Originalien Z Rheumatol 2014 DOI 10.1007/s00393-013-1330-7 © Springer-Verlag Berlin Heidelberg 2014
S. Haliloğlu1 · A. Carlioglu2 · E. Sahiner3 · Y. Karaaslan4 · A. Kosar5 1 Department of Physical Medicine and Rehabilitation, Erzurum
Regional Research and Training Hospital, Erzurum 2 Department of Endocrinology, Erzurum Regional Research and Training Hospital, Erzurum 3 Department of Internal Medicine, Faculty of Medicine, Fatih University, Ankara 4 Department of Rheumatology, Ankara Numune Research and Training Hospital, Ankara 5 Department of Hematology, Faculty of Medicine, Fatih University, Ankara
Mean platelet volume in patients with fibromyalgia Introduction Fibromyalgia (FM) is a syndrome characterised by chronic widespread pain (in any bodily region, including the visceral organs) at multiple tender points, as well as joint stiffness and systemic symptoms (e.g. mood disorders, fatigue, cognitive dysfunction, insomnia, psychological distress and impaired function, including sexual dysfunction) [1, 2, 3, 4]. The American College of Rheumatology (ACR) committee gave an account of the widely used diagnostic criteria for FM in 1990 [5]. More recently, the ACR proposed a new set of such criteria, which include fatigue, waking unrefreshed, cognitive symptoms and somatic (physical) symptoms [6, 7]. The prevalence of FM has been estimated as being approximately 2.9–4.7% [8, 9].
»
Diagnostic criteria for fibromyalgia include fatigue, waking unrefreshed, cognitive symptoms and somatic (physical) symptoms The aetiology and pathogenesis of FM still remain unclear, although many contributory factors, such as dysfunction of the central and autonomic nervous systems, neurotransmitters, hormones and the immune system, as well as deterioration of muscle microcirculation, decrease of pressure pain threshold, genetic susceptibility,
external stressors and psychiatric aspects, among others, have been suggested. The relationship between FM and sleep disturbance, depression and stress is well known [1, 2, 3, 4]. Furthermore, some studies have pointed to a relationship between cardiac disease and chronic sleep deprivation and depression [10, 11]. The presence of these common features between FM and cardiovascular risk factors led to the question whether there is a relationship between FM and cardiovascular disease and/or atherosclerosis. Mean platelet volume (MPV) has become a conspicuous and useful parameter because of its relationship with atherosclerosis [12, 13]. MPV, an accurate measure of platelet size, is considered a marker and determinant of platelet function [14]. Larger platelets with higher MPV values are haemostatically more reactive and produce higher amounts of the prothrombotic factor thromboxane A2, increasing propensity to thrombosis [15]. MPV has been reported to be increased in patients with coronary heart disease, diabetes, atherosclerosis, hypertension, hypercholesterolaemia, smoking, renal artery stenosis, polycystic ovary syndrome and subclinical hypothyroidism, obesity, cerebrovascular disease, venous thromboembolism and several chronic inflammatory disorders (systemic lupus erythematosus, inflammatory bowel disease, rheumatoid arthritis, ankylosing spondyloarthritis, familial Mediterranean fever and Behçet’s disease) [12, 14, 16, 17, 18]. Fur-
thermore, increased MPV is associated with increased risk of myocardial infarction (MI), independent of known cardiovascular risk factors [13].
»
Mean platelet volume is a marker of inflammation and thrombosis On the basis of this background, it can be considered that MPV might be affected by inflammation and number of platelets, and, consequently, infectious disease. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are inflammatory markers, and white blood cell count (WBC) is also increased in infectious disease. We examined the role of MPV, as well as atherosclerosis, in FM pathogenesis; this study is the first to investigate the relationship between MPV values and FM.
