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. 2022 Jun 25;6(2):rkac053.
doi: 10.1093/rap/rkac053. eCollection 2022.

Elevated highly sensitive C-reactive protein in fibromyalgia associates with symptom severity

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

Elevated highly sensitive C-reactive protein in fibromyalgia associates with symptom severity

Teemu Zetterman et al. Rheumatol Adv Pract. .

Abstract

Objectives: Fibromyalgia (FM), a common pain syndrome, is thought to be a non-inflammatory, nociplastic condition, but evidence implicating neuroinflammation has been increasing. Systemic inflammation may be associated with more severe symptoms in some FM patients. We studied healthy controls and FM patients with and without systemic inflammation detectable using high-sensitivity CRP (hsCRP) measurement.

Methods: We measured hsCRP levels and gathered clinical and questionnaire data [including the Fibromyalgia Impact Questionnaire (FIQ)] from 40 female FM patients and 30 age-matched healthy women. An hsCRP level >3 mg/l was considered elevated.

Results: FM patients had significantly higher mean hsCRP levels than controls, explained by overweight and lower leisure-time physical activity. Eight FM patients had elevated hsCRP levels and 29 had normal hsCRP levels. Levels of hsCRP were significantly correlated with FIQ scores. Patients with elevated hsCRP had higher FIQ scores, with worse physical functioning and greater pain and were less likely to be employed than patients with normal hsCRP. These patient groups did not differ by blood count, liver function or lipid profiles, nor by education, psychological measures, sleep disturbance, smoking or comorbidities.

Conclusion: Some FM patients have elevated hsCRP, mostly due to overweight and physical inactivity. They have worse symptoms and their ability to work is impaired. Measurement of hsCRP may help to identify FM patients in greatest need of interventions supporting working ability.

Trial registration: ClinicalTrials.gov (https://clinicaltrials.gov), NCT03300635.

Keywords: CRP; FM; chronic pain; hsCRP; inflammation; widespread pain.

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Figures

<sc>Fig</sc>. 1
Fig. 1
Relationship between BMI and hsCRP Regression lines are for linear regression between hsCRP and BMI for both FM patients and controls. Outliers not included in the regression are shown for completeness. con: control.
<sc>Fig</sc>. 2
Fig. 2
Relationship between hsCRP and symptom severity as measured by the FIQ score Regression line is for linear regression between hsCRP and FIQ. Outliers not included in the regression are shown for completeness.
See this image and copyright information in PMC

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