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Objective: Fibromyalgia Syndrome is a chronic disease of the musculoskeletal system accompanied by the conditions such as widespread body pain, increased fatigue and hypersensitivity in specific anatomical regions, and sleeping disorder. Hypothalamic-pituitary-adrenal (HPA) axis abnormalities play a key role in the cause and pathogenesis of many psychiatric disorders and fibromyalgia. It is aimed to investigate that the serum cortisol and dehydroepiandrosterone-sulfate (DHEA-S) levels between fibromyalgia patients and control group, and to research whether depression has effects on these hormones or not.
Method: 72 patients and 39 healthy volunteers who were diagnosed as FMS according to the ACR 1990 criteria were included in this study. Patients were divided into two groups. There were 40 patients in the first group, who were applied both balneotherapy (BT) and physical therapy (FT). In the second group, there were 32 FMS patients, who were only FT applied. The control group was consisted of 39 healthy individuals. To determine the levels of the cortisol and DHEA-S, the blood samples were taken from the patients and the control group that match with the study criteria between 08.00 am and 09.00 am. Blood samples were taken twice including before and after treatment.
Results: Serum cortisol average of individuals in patient group and control group was found as 10.10±4.08 цg/dL and 11.78±3.6 цg/dL. DHEA-S level of patient group was determined as 89.93±53.96 цg/dL while control group as 143.15±107.92 цg/dL. Patients under balneotherapy treatment have an average of serum cortisol level of 9.95±3.20 цg/dL before treatment and 9.06±3.77 цg/dL after treatment while serum DHEA-S levels before and after treatment was found as 77.60±48.05 цg/dL and 76.84±48.71 цg/dL. Before the treatment Beck Depression score was 11.58±5.65. After the treatment Beck Depression score was 8.43±5.57.
Conclusion: In this study, serum cortisol and serum DHEA-S levels of fibromyalgia patients were significantly lower than levels of healthy control patients. However, there was no significant correlation between depression and serum hormones levels. Although the cause and effect relation cannot be clearly explained hence our study is cross-sectional, in view of our results and the data of early studies, low levels of serum cortisol and DHEA-S were thought to be related to physiopathology of fibromyalgia disease than depression.