C-telopeptide of type I collagen (CTX-1) in premenopausal Egyptian women with fibromyalgia syndrome

Introduction The majority of the fibromyalgia syndrome (FMS) patients do not exercise regularly and their physical fitness is low. Physical inactivity accelerates bone loss. This suggests that FMS patients are at risk in terms of osteoporosis. The aim of this study was to measure serum C-telopeptide of type I collagen (CTX-1) as a marker of bone resorption in premenopausal women with FMS. Patients and methods A total of 100 premenopausal female patients with FMS diagnosed according to the American College of Rheumatology (ACR) criteria 1990 and 50 healthy women were chosen to serve as the control group. Serum CTX-1 levels were measured using beta-CrossLaps Roche Elecsys. Results The serum CTX-1 level was significantly higher in patients with FMS compared with the control group. The mean serum CTX-1 in FMS patients was 340.2 ± 112.6 pg/ml compared with 283.6 ± 113.1 pg/ml in controls ( P = 0.004). The serum CTX-1 level was positively correlated with the visual analogue scale(VAS) of pain ( P = 0.028), the VAS of fatigue ( P = 0.031), the VAS of global severity ( P = 0.016), the VAS of anxiety ( P = 0.013), the Health Assessment Questionnaire score ( P = 0.022), the Fibromyalgia Impact Questionnaire ( P = 0.010), the Beck Depression Inventory ( P = 0.007), the tender points count ( P = 0.003), the tender points score ( P = 0.004), and the Pittsburg Sleep Quality Index ( P = 0.021). The mean serum CTX-1 level was also significantly higher in FMS patients with postexertion pain ( P = 0.010), confusion ( P = 0.025), dizziness ( P = 0.012), depression ( P = 0.029), mood disturbance ( P = 0.018), anxiety ( P = 0.030), short memory difficulties ( P = 0.017), and sleep disturbance ( P = 0.028) than in those without these symptoms. Conclusion We found a significant increase in serum CTX-1 in FMS patients compared with controls, and this was correlated with the disease severity. Increased CTX-1 may lead to the early development of osteoporosis. More comprehensive and detailed studies are needed to determine the exact role of CTX-1 in FMS.