Proinflammatory cytokines and DHEA-S in women with fibromyalgia: impact of psychological distress and menopausal status

John A Sturgeon,¹ Beth D Darnall,¹ Heather L Zwickey,² Lisa J Wood,³ Douglas A Hanes,² David T Zava,⁴ Sean C Mackey<sup>1

1</sup>Stanford University School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Palo Alto, CA, USA; ²Helfgott Research Institute, National College of Natural Medicine, Portland, OR, USA; ³MGH Institute of Health Professions, Boston, MA, USA; ⁴ZRT Laboratories, Beaverton, OR, USA

Abstract: Though fibromyalgia is not traditionally considered an inflammatory disorder, evidence for elevated inflammatory processes has been noted in this disorder in multiple studies. Support for inflammatory markers in fibromyalgia has been somewhat equivocal to date, potentially due to inattention to salient patient characteristics that may affect inflammation, such as psychiatric distress and aging milestones like menopause. The current study examined the relationships between proinflammatory cytokines and hormone levels, pain intensity, and psychological distress in a sample of 34 premenopausal and postmenopausal women with fibromyalgia. Our results indicated significant relationships between interleukin-8 and ratings of pain catastrophizing (r=0.555, P<0.05), pain anxiety (r=0.559, P<0.05), and depression (r=0.551, P<0.05) for postmenopausal women but not premenopausal women (r<0.20 in all cases). Consistent with previous studies, ratios of interleukin-6 to interleukin-10 were significantly lower in individuals with greater levels of depressive symptoms (r=−0.239, P<0.05). Contrary to previous research, however, dehydroepiandrosterone sulfate did not correlate with pain intensity or psychological or biological variables. The results of the current study highlight the importance of psychological functioning and milestones of aging in the examination of inflammatory processes in fibromyalgia.

Keywords: fibromyalgia, cytokines, psychological distress, inflammation