ORIGINAL ARTICLE
Dysfunction of anterior pituitary gland in women patients with recent fibromyalgia: A cross-sectional observational study
 
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1
Al-Mustansiriya University, College of Medicine, Baghdad, Iraq
2
Hawler Medical University, College of Pharmacy, Erbil, Iraq
3
Department of Pharmacology and toxicology, Clinical Pharmacy Hawler Medical University, Erbil, Iraq
4
Senior Specialist in Rheumatology, Rizagary Teaching Hospital, Erbil, Iraq
Online publish date: 2018-05-11
Publish date: 2018-05-11
 
Electron J Gen Med 2018;15(4):em58
KEYWORDS:
TOPICS:
ABSTRACT:
Objective:
To assess the basal levels of circulating anterior pituitary gland hormones in women presented with a recent diagnosis of fibromyalgia (FM).

Methods:
This cross-sectional study was included 130 women presented with a clinical signs and symptoms of FM women and 35 age-matched healthy subjects served as controls. The plasma levels of growth hormone (GH) and adrenocorticotrophic hormone (ACTH), and the serum levels of prolactin (PRL) and thyroid stimulating hormone (TSH) were measured. The scores of the Revised Fibromyalgia Impact Questionnaire (FIQR), the number of tender points (TPs), Fatigue Severity Scale (FSS), Insomnia Severity Index (ISI), and the Hamilton’s scale for depression (HSD) were measured.

Results:
Significantly higher levels of PRL, TSH, and ACTH and lower levels of GH were observed in FM patients. The ACTH level was inversely and significantly correlated with the number of the TPs (r =-0.173, R2= 0.31, F=4.110, p=0.045). The positive predictive values of GH, THS, PRL and ACTH were 92.3, 63.8, 90.8, and 86.1%, respectively.

Conclusions:
Our results indicate that dysfunction of the anterior pituitary gland is a feature of FM.

