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. 2021 Nov 19;100(46):e27803.
doi: 10.1097/MD.0000000000027803.

Glucose tolerance in fibromyalgia

Teemu Zetterman  1   2 , Ritva Markkula  1 , Eija Kalso  1   3
Affiliations

Glucose tolerance in fibromyalgia

Teemu Zetterman et al. Medicine (Baltimore). .

Abstract

Objectives: Fibromyalgia (FM) patients have an increased risk for glucose metabolism disturbances, and impaired glucose tolerance may be associated with symptom severity. Elevated levels of plasma lactate have been detected in FM patients. Both pyruvate and lactate are produced in glucose metabolism and reflect oxidative metabolism. The objective of our study was to analyse disturbances in glucose, pyruvate, or lactate metabolism in FM patients.

Methods: We measured plasma levels of glucose, pyruvate, and lactate during an oral glucose tolerance test in 40 non-diabetic, female FM patients and 30 age- and gender-matched healthy controls.

Results: FM patients showed a higher glycaemic response to the glucose load at 1 hour (F [1,68] = 10.4, P = .006) and 2 hours (F [1,68] = 7.80, P = .02), and higher glucose area under the curve (13.8 [SD 2.92] vs 11.6 [SD 2.31], P < .01), than healthy controls. Group differences were explained by higher body mass index and percentage of smokers among the FM patients. Pyruvate and lactate levels were similar in both groups.

Discussion: Impaired glucose regulation in FM patients is likely not due to FM itself, but to associated lifestyle factors. Our results highlight the importance of assessing the glucose regulation status and the lifestyle factors affecting glucose regulation in FM patients for prevention or early treatment of diabetes and associated complications.

Trial registration: ClinicalTrials.gov (NCT03300635).

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Conflict of interest statement

The other authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Blood glucose (mmol/L), pyruvate (μmol/L), and lactate (mmol/L) levels for fibromyalgia patients (red) and healthy controls at baseline and 1 h and 2 h after an oral glucose test. ∗∗significant group difference P < .01 (Tukey's HSD).
Figure 2
Figure 2
Blood glucose area under the curve (AUC, mmol × h/L) values of the fibromyalgia patients by lifestyle factors. ∗significant at P < .05 (Student t-test).
Figure 3
Figure 3
Venn diagram of the evaluated lifestyle factors among the fibromyalgia patients (total with complete data n = 36).
Figure 4
Figure 4
Visualization of the effect of overweight and smoking on blood glucose levels and area under the curve for the fibromyalgia patients and controls. Significant differences at ∗P < .05 and ∗∗P < .01 (Tukey's HSD).
See this image and copyright information in PMC

References

    1. Wolfe F, Smythe HA, Yunus MB, et al. . The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 1990;33:160–72. - PubMed
    1. Wolfe F, Clauw DJ, Fitzcharles MA, et al. . 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum 2016;46:319–29. - PubMed
    1. Markkula RA, Kalso EA, Kaprio JA. Predictors of fibromyalgia: a population-based twin cohort study. BMC Musculoskelet Disord 2016;17:01–11. - PMC - PubMed
    1. Tishler M, Smorodin T, Vazina-Amit M, Ramot Y, Koffler M, Fishel B. Fibromyalgia in diabetes mellitus. Rheumatol Int 2003;23:171–3. - PubMed
    1. Loevinger BL, Muller D, Alonso C, Coe CL. Metabolic syndrome in women with chronic pain. Metabolism 2007;56:87–93. - PubMed

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