THU0465 SERUM LEVEL OF ADRENOCORTICOTROPHIC HORMONE IS A CONTRIBUTING HORMONE OF METABOLIC SYNDROME IN NEWLY DIAGNOSED FIBROMYALGIA
Authors: T. Merza Mohammad, M. Alnimer
Journal: Annals of the Rheumatic Diseases (2020)

Background: Evidence of components of metabolic syndrome including. Obesity dyslipidemia, abnormal glucose tolerance rate and hypertension are associated with fibromyalgia. Adrenocorticotrophic hormone (ACTH) is reported to be significantly higher in fibromyalgia patients, and it causes obesity, high blood pressure. Objectives: This study aimed to assess the serum level of ACTH as a contributing as well as a discriminator hormone in newly diagnosed fibromyalgia women presented with variable components of metabolic syndrome. Methods: This cross-sectional study comprised 100 women with newly diagnosis fibromyalgia and 30 apparent healthy women served as control from Kurdistan region-Iraq. Clinical data including the score of fibromyalgia impact questionnaire-revised (FIQR), tender point, body mass index, waist circumference, blood pressure and fasting serum levels of glucose and lipid profile, and ACTH level. The score of metabolic syndrome was calculated using the formula: Results: Compared to the controls, the Fibromyalgia women displayed significantly higher values of waist circumference (88.9 ± 5.7cm versus 87.1 ± 2.7cm, p=0.019), systolic blood pressure (136.1 ±13.5mmHg versus 131.4 ± 7.1, p=0.014), metabolic syndrome score (3.10 ±0.25 versus 3.03±0.19, p=0.039), and serum ACTH levels (16.66 ± 3.23pg/ml versus 14.42 ± 2.18pg/ml. p&lt;0.001). Serum ACTH levels significantly and inversely correlated with the total score of the FIQR (r = - 0.320. p=0.001) and number of tender points (r= - 0.374, p&lt;0.001). Metabolic syndrome score is significantly and inversely correlated with the total FIQR score (r = - 0.296, p=0.003). Multivariable regression analysis using showed that serum level of ACTH is a significant (p= predictor of 19.7% of fibromyalgia patients (Figure 1), and it is a significant (p=0.007) discriminator of tender points as the area under the curve is 0.325( 95% C.I.: 0.212-0.438) (Figure 2). Figure 1. Multivariable regression analysis with posthoc ANOVA test showed significant correlations between serum level adrenocorticotrophic hormone as a dependent variable with the score s of fibromyalgia impact questionnaire and metabolic syndrome, and the number of tender points. R=0.443, F=7.777, P&lt;0.001, prediction 19.7%), Figure 2. serum level of ACTH (cutoff level ≥14.5pg/ml, sensitivity=72%, specificity=50%) as a discriminator of the tender points (AUC 95% C.I : 0.325[0.212-0.438], p=0.007), score of fibromyalgia symptoms (AUC 95% C.I : 0.474[0.313-0.581], p=0.409), and metabolic syndrome score (AUC 95% C.I : 0.546[0.423-0.668], p=0.480) Conclusion: Fibromyalgia women responded to the stress of pain by increasing the serum level of ACTH which effectively improves the clinical feature of fibromyalgia symptoms, but at the same time elevates the score of metabolic syndrome. Therefore, assessment of serum level of ACTH can serve as a predictor and discriminator of fibromyalgia comorbidity. References: [1]Acosta-Manzano P, Segura-Jiménez V, Estévez-López F, Álvarez-Gallardo IC, Soriano-Maldonado A, Borges-Cosic M, Gavilán-Carrera B, Delgado-Fernández M, Aparicio VA. Do women with fibromyalgia present higher cardiovascular disease risk profile than healthy women? The al-Ándalus project. Clin Exp Rheumatol. 2017; 35 Suppl 105(3):61-67. [2]Marwan S.M. Al-Nimer, Talar A.M. Mohammad, Avin M.A. Maroof. Dysfunction of anterior pituitary gland in women patients with recent fibromyalgia: A cross-sectional observational study. Electron J Gen Med 2018;15(4):em58 [3]Soldatovic I, Vukovic R, Culafic D, Gajic M, Dimitrijevic-Sreckovic V. siMS score: simple method for quantifying metabolic syndrome. PLoS One. 2016; 11(1):e0146143 Disclosure of Interests: : None declared