THU0476 NEW PARADIGMS IN FIBROMYALGIA RESEARCH: INFLAMMATORY CELLS-TO-LIPOPROTEINS RATIOS AS PREDICTIVE AND DISCRIMINATOR MARKERS
Authors: Marwan Alnimer, Talar Merza, Avin Maroof
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Fibromyalgia (FM) is a chronic idiopathic disease characterized by diffuse pain, fatigue, sleep disturbances, stiffness, anxiety and depression. Compared to healthy subjects. FM patients have significant high ratios of mean platelet volume, Neutrophil-to-lymphocyte, and platelet to lymphocyte. Fibromyalgia showed a significant abnormal lipid profile characterized by higher levels of fasting serum triglyceride and cholesterol. <h3>Objectives</h3> This study aimed to derive ratios from the circulating inflammatory cells and serum lipoprotein levels as markers of disease-severity in newly diagnosed fibromyalgia. <h3>Methods</h3> We carried out a cross-sectional study with 90 newly-diagnosed fibromyalgia patients and 25 aged-matched healthy subjects to determine the haematological indices and serum lipoprotein profile. Revised fibromyalgia impact questionnaire (FIQR), Tender points (TPs), fatigue severity scale, insomnia severity index, and the Hamilton's scale for depression were used to assess the disease severity. <h3>Results</h3> Monocyte- to- high density lipoprotein ratio (MHDR) correlated significantly and inversely with tender points and FIQR scores while lymphocyte- to- high density lipoprotein ratio(LNHDLR) and lymphocyte-to-apolipoprotein-B100 (LAPOR)ratio correlated significantly and directly with FIQR. None of the circulating inflammatory cells-to-lipoprotein ratios correlated with fatigue, insomnia, and depression-related symptoms. Multi-variable regression analysis revealed a significant mean score of FIQR-symptoms equal to 63.2 with prediction of 11.9% (R=0.346, F=5.903, p=0.004, β-coefficients for MHDLR=-0.257, and for LNHDLR=3.789). The area under the curve and 95% confidence intervals of LNHDL is 0.658 (0.545-0.771) at the cut-off score of the FIQ3-related symptoms at 63.2. <h3>Conclusion</h3> Circulating inflammatory cell-to-lipoprotein ratios can serve as prognostic markers in the assessment of disease-severity in fibromyalgia patients. <h3>References</h3> [1] Al-Nimer MSM, Mohammad TAM. Correlation of haematological indices and ratios derived from them with FIQR scores in fibromyalgia. Pak J Med Sci. 2018;34(5):1219-1224. [2] Aktürk S, Büyükavcı R Evaluation of blood neutrophil-lymphocyte ratio and platelet distribution width as inflammatory markers in patients with fibromyalgia. Clin Rheumatol. 2017;36(8):1885-1889. [3] Cordero MD, Alcocer-Gómez E, Cano-García FJ, Sánchez-Domínguez B, Fernández-Riejo P, Moreno Fernández AM, Fernández-Rodríguez A, De Miguel M. Clinical symptoms in fibromyalgia are associated to overweight and lipid profile. Rheumatol Int. 2014;34(3):419-422. [4] 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;62(5):600-610. [5] 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;33(3):391-396. <h3>Disclosure of Interests</h3> None declared