Aytaç Atamer

Fibromyalgia (FM) is a multifactorial syndrome with poorly understood pathophysiology, characterized by chronic widespread pain and fatigue affecting the central and peripheral nervous systems, as well as the endocrine and muscular systems. These characteristics create significant challenges in diagnosis and treatment. This study compared the metabolic profiles of FM patients and healthy controls using one‐dimensional (1D) 1H nuclear magnetic resonance (NMR) spectroscopy and multivariate statistical analysis to identify potential biomarkers associated with FM symptoms. Urine and serum samples from 50 FM patients and 50 healthy individuals underwent untargeted metabolic profiling. Quantitative ¹ H‐NMR spectroscopy was used to determine metabolic changes. Chemometric models and receiver operating characteristic (ROC) curves were generated using the MetaboAnalyst platform. Fold change (FC) analysis and t ‐tests were conducted to determine statistically significant differences between groups. Our findings showed significant differences at the metabolic level between FM patients and healthy controls. Increased urea, glutamate, valine, taurine, proline, glycine, and homoserine metabolites, and decreased benzoate, leucine, π‐methylhistidine, galactitol, τ‐methylhistidine, glutamine, 3‐hydroxykynurenine, and fructose levels were observed in FM serum; while increased malate, dimethylamine, trimethylamine N ‐oxide (TMAO), creatine phosphate, N ‐phenylacetylglycine, N ‐acetylglutamate (NAG), hippurate, and urea levels were observed in FM urine, and decreased guanidoacetate, creatine, malonate, serine, glucuronate, creatinine, and uracil levels were observed. Serum glutamate was positively correlated with waist/hip ratio (WHR) and negatively correlated with Fibromyalgia Impact Questionnaire (FIQ) and Visual Analog Scale (VAS); negative correlations existed between taurine and FIQ and VAS; a positive correlation existed between urea and WHR; there was a positive correlation between anserine and body mass index (BMI). Also, in urine, there were positive correlations between TMAO, N ‐phenylacetylglycine, glutamate, and xylose and WHR; negative correlations existed between glutamine and FIQ; and a positive correlation existed between glucuronate and FIQ. Our findings provide important information about potential biomarkers, associated different metabolites, and metabolic pathways of FM patients; we think that they will provide new insight into the pathogenesis of the disease and help expand our knowledge.

The aim of this study was to investigate the levels of leptin, growth hormone, insulin-like growth factor-1, and insulin-like growth factor binding protein-3 and their relations with clinical parameters in patients with primary fibromyalgia and healthy controls. Our study was performed on 30 female patients with primary fibromyalgia and 30 healthy controls. The levels of insulin-like growth factor-1 and insulin-like growth factor binding protein-3 were measured by a two-site immunoradiometric assay. The serum level of leptin was measured by the ELISA kit. The serum level of leptin was significantly higher, but the serum levels of insulin-like growth factor-1 were significantly lower in patients with fibromyalgia syndrome than healthy controls (p<0.001). The leptin level was positively correlated with the Visual Analog Scale, Fibromyalgia Impact Questionnaire score, Beck Depression Inventory score, tender point count, age, and duration of disease (p<0.001), but it was negatively correlated with insulin-like growth factor-1 (p<0.001). The insulin-like growth factor-1 level was negatively correlated with age, Visual Analog Scale, Fibromyalgia Impact Questionnaire and Beck Depression Inventory scores, duration of disease, and tender point count (p<0.001). Our results indicate that high levels of serum leptin and low levels of serum insulin-like growth factor-1 may play a role in the physiopathogenesis of fibromyalgia and may be related to some symptoms.