 
REFERENCES (32):
1. Ohara N, Katada S, Yamada T, Mezaki N, Suzuki H, Suzuki A, et al. Fibromyalgia in a patient with cushing’s disease accompanied by central hypothyroidism. Intern Med. 2016;55(21):3185-90. PubMed PMID: 27803417. https://doi.org/10.2169/intern....
2. Schertzinger M, Wesson-Sides K, Parkitny L, Younger J. Daily fluctuations of progesterone and testosterone are associated with fibromyalgia pain severity. J Pain. 2017 Dec 14. pii: S1526-5900(17)30804-0, PubMed PMID: 29248511. https://doi.org/10.1016/j.jpai....
3. Doerr JM, Fischer S, Nater UM, Strahler J. Influence of stress systems and physical activity on different dimensions of fatigue in female fibromyalgia patients. J Psychosom Res. 2017 Feb;93:55-61. PubMed PMID: 28107893. https://doi.org/10.1016/j.jpsy....
4. Eller-Smith OC, Nicol AL, Christianson JA. Potential mechanisms underlying centralized pain and emerging therapeutic interventions. Front Cell Neurosci. 2018 Feb 13;12:35. eCollection 2018. Pubmed PMID: 29487504. https://doi.org/10.3389/fncel.....
5. Vincent A, Lahr BD, Wolfe F, Clauw DJ, Whipple MO, Oh TH, et al. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken). 2013 May;65(5):786-92. Pubmed PMID: 23203795. https://doi.org/10.1002/acr.21....
6. Nickel JC, Tripp DA, Pontari M, Moldwin R, Mayer R, Carr LK, et al. Psychosocial phenotyping in women with interstitial cystitis/painful bladder syndrome: a case control study. J Urol. 2010 Jan;183(1):167-72. PMID: 19913812. https://doi.org/10.1016/j.juro....
7. Bullones Rodríguez MÁ, Afari N, Buchwald DS; National Institute of Diabetes and Digestive and Kidney Diseases Working Group on Urological Chronic Pelvic Pain. Evidence for overlap between urological and nonurological unexplained clinical conditions. J Urol. 2013 Jan;189(1 Suppl):66-74. PMID: 23234637. https://doi.org/10.1016/j.juro....
8. Genc A, Tur BS, Aytur YK, Oztuna D, Erdogan MF.‏ Does aerobic exercise affect the hypothalamic-pituitary-adrenal hormonal response in patients with fibromyalgia syndrome? J Phys Ther Sci 2015 Jul; 27(7):2225-31. PubMed PMID: 26311959. https://doi.org/10.1589/jpts.2....
9. Aschbacher K, Adam EK, Crofford LJ, Kemeny ME, Demitrack MA, Ben-Zvi A. Linking disease symptoms and subtypes with personalized systems-based phenotypes: a proof of concept study. Brain Behav Immun 2012 Oct;26(7):1047-56. PubMed PMID: 22687333. https://doi.org/10.1016/j.bbi.....
10. Lesuis N, van Vliet J, Boers N den Broeder N, Cats H, Hulscher ME, et al. The value of routine creatine kinase and thyroid stimulating hormone testing in patients with suspected fibromyalgia: a cross-sectional study. Rheumatology 2016 Jul;(Oxford)55(7):1273-76. PubMed PMID: 27032423. https://doi.org/10.1093/rheuma....
11. Nishioka K, Uchida T, Usui C , Tanaka R, Matsushima T, Matsumoto Y, et al. High prevalence of anti-TSH receptor antibody in fibromyalgia syndrome. Int J Rheum Dis 2017 Jun;20(6):685-90. PubMed PMID: 27905199. https://doi.org/10.1111/1756-1....
12. Haliloglu S, Ekinci B, Uzkeser H Sevimli H, Carlioglu A, Macit PM. Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity. Clin Rheumatol 2017 Jul; 36(7):1617-21. PubMed PMID: 28176037. https://doi.org/10.1007/s10067....
13. Gürsel Y, Ergin S, Ulus Y, Erdoğan MF, Yalçin P, Evcik D. Hormonal responses to exercise stress test in patients with fibromyalgia syndrome. Clin Rheumatol 2001;20(6):401-5. PubMed PMID: 11771522.
  Pubmed
14. Mannerkorpi K, Landin-Wilhelmsen K, Larsson A Cider Å, Arodell O, Bjersing JL. Acute effects of physical exercise on the serum insulin-like growth factor system in women with fibromyalgia. BMC Musculoskelet Disord 2007 Jan;18(1):37. PubMed PMID: 28122522. https://doi.org/10.1186/s12891....
15. Reuter E, Tafelski S, Thieme K, West C, Haase U, Beck L, et al. Treatment of fibromyalgia syndrome with gamma-hydroxybutyrate: A randomized controlled study. Schmerz. 2017 Apr;31(2):149-58. PubMed PMID: 28122522. https://doi.org/10.1007/s00482....
16. Weaver SA, Janal MN, Aktan N, Ottenweller JE, Natelson BH. Sex differences in plasma prolactin response to tryptophan in chronic fatigue syndrome patients with and without comorbid fibromyalgia. J Womens Health (Larchmt). 2010 May;19(5):951-8. PubMed PMID:20384451. https://doi.org/10.1089/jwh.20....
17. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL et al The American college of rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis Rheum 1990 Feb;33(2):160–72. PubMed PMID: 2306288.
  Pubmed
18. Wolfe F, Clauw DJ, Fitzcharles M, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res 2010 May;62(5):600–10. PubMed PMID: 20461783. https://doi.org/10.1002/acr.20....
19. Abu-Dahab S, AbuRuz SM, Mustafa K, Sarhan Y. Validation of the Arabic version of the revised Fibromyalgia Impact Questionnaire (FIQR_A) on Jordanian females with fibromyalgia. Clin Rheumatol 2014 Mar;33(3):391-6. PubMed PMID: 23900578. https://doi.org/10.1007/s10067....
20. Bennett RM, Friend R, Jones KD, Han BK, Ross RL. The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties. Arthritis Res Ther 2009;11(4):R120. PubMed PMID: 19664287. https://doi.org/10.1186/ar2783.
21. Morin CM, Belleville G, Belanger L, Ivers H. The Insomnia Severity Index: psychometric indicators to determine insomnia cases and evaluate treatment response. Sleep 2011 May;34(5):601-8. PubMed PMID: 21532953.
  Pubmed
22. Kim J, Cho SJ, Kim WJ Yang KI, Yun CH, Chu MK. Insomnia in tension-type headache: a population-based study. J Headache Pain 2017 Sep 12;18(1):95. Ther 2009;11(4):R120. PubMed PMID: 28900887. https://doi.org/10.1186/s10194....
23. Sajatovic M, Chen P, Young RC. Rating scale in bipolar disorder. In:Clinical trial design challenges in mood disorders, Mauricio Tohen, Charles Bowden, Andrew A. Nierenberg and John Geddes (eds), Elseiver Inc, USA, 2015, p.105-36.
24. Learmonth YC, Dlugonski D, Pilutti LA, Sandroff BM, Klaren R, Motl RW. Psychometric properties of the fatigue severity scale and the modified fatigue impact scale. J Neurol Sci 2013 Aug 15;331(1-2):102-7. PubMed PMID: 23791482. https://doi.org/10.1016/j.jns.....
25. Maresca T, Covini E, Mato AM. Conditions, controversies and contradictions between central sensitivity syndrome and depressive disorders. Vertex 2013 Se-Oct;24(111):373-91. PubMed PMID: 24312923.
  Pubmed
26. Cuatrecasas G, Alegre C, Fernandez-Solà J Gonzalez MJ, Garcia-Fructuoso F, Poca-Dias V, et al. Growth hormone treatment for sustained pain reduction and improvement in quality of life in severe fibromyalgia. Pain 2012 Jul;153(7):1382-9. PubMed PMID: 20631018. https://doi.org/10.1210/jc.201....
27. Braverman E, Oscar-Berman M, Lohmann R, Kennedy R, Kerner M, Dushaj K, et al. Low and normal IGF-1 levels in patients with chronic medical disorders (CMD) is independent of anterior pituitary hormone deficiencies: Implications for treating IGF-1 abnormal deficiencies with CMD. J Genet Syndr Gene Ther 2013 Feb 9; 4(123). pii: 1000123. PubMed PMID: 23616929. https://doi.org/10.4172/2157-7....
28. Liu TT, Qu ZW, Ren C Gan X, Qiu CY, Hu WP. Prolactin potentiates the activity of acid-sensing ion channels in female rat primary sensory neurons. Neuropharmacology 2016 Apr;103:174-82. PubMed PMID: 26188144. https://doi.org/10.1016/j.neur....
29. Bote ME, García JJ, Hinchado MD, Ortega E. Inflammatory/stress feedback dysregulation in women with fibromyalgia. Neuroimmunomodulation 2012;19(6):343-51. PubMed PMID: 22986514. https://doi.org/10.1159/000341....
30. Cuatrecasas Cambra G. Stress and chronic pain: An endocrine perspective. Rheumatol Clin 2009 Aug;5(Suppl 2):12-4. PubMed PMID: 21794652. https://doi.org/10.1016/j.reum....
31. Doerr JM, Fischer S, Nater UM, Strahler J. Influence of stress systems and physical activity on different dimensions of fatigue in female fibromyalgia patients. J Psychosom Res 2017 Feb;93:55-61. PubMed PMID: 28107893. https://doi.org/10.1016/j.jpsy....
32. Semiz EA, Hizmetli S, Semiz M, Karadağ A, Adalı M, Tuncay MS, et al Serum cortisol and dehydroepiandrosterone-sulfate levels after balneotherapy and physical therapy in patients with fibromyalgia. Saudi Med J 2016 May;37(5):544-50. PubMed PMID: 27146618. https://doi.org/10.15537/smj.2....
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