Is insulin resistance the cause of fibromyalgia? A preliminary report

Miguel Pappolla, Laxmaiah Manchikanti, Clark R. Andersen, Nigel H. Greig, Fawad Ahmed, Xiang Fang, Michael A. Seffinger, Andrea M. Trescot

Research output: Contribution to journalArticle

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Abstract

Fibromyalgia (FM) is one of the most frequent generalized pain disorders with poorly understood neurobiological mechanisms. This condition accounts for an enormous proportion of healthcare costs. Despite extensive research, the etiology of FM is unknown and thus, there is no disease modifying therapy available for this condition. We show that most (if not all) patients with FM belong to a distinct population that can be segregated from a control group by their glycated hemoglobin A1c (HbA1c) levels, a surrogate marker of insulin resistance (IR). This was demonstrated by analyzing the data after introducing an age stratification correction into a linear regression model. This strategy showed highly significant differences between FM patients and control subjects (p < 0.0001 and p = 0.0002, for two separate control populations, respectively). A subgroup of patients meeting criteria for pre-diabetes or diabetes (patients with HbA1c values of 5.7% or greater) who had undergone treatment with metformin showed dramatic improvements of their widespread myofascial pain, as shown by their scores using a pre and post-treatment numerical pain rating scale (NPRS) for evaluation. Although preliminary, these findings suggest a pathogenetic relationship between FM and IR, which may lead to a radical paradigm shift in the management of this disorder.

Original languageEnglish (US)
Pages (from-to)e0216079
JournalPloS one
Volume14
Issue number5
DOIs
StatePublished - Jan 1 2019

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Fibromyalgia
insulin resistance
glycohemoglobin
Insulin Resistance
Insulin
Medical problems
pain
diabetes
Metformin
Glycosylated Hemoglobin A
metformin
health care costs
Linear Models
Linear regression
rating scales
Hemoglobins
Pain
Somatoform Disorders
etiology
Health Care Costs

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Pappolla, M., Manchikanti, L., Andersen, C. R., Greig, N. H., Ahmed, F., Fang, X., ... Trescot, A. M. (2019). Is insulin resistance the cause of fibromyalgia? A preliminary report. PloS one, 14(5), e0216079. https://doi.org/10.1371/journal.pone.0216079

Is insulin resistance the cause of fibromyalgia? A preliminary report. / Pappolla, Miguel; Manchikanti, Laxmaiah; Andersen, Clark R.; Greig, Nigel H.; Ahmed, Fawad; Fang, Xiang; Seffinger, Michael A.; Trescot, Andrea M.

In: PloS one, Vol. 14, No. 5, 01.01.2019, p. e0216079.

Research output: Contribution to journalArticle

Pappolla, M, Manchikanti, L, Andersen, CR, Greig, NH, Ahmed, F, Fang, X, Seffinger, MA & Trescot, AM 2019, 'Is insulin resistance the cause of fibromyalgia? A preliminary report', PloS one, vol. 14, no. 5, pp. e0216079. https://doi.org/10.1371/journal.pone.0216079
Pappolla, Miguel ; Manchikanti, Laxmaiah ; Andersen, Clark R. ; Greig, Nigel H. ; Ahmed, Fawad ; Fang, Xiang ; Seffinger, Michael A. ; Trescot, Andrea M. / Is insulin resistance the cause of fibromyalgia? A preliminary report. In: PloS one. 2019 ; Vol. 14, No. 5. pp. e0216079.
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