Hypothalamic-pituitary-gonadal axis and cortisol in young women with primary fibromyalgia: the potential roles of depression, fatigue, and sleep disturbance in the occurrence of hypocortisolism.
OBJECTIVE
To investigate abnormalities of the hypothalamic-pituitary-gonadal (HPG) axis and cortisol concentrations in young women with primary fibromyalgia (FM); and to determine whether depression, fatigue, and sleep disturbance affect these hormones.


METHODS
Follicle stimulating hormone (FSH), luteinising hormone (LH), oestradiol, progesterone, prolactin, and cortisol concentrations in 63 women with FM were compared with those in 38 matched healthy controls; all subjects aged <35 years. The depression rate was assessed by the Beck Depression Inventory (BDI) and patients with high and low BDI scores were compared. Additionally, patients were divided according to sleep disturbance and fatigue and compared both with healthy controls and within the group.


RESULTS
No significant differences in FSH, LH, oestradiol, prolactin, and progesterone levels were found between patients with FM and controls, but cortisol levels were significantly lower in patients than in controls (p<0.05). Cortisol levels in patients with high BDI scores, fatigue, and sleep disturbance were significantly lower than in controls (p<0.05). Correlation between cortisol levels and number of tender points in all patients was significant (r = -0.32, p<0.05).


CONCLUSIONS
Despite low cortisol concentrations in young women with FM, there is no abnormality in HPG axis hormones. Because fatigue, depression rate, sleep disturbance, and mean age of patients affect cortisol levels, these variables should be taken into account in future investigations.
Gur
A
A
Physical Medicine and Rehabilitation, Dicle University School of Medicine, 21280 Diyarbakir, Turkey. alig@dicle.edu.tr
Cevik
R
R
Sarac
A J
AJ
Colpan
L
L
Em
S
S
D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D003863:Depression / Q000150:complications; D004958:Estradiol / Q000097:blood; D005221:Fatigue / Q000150:complications; D005260:Female; D005356:Fibromyalgia / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D005640:Follicle Stimulating Hormone / Q000097:blood; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006065:Gonadotropins, Pituitary / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D007986:Luteinizing Hormone / Q000097:blood; D010053:Ovary / Q000503:physiopathology; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D012893:Sleep Wake Disorders / Q000150:complications
D012739:Gonadal Steroid Hormones; D006065:Gonadotropins, Pituitary; D011374:Progesterone; D004958:Estradiol; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D006854:Hydrocortisone