Evidence of defective growth hormone response and adaptive hormonal changes in fibromyalgia

Abstract

Objective: To investigate pituitary and growth hormone status in patients with fibromyalgia (FM) and their response to balneotherapy. Materials and Methods: This is a nonrandomized controlled trial performed with the outpatients and hospital staff. 20 FM patients diagnosed according to American College of Rheumatology (ACR) criteria and 20 healthy controls who volunteered to participate in the study were selected from 64 outpatients and 24 hospital staff. All of the participants completed the study except 1 FM patient. Both groups had balneotherapy by the supervision of a physiotherapist for totally 3 weeks (15 sessions). Analysis of adrenocorticotropic hormone (ACTH), growth hormone (GH), cortisol and insuline like growth factor-1 (IGF-1) were done before and after the balneotherapy sessions at the first and the last days of the study in both of the groups. Pain is evaluated by the number of tender points (NTP) by a pressure algometer. Results: Both of the groups showed non-significant hormonal changes after balneotherapy session at the 1(st) day of the study, except IGF-1 increase in favor of FM patients. When the groups were compared by percent of changes, difference was found between the groups for change in GH, cortisol and IGF-1 levels. GH baseline values and IGF-1 were negatively correlated with the decrease in NTP in the FM patients. Conclusion: GH insensitivity and improper IGF-1 levels are observed in FM patients and it is found that decrease in tender points was in negative correlation with IGF-1 increase as a therapeutic response to balneotherapy.