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. 2025 Feb 1;26(1):97.
doi: 10.1186/s12891-025-08337-0.

Serum choline, leptin and interleukin-6 levels in fibromyalgia syndrome-induced pain: a case-control study

Elif Baris  1 , Izel Topaloglu  2 , Elif Akalin  2 , Emre Hamurtekin  3 , Seray Kabaran  4 , Ayse Gelal  5 , Reyhan Ucku  6 , Mualla Aylin Arici  7
Affiliations

Serum choline, leptin and interleukin-6 levels in fibromyalgia syndrome-induced pain: a case-control study

Elif Baris et al. BMC Musculoskelet Disord. .

Abstract

Background: Fibromyalgia Syndrome (FMS) predominantly affects middle-aged women, characterized by musculoskeletal pain, fatigue, and cognitive issues. Choline, an endogenous molecule, may influence FMS due to its analgesic and anti-inflammatory properties. This study compared choline, leptin, and interleukin-6 (IL-6) levels in FMS patients and controls and examining their association with pain severity.

Methods: Volunteers with FMS were clinically diagnosed at a Physical Medicine and Rehabilitation Department. The control group included pain-free volunteers. Pain severity was gauged using a numeric scale, dietary choline intake through a questionnaire. Serum choline, leptin and (interleukin)IL-6 levels were measured from fasting blood samples of volunteers with enzyme-linked immunosorbent assays (ELISA).

Results: All FMS patients (n = 38) and healthy volunteers (n = 38) were female. Pain score in patients with FMS was 7.6 ± 0.2. Dietary choline intake was lower in patients with FMS than the controls (p = 0.036). Serum choline and leptin levels were lower in the FMS group compared to control (p = 0.03). Serum IL-6 levels were higher in the FMS group than in the control (p < 0.001). There was weak positive correlation between IL-6 levels and pain scores and there were no correlation between leptin levels and pain scores in FMS.

Conclusions: This research highlights FMS's complex nature, involving neurochemical, immunological, and nutritional factors. It suggests the significance of choline's anti-inflammatory effect, leptin's metabolic function, and IL-6's role in FMS pathology. The results suggest that reduced dietary choline might influence serum choline, leptin, and IL-6 levels, potentially impacting FMS-related pain. This points to the potential of supplementary choline intake in FMS management.

Trial registration: Not applicable (Non-interventional study).

Keywords: Choline; Fibromyalgia; Inflammation; Interleukin-6; Leptin; Nutrition; Pain.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This case–control study was approved by Clinical Research Ethics Committee of Dokuz Eylul University (No:469-SBKAEK) and carried out within the framework of the Declaration of Helsinki, Good Clinical Practices Guideline and relevant legislation provisions. Patients over the age of 18, diagnosed with FMS by a Physical Medicine and Rehabilitation specialist, and who gave written consent to participate, were included in the study as the case group. Volunteers of similar age and gender, who did not have pain in the last 6 months and were not diagnosed with FMS, gave written consent to participate and were included in the study as the control group. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Serum total choline, leptin and IL-6 levels of groups. Shown are serum total choline (A), leptin (B) and IL-6 (C) levels in control and FMS groups. The mean and standard deviation (SD) are shown in the figures. Mann Whitney U test used for comparison of two groups. *: p = 0.002, **: p = 0.034, ***: p < 0.001 vs control. FMS: Fibromyalgia Syndrome; IL-6: Interleukin 6
Fig. 2
Fig. 2
Dietary choline intake of groups. Shown are dietary choline intake in control and FMS groups within a month. The mean and standard deviation (SD) are shown in the figures. Student’s t test used for comparison of two groups. *: p = 0.036 vs control. FMS: Fibromyalgia Syndrome
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