Stress biomarkers in individuals with fibromyalgia syndrome: a systematic review with meta-analysis

Eva Beiner; VICTORIA LUCAS; Julian Reichert; Diana-Victoria Buhai; Meike Jesinghaus; Stephanie Vock; Armin Drusko; David Baumeister; Wolfgang Eich; Hans-Christoph Friederich; Jonas Tesarz

doi:10.1097/j.pain.0000000000002857

journal article Jan 05, 2023

Stress biomarkers in individuals with fibromyalgia syndrome: a systematic review with meta-analysis

VICTORIA LUCAS Julian Reichert Diana-Victoria Buhai Meike Jesinghaus Stephanie Vock Armin Drusko David Baumeister Wolfgang Eich Hans-Christoph Friederich

Jonas Tesarz

Pain Vol. 164 No. 7 pp. 1416-1427 · Ovid Technologies (Wolters Kluwer Health)

View at Publisher Save 10.1097/j.pain.0000000000002857

Abstract

Abstract
Evidence suggests an involvement of hypothalamic–pituitary–adrenal (HPA) axis dysregulation in the development and maintenance of fibromyalgia syndrome (FMS). However, studies on the stress response via the HPA-axis in individuals with FMS show conflicting results. To better understand the relationship between FMS and HPA-axis dysregulation, we (1) systematically summarized the current level of evidence on HPA biomarkers in individuals with FMS compared with individuals without and (2) evaluated whether FMS is associated with a specific pattern of HPA dysregulation. The main outcome measures were cortisol, adrenocorticotropic hormone (ACTH), corticotropin-releasing hormone (CRH), epinephrine, and norepinephrine. A systematic search of MEDLINE, EMBASE, and PsychMed yielded 47 studies eligible for meta-analysis, including 1465 individuals with FMS and 1192 FMS-free controls. No main effect of FMS was found on altered levels of blood cortisol, ACTH, CRH, and epinephrine. Compared with controls, salivary and urinary cortisol levels were decreased in individuals with FMS, whereas blood levels of norepinephrine were increased. However, heterogeneity of data was high with significant evidence for publication bias. Overall, the data are compatible with association of FMS with adrenocortical hypofunction in the presence of increased sympathetic tone. However, the data are partially contradictory, so it must be assumed that the data are highly dependent on the respective study designs, patient samples, and analytical methods and do not necessarily demonstrate an abnormal HPA-axis function in FMS.

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Details

Published: Jan 05, 2023
Vol/Issue: 164(7)
Pages: 1416-1427

Authors

Hans-Christoph Friederich

J

Jonas Tesarz

Cite This Article

Eva Beiner, VICTORIA LUCAS, Julian Reichert, et al. (2023). Stress biomarkers in individuals with fibromyalgia syndrome: a systematic review with meta-analysis. Pain, 164(7), 1416-1427. https://doi.org/10.1097/j.pain.0000000000002857

Stress biomarkers in individuals with fibromyalgia syndrome: a systematic review with meta-analysis

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