Subjects and methods The study group consisted of 283 FM patients (mean age 42.5±10.7 years) attending the outpatient Rheumatology Clinic, Faculty of Medicine, Fatih University, Ankara, Turkey, and the control group comprised 72 healthy individuals (mean age 39.5±12 years), attending the Family Practice outpatient clinic for checkups. Any patient known to have chronic inflammatory disorders, hypertension, hypercholesterolaemia or diabetes, using anZeitschrift für Rheumatologie 2014
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Originalien
Discussion
Tab. 1 Laboratory parameters of the study population WBC (×103/l) ESR (mm/h) CRP (mg/l) PLT (×103/l) MPV (fl)
Control 6.73±1.92 15.48±11.34 5.73±5.26 263.17±60.78 7.72±0.66
Fibromyalgia 6.93±1.87 16.12±10.36 5.18±4.76 271.64±78.41 8.08±0.84
p value >0.05 >0.05 >0.05 >0.05
S. Haliloğlu1 · A. Carlioglu2 · E. Sahiner3 · Y. Karaaslan4 · A. Kosar5 1 Department of Physical Medicine and Rehabilitation, Erzurum
Regional Research and Training Hospital, Erzurum 2 Department of Endocrinology, Erzurum Regional Research and Training Hospital, Erzurum 3 Department of Internal Medicine, Faculty of Medicine, Fatih University, Ankara 4 Department of Rheumatology, Ankara Numune Research and Training Hospital, Ankara 5 Department of Hematology, Faculty of Medicine, Fatih University, Ankara
Mean platelet volume in patients with fibromyalgia Introduction Fibromyalgia (FM) is a syndrome characterised by chronic widespread pain (in any bodily region, including the visceral organs) at multiple tender points, as well as joint stiffness and systemic symptoms (e.g. mood disorders, fatigue, cognitive dysfunction, insomnia, psychological distress and impaired function, including sexual dysfunction) [1, 2, 3, 4]. The American College of Rheumatology (ACR) committee gave an account of the widely used diagnostic criteria for FM in 1990 [5]. More recently, the ACR proposed a new set of such criteria, which include fatigue, waking unrefreshed, cognitive symptoms and somatic (physical) symptoms [6, 7]. The prevalence of FM has been estimated as being approximately 2.9–4.7% [8, 9].
»
Diagnostic criteria for fibromyalgia include fatigue, waking unrefreshed, cognitive symptoms and somatic (physical) symptoms The aetiology and pathogenesis of FM still remain unclear, although many contributory factors, such as dysfunction of the central and autonomic nervous systems, neurotransmitters, hormones and the immune system, as well as deterioration of muscle microcirculation, decrease of pressure pain threshold, genetic susceptibility,
external stressors and psychiatric aspects, among others, have been suggested. The relationship between FM and sleep disturbance, depression and stress is well known [1, 2, 3, 4]. Furthermore, some studies have pointed to a relationship between cardiac disease and chronic sleep deprivation and depression [10, 11]. The presence of these common features between FM and cardiovascular risk factors led to the question whether there is a relationship between FM and cardiovascular disease and/or atherosclerosis. Mean platelet volume (MPV) has become a conspicuous and useful parameter because of its relationship with atherosclerosis [12, 13]. MPV, an accurate measure of platelet size, is considered a marker and determinant of platelet function [14]. Larger platelets with higher MPV values are haemostatically more reactive and produce higher amounts of the prothrombotic factor thromboxane A2, increasing propensity to thrombosis [15]. MPV has been reported to be increased in patients with coronary heart disease, diabetes, atherosclerosis, hypertension, hypercholesterolaemia, smoking, renal artery stenosis, polycystic ovary syndrome and subclinical hypothyroidism, obesity, cerebrovascular disease, venous thromboembolism and several chronic inflammatory disorders (systemic lupus erythematosus, inflammatory bowel disease, rheumatoid arthritis, ankylosing spondyloarthritis, familial Mediterranean fever and Behçet’s disease) [12, 14, 16, 17, 18]. Fur-
thermore, increased MPV is associated with increased risk of myocardial infarction (MI), independent of known cardiovascular risk factors [13].
»
Mean platelet volume is a marker of inflammation and thrombosis On the basis of this background, it can be considered that MPV might be affected by inflammation and number of platelets, and, consequently, infectious disease. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are inflammatory markers, and white blood cell count (WBC) is also increased in infectious disease. We examined the role of MPV, as well as atherosclerosis, in FM pathogenesis; this study is the first to investigate the relationship between MPV values and FM.
Subjects and methods The study group consisted of 283 FM patients (mean age 42.5±10.7 years) attending the outpatient Rheumatology Clinic, Faculty of Medicine, Fatih University, Ankara, Turkey, and the control group comprised 72 healthy individuals (mean age 39.5±12 years), attending the Family Practice outpatient clinic for checkups. Any patient known to have chronic inflammatory disorders, hypertension, hypercholesterolaemia or diabetes, using anZeitschrift für Rheumatologie 2014
| 1
Originalien
Discussion
Tab. 1 Laboratory parameters of the study population WBC (×103/l) ESR (mm/h) CRP (mg/l) PLT (×103/l) MPV (fl)
Control 6.73±1.92 15.48±11.34 5.73±5.26 263.17±60.78 7.72±0.66
Fibromyalgia 6.93±1.87 16.12±10.36 5.18±4.76 271.64±78.41 8.08±0.84
p value >0.05 >0.05 >0.05 >0.05
