AB0944 Vitamin D Deficiency Might Contribute Fatigue and Disease Activity in Patients with Fibromyalgia

• Published in: Annals of the rheumatic diseases Vol. 74; no. Suppl 2; p. 1215
• Main Authors: Solmaz, D., Avci, O., Yalcin, B.C., Kara, S.P., Oran, M.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2015
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2015-eular.2472

BackgroundFibromyalgia syndrome (FMS) is a chronic musculoskeletal system disease characterized by widespread pain and allodynia in at least 11/18 anatomic regions. Other important symptoms are fatigue, sleep disturbance and cognitive impairment. Widespread pain and fatigue can also be seen in patients with vitamin D deficiency. The association between low levels of 25-hydroxy (OH) vitamin D and non-specific musculoskeletal pain, including fibromyalgia syndrome, is controversial.ObjectivesThe aim of this study is to assess fatigue and health quality in patients with isolated FMS, isolated vitamin D deficiency and FMS in together with vitamin D deficiency.MethodsPatients followed by rheumatology clinic and classified as FMS according to ACR 2010 criteria were included in this study. 25- OH vitamin D levels below 20 ng/ml were accepted as vitamin D deficiency. Study groups classified as first group; patient with isolated FMS, second group; isolated vitamin D deficiency and third group was FMS in together with vitamin D deficiency. Patients with known calcium abnormality, hyperparathyroidism and osteomalacia were excluded. Fatigue level was measured by the visual analog scale (VAS) and functional assessments were determined by using BASFI and HAQ. Routine laboratory data were recorded. Widespread Pain Index (WPI); by evaluation of 0-19 tender points and Symptom Severity Score (SS); by the sum of fatigue, sleep, cognitive disturbances with general somatic symptoms were obtained.ResultsPatients distribution according to groups and properties were summarized in the table. As expected, in all groups, the majority of patients were female. While fatigue levels were similar between isolated vitamin D deficiency group and isolated FMS group, in FMS together with vitamin D deficiency group fatigue level was measured higher than the other two groups. Moderate and negative correlation was detected between fatigue level and vitamin D level (r:- 413, p:0,002). Negative relation was also detected between widespread pain index and symptom severity score with vitamin D level (r: -0.325, p: 0.023; r: -0.315, p: 0.037 respectively). HAQ and BASFI scores were higher with D vitamin deficiency between FMS patients (respectively p: 0.018, p<0.001).Group 1:Group 2:Group 3:Isolated vitamin D deficiency (n=37)Isolated FMS (n=21)FMS and vitamin D deficiency (n=43)Age, mean ± SD49±13.045±6.647±9.9Gender, female %32, 86.521, 10043, 100ESR mm/h; mean ± SD15±8.819±10.518±9.5CRP mg/L; mean ± SD2.3±2.43.9±3.14.1±1.825-Hydroxy vitamin D, ng/ml; mean ± SD11.6±5.334.6±12.011.3±4.7Ca mg/dl; mean ± SD9.7±0.39.6±0.29.6±0.3P mg/dl; mean ± SD3.3±0.43.4±0.53.6±1.1PTH pg/ml; mean ± SD54±20.052±9.952±25.1ALP IU/L ; mean ± SD74±21.269±19.283±24.5BASFI; mean ± SD2.0±0.92.6±1.54.5±1.8*HAQ; mean ± SD0.6±0.90.8±0.41.2±0.3*VAS fatigue; mean ± SD54±2259±1076±15*WPI score; mean ± SDN/A10±1.512±2.1SS score; mean ± SDN/A6±1.28±1.5ConclusionsVitamin D deficiency may contribute disease severity, fatigue and disturbances in health quality in FMS patients. Based on this, in FMS screening the level of vitamin D and correction may be helpful in symptom control.Disclosure of InterestNone declared