The effect of ferritin and iron parameters on pain and quality of life in pati̇ents wi̇th fibromyalgia syndrome

ABSTRACT THE EFFECT OF FERRITIN AND IRON PARAMETERS ON PAIN AND QUALITY OF LIFE IN PATİENTS WİTH FIBROMYALGIA SYNDROME Our aim in this study is to examine the effects of ferritin and iron parameters on pain, quality of life and sleep in female patients diagnosed with Fibromyalgia Syndrome (FMS). The study included 87 female patients who applied to Fırat University Faculty of Medicine Hospital Physical Medicine and Rehabilitation and Rheumatology outpatient clinics due to widespread pain lasting more than 3 months and were diagnosed with FMS according to the 2016 ACR FMS diagnostic criteria. Sociodemographic characteristics [age, weight, height, body mass index (BMI), marital status, education level, occupation and smoking] and laboratory parameters of the patients were recorded. Data were obtained from Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), Short Form-36 (SF-36), Fatigue Severity Scale (FSS), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI) and Nottingham Health Profile (NHP) measurement methods. The patients included in the study were divided into 3 groups according to ferritin and iron levels. The mean age of the female patients included in the study was found to be 43.1±10.7 (min: 21-max: 60) years. Ferritin levels were found to be low in 18.4% of the patients (Group 1), both ferritin and iron levels were found to be low in 25.3% (Group 2), and ferritin and iron levels were normal in 56.3% (Group 3). There was no significant difference between the groups in terms of FIQ, VAS, NHP (Part 1), NHP (Part 2), FSS and SF-36 subscale scores (p>0.05). According to HADS, the number of patients with symptoms of depression was 29 (33.3%) and the number of patients with anxiety was 33 (37.9%). There was no significant difference between the groups in terms of the presence of depression and anxiety (p>0.05). The number of patients with poor sleep quality according to PSQI was 52 (59.8%). There was no significant difference between the groups in terms of PSQI (p>0.05). FIQ, HADS depression, HADS anxiety, NHP 1 and NHP 2 scores were found to be significantly higher in patients with poor sleep quality (p<0.05). SF-36 Physical Function, Emotional Role Limitation, Energy-Vitality, Spiritual Well-being and General Health subscale scores were found to be significantly lower in patients with poor sleep quality (p<0.05). A weak negative correlation was found between the age of the patients and the SF-36 Physical Function and Physical Role Limitation score (p<0.05). Ferritin and iron deficiency were quite common in individuals diagnosed with fibromyalgia. Although there was no relationship between iron deficiency and pain, sleep quality, depression, anxiety and quality of life in individuals with ferritin and iron deficiency, deterioration in sleep quality was found to be associated with pain and quality of life in FMS patients. As a result, sleep disturbance, a common symptom in FMS, reduces the quality of life and increases depression and anxiety levels. Key Words: Fibromyalgia, ferritin, iron, pain, quality of life, depression