Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. X:X | DOI: 10.5507/bp.2025.014
A new approach to prealbumin as a biomarker for fibromyalgia?
- 1 Department of Pharmacology, Faculty of Pharmacy, Duzce University, Duzce, Turkey
- 2 Family Medicine Department, Adana Medicine Faculty, Health Science University, Adana, Turkey
- 3 Department of Physical Medicine and Rehabilitation, Adana Medicine Faculty, Health Science University, Adana, Turkey
- 4 Ophthalmology Clinics, Adana City Training and Researching Hospital, Adana, Turkey
Aims: Fibromyalgia (FM) is a chronic, widespread musculoskeletal disease that is usually accompanied by hyperalgesia, fatigue, sleep disturbance and depression. Although the etiopathogenesis of this syndrome is unclear, it is presumed to have an inflammatory basis. There are currently no laboratory markers available to diagnose the condition. The aim of this study was to investigate potential biochemical markers that would prove to be valid, simple, routinely used, quickly and cheaply studied and obtainable in blood count tests.
Methods: 46 patients diagnosed with FM according to ACR (American College of Rheumatology) 2010 diagnostic criteria and 35 patients as a healthy control group were included in the study. Prealbumin, complete blood count, sediment and C-reactive protein (CRP) values of FM and control group patients were examined. Additionally, Hospital Anxiety and Depression Scale, Jenkins Sleep Scale and the Fibromyalgia Impact Questionnaire (FIQ) were administered to patients diagnosed with FM.
Results: There was a significant difference between fibromyalgia patients and control groups in terms of prealbumin, platelet, CRP, CRP/prealbumin and lymphocyte parameters (P=0.048, P=0.046, P<0.001, P=0.003 and P<0.001, respectively). Only a weak positive correlation was found between CRP and FIQ (rS =0.309, P=0.037, CI=0.012-0.556).
Conclusion: The serum levels of some tested markers, including platelets, CRP, CRP/prealbumin and lymphocytes, were significantly higher and prealbumin was lower in patients with FM than in the control group, suggesting they could be valid in fibromyalgia diagnosis. The CRP level may be informative about the severity of the FM and it may play a role in the inflammation possibly underlying the pathogenesis of FM.
Keywords: CRP, CRP/prealbumin, lymphocyte, platelet, prealbumin
Received: December 5, 2024; Revised: March 14, 2025; Accepted: April 24, 2025; Prepublished online: May 16, 2025
References
- . Ruschak, I, Montesó-Curto, P, Rosselló, L, Aguilar Martín, C, Sánchez-Montesó, L, Toussaint, L. Fibromyalgia syndrome pain in men and women: a scoping review. Healthcare 2023;11(2):223.
Go to original source...
Go to PubMed...
- . Khamisy-Farah R, Fund E, Raibman-Spector S, Adawi M. Inflammatory Markers in the Diagnosis of Fibromyalgia. IMAJ 2021;23(12):801-4.
- . Ruggiero V, Era B, Cacace E, Molin L, Corda M, Fais A, Utzeri S. A preliminary study on serum proteomics in fibromyalgia syndrome. Clinical Chemistry and Laboratory Medicine (CCLM) 2014;52(9):207-10.
Go to original source...
Go to PubMed...
- . Feinberg T, Sambamoorthi U, Lilly C, Innes KK. Potential mediators between fibromyalgia and C-reactive protein: results from a large US community survey. BMC musculo skeletal disorders 2017;18(294):1-12.
Go to original source...
Go to PubMed...
- . Sanada K., Díez M. A, Valero MS, Pérez-Yus MC, Demarzo MM, García-Toro M, García-Campayo J. Effects of non-pharmacological interventions on inflammatory biomarker expression in patients with fibromyalgia: a systematic review. Arthritis Res Ther 2015;17(272):1-16.
Go to original source...
Go to PubMed...
- . López B, Castañón-Apilánez M, Molina-Gil J, Fernández-Gordón Sánchez S, González G, Acuña AR, Jimenez JM, Campo DL, Delgado MG, Benavente-Fernández L, Rico-Santos M, García-Cabo C, Puerta SC, López-Cancio E. Serum prealbumin levels on admission as a prognostic marker in stroke patients treated with mechanical thrombectomy. Cerebrovasc Dis Extra 2022;12(3):103-8.
Go to original source...
Go to PubMed...
- . Cheng L, Li L, Liu C, Yan S, Chen H, Chen H, Zhang F, Li Y. Prealbumin Correlates with C-reactive Protein in Rheumatic Musculo skeletal Diseases. Ann Clin Lab Sci 2021;51(1):82-9.
- . Yamada T, Haruki S, Minami Y, Numata M, Hagiwara N. The C-reactive protein to prealbumin ratio on admission and its relationship without come in patients hospitalized for acute heart failure. J Cardiol 2021;78(4):308-13.
Go to original source...
