investigated the possible role of oxidative stress in the pathophysiology of FM, none has analysed a significant number of oxidative markers in the same patients. Consequently, we have performed an exhaustive study of the oxidative/antioxidative status in FM patients and healthy controls, as well as the relationship with FM clinical parameters. METHODS: In 45 female patients and 25 age-matched controls, we investigated the oxidative (lipid and protein peroxidation, and oxidative DNA damage) and antioxidative status (total antioxidant capacity (TAC), and antioxidant enzyme activities and compounds). Functional capacity and musculoskeletal pain were assessed by Fibromyalgia Impact Questionnaire (FIQ) and Visual Analogue Scale (VAS), respectively. The physical (PCS-12) and mental (MCS-12) health status was evaluated by SF-12. RESULTS: A significant increase in oxidative DNA damage and protein carbonyl content was found in FM patients vs. controls, as well as in antioxidant compounds such as copper and ceruloplasmin. Patients had diminished levels of TAC and zinc. Enzyme activities of superoxide dismutase, glutathione peroxidase, and catalase were lower in FM patients. Significant correlations were observed in patients between oxidative DNA damage and MCS-12, and zinc and PCS-12. CONCLUSIONS: These findings reveal an imbalance between oxidants and antioxidants in FM patients. The lower antioxidant enzyme activities may lead to oxidative stress through the oxidation of DNA and proteins, which may affect the health status of FM patients.