Go to PubMed...
- . Wang W, Ren D, Wang CS, Li T, Yao HC. High sensitivity C-reactive protein to prealbumin ratio measurement as a marker of the prognosis in acute coronary syndrome. Scientific reports 2019;9:11583.
Go to original source...
Go to PubMed...
- . Zigmond AS, Snaith RP.The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67(6):361-70.
Go to original source...
Go to PubMed...
- . Aydemir O, Koroglu E. Psikiyatride Kullanilan Klinik Ölçekler. Türk Psikiyatri Dergisi 2000;8:280-7.
- . Jenkins CD, Stanton BA, Niemcryk SJ, Rose RM. A scale for the estimation of sleep problems in clinical research. J Clin Epidemiol 1998;41(4):313-21.
Go to original source...
Go to PubMed...
- . Duruoz MT, Cagri U, Ulutatar F, Toprak CS, Gündüz OH. The validity and reliability of Turkish version of the Jenkins sleep evaluation scale in rheumatoid arthritis. Arch Rheumatol 2018;33(2):160-7.
Go to original source...
Go to PubMed...
- . Bennett R. The Fibromyalgia Impact Questionnaire (FIQ): a review of its development, current version, operating characteristics and uses. Clin Exp Rheumatol 2005;23(39):154-62.
- . Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int 2000;20:9-12.
Go to original source...
Go to PubMed...
- . Akturk S, Buyukavci R. Evaluation of blood neutrophil-lymphocyte ratio and platelet distribution width as inflammatory markers in patients with fibromyalgia. Clin Rheumatol 2017;36:1885-9.
Go to original source...
Go to PubMed...
- . Erden E, Turk AC. Can the monocyte to HDL ratio be used as an inflammation marker in patients with fibromyalgia syndrome? Niger J Clin Prac 2023;26(7):998-1004.
Go to original source...
Go to PubMed...
- . Zetterman T, Markkula R, Kalso E(2022): Elevated highly sensitive C-reactive protein in fibromyalgia associates with symptom severity. Rheumatol Adv Prac 2022;6(2):1-13
Go to original source...
Go to PubMed...
- . Rus A, Molina F, Gassó M, Camacho MV, Peinado MA, Del Moral ML. Nitricoxide, inflammation, lipid profile, and cortisol in normal-and overweight women with fibromyalgia. Biol Res Nurs 2015;18(2):138-46.
Go to original source...
Go to PubMed...
- . El-Sawy EA, Hakim MMA, El-Zohiery A,Salama SM. Significance of inflammatory markers in primary Fibromyalgia syndrome and their relation in assessing the disease severity. Egypt J Immunol 2024;31(1):67-74.
Go to original source...
- . Ege F, Isik R. A Comparative Assessment of the Inflammatory Markers in Patients with Fibromyalgia under Duloxetine Treatment. Front Biosci 2023;28(8):161.
Go to original source...
Go to PubMed...
- . Zhang K, Wang J, Chen J, Li Z, Lou Z. The serum C-reactive protein to prealbumin ratio and fibrinogen to prealbumin ratio are two relevant indicators for evaluating the disease activity of ankylosing spondylitis. Eur J Inflamm 2021;19. doi: 10.1177/20587392211014092
Go to original source...
- . Wang J, Xi H, Zhang K, Li Z, Li L, Chen J, Lou Z. Circulating C-Reactive Protein to Prealbumin Ratio and Prealbumin to Fibrinogen Ratio are Two Promising Inflammatory Markers Associated with Disease Activity in Rheumatoid Arthritis. Clin Lab 2020;66(5). doi: 10.7754/Clin.Lab.2019.190833
Go to original source...
Go to PubMed...
- . Molina F, Del Moral ML, La Rubia M, Blanco S, Carmona R, Rus A. Are patients with fibromyalgia in a prothrombotic state? Bio Res Nurs 2019;21(2):224-30.
Go to original source...
Go to PubMed...
- . Paiva ES, Andretta A, Batista ED, Lobo MMMT, Costa de Miranda R, Nisihara R, Schieferdecker MEM, Boguszewski CL. Serum levels of leptin and adiponectin and clinical parameters in women with fibromyalgia and overweight/obesity. Arch Endocrinol Metab 2017;61(3):249-56.
Go to original source...
Go to PubMed...
- . Farrell SF, Armfield NR, Cabot PJ, Elphinston RA, Gray P, Minhas G, Collyer MR, Sterling M. C-reactive protein (CRP) is associated with chronic pain independently of biopsychosocial factors. The J Pain 2024;25(2):476-96.
Go to original source...
Go to PubMed...
- . Zetterman T, Markkula R, Kalso E. Elevated highly sensitive C-reactive protein in fibromyalgia associates with symptom severity. Rheumatol Adv Pract 2022;6(2):rkac053. doi: 10.1093/rap/rkac053
Go to original source...
Go to PubMed...
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