The Significance of inflammation markers in complete blood count in patients with fibromyalgia

Main Article Content

Gülşah Karataş
Ramazan Gündüz


Objective:  Fibromyalgia is a chronic pain disorder mostly seen in women, it mainly characterized by diffuse body pain accompanied by chronic fatigue and depression-like mood disorders. Its etiology still remains unknown but in some studies, fibromyalgia has been reported to be an inflammatory disease several cytokines shown to be responsible for the possible inflammatory basis of the disease. No laboratory marker is currently available to diagnose the disease. We aimed to investigate the diagnostic significance of inflammation markers in fibromyalgia, including platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte (MLR) ratio, and mean platelet volume (MPV).

Material and Methods: This retrospective and case-control study included 188 patients who were followed up and treated for fibromyalgia in physical therapy and rehabilitation outpatient clinic from 2017 through 2019 and 64 age-matched healthy controls. The PLR, NLR, MLR, MPV and vitamin D were calculated from the results of complete blood count test. The differences between the two groups were examined.

Results: The mean age, hemoglobin levels, and erythrocyte sedimentation rates were not different between the groups. In fibromyalgia group, the values of PLR (p = 0.031), NLR (p = 0.044), MLR (p = 0.023), and MPV (p = 0.013) were higher than those in control group, whereas vitamin D levels were significantly lower (p = 0.021). In multivariate regression analysis, PLR, NLR and MLR were not found to be independent predictors (p> 0.05).

Conclusion: The findings of this study reveal that NLR, MLR, PLR, and MPV are not independent markers for the diagnosis of fibromyalgia, suggesting that fibromyalgia does not appear to be an inflammatory disease.


Download data is not yet available.

Article Details

How to Cite
Karataş, G., & Gündüz, R. (2020). The Significance of inflammation markers in complete blood count in patients with fibromyalgia. Medical Science and Discovery, 7(1), 364–367.
Research Article
Received 2019-12-24
Accepted 2020-01-18
Published 2020-01-21


Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res 2010;62(5):600-10.

Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995;38(1):19-28.

Ribeiro V, Mendonça V, Souza A, Fonseca S, Camargos A, Lage V, et al. Inflammatory biomarkers responses after acute whole body vibration in fibromyalgia. Braz J Med Biol Res 2018;51(4).

Ortega E, García J, Bote M, Martín-Cordero L, Escalante Y, Saavedra J, et al. Exercise in fibromyalgia and related inflammatory disorders: known effects and unknown chances. Exerc Immunol Rev 2009;15(3):42-4.

Fatima G, Mahdi AA, Das SK, Anjum B, Verma NS, Kumar P, et al. Lack of circadian pattern of serum TNF-α and IL-6 in patients with fibromyalgia syndrome. Indian J Clin Biochem 2012;27(4):340-3.

Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A, Ozturk MA, et al. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 2008;75(3):291-4.

Uslu AU, Küçük A, Şahin A, Ugan Y, Yılmaz R, Güngör T, et al. Two new inflammatory markers associated with Disease Activity Score‐28 in patients with rheumatoid arthritis: neutrophil‐lymphocyte ratio and platelet‐lymphocyte ratio. Int J Rheum Dis 2015;18(7):731-5.

Fu H, Qin B, Hu Z, Ma N, Yang M, Wei T, et al. Neutrophil-and platelet-to-lymphocyte ratios are correlated with disease activity in rheumatoid arthritis. Clin Lab 2015;61(3-4):269-73.

Kim DS, Shin D, Lee MS, Kim HJ, Kim DY, Kim SM, et al. Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. J Dermatol 2016;43(3):305-10.

Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H, et al. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol 2016;26(3):372-6.

Turkmen K, Erdur FM, Ozcicek F, Ozcicek A, Akbas EM, Ozbicer A, et al. Platelet‐to‐lymphocyte ratio better predicts inflammation than neutrophil‐to‐lymphocyte ratio in end‐stage renal disease patients. Hemodial Int 2013;17(3):391-6.

Ablin J, Neumann L, Buskila D. Pathogenesis of fibromyalgia–a review. Joint Bone Spine 2008;75(3):273-9.

Karabaş, Ç. Fibromyalji Hastalarinda Nötrofil/lenfosit Orani, Platelet/lenfosit orani ve Ortalama Trombosit Hacminin Değerlendirilmesi. J Anatol Med Res, 3(1), 1-10.

Sayilir S. Remarkable Hematological Laboratory Findings in Patients with Fibromyalgia Syndrome. Turk J Osteoporos 2016;22(3):121.

İlgün E, Akyürek Ö, Kalkan AO, Demir F, Demirayak M, Bilgi M. Neutrophil/Lymphocyte ratio and Platelet/Lymphocyte ratio in fibromyalgia. Eur J Gen Med 2016;13(2):100-4.

Aktürk S, Büyükavcı R. Evaluation of blood neutrophil-lymphocyte ratio and platelet distribution width as inflammatory markers in patients with fibromyalgia. Clin Rheumatol 2017;36(8):1885-9.

Al-Nimer MSM, Mohammad TAM. Correlation of hematological indices and ratios derived from them with FIQR scores in fibromyalgia. Pak J Med Sci 2018;34(5):1219.

Kılıç E, Rezvani A, Toprak AE, Erman H, Ayhan SK, Poyraz E, et al. Romatoid Artritte Nötrofil/Lenfosit ve Platelet/Lenfosit Oranlarının Değerlendirilmesi. Dicle Med J 2016;43(2):241-7.

Atar E, Aşkın A. Diz osteoartrit hastalarında nötrofil/lenfosit oranı, trombosit/lenfosit oranı ve ortalama trombosit hacminin değerlendirilmesi. Cukurova Med J 2017;42(2):329-36.

Taşoğlu Ö, Şahin A, Karataş G, Koyuncu E, Taşoğlu İ, Tecimel O, et al. Blood mean platelet volume and platelet lymphocyte ratio as new predictors of hip osteoarthritis severity. Medicine 2017;96(6).

Taşoğlu Ö, Bölük H, Onat ŞŞ, Taşoğlu İ, Özgirgin N. Is blood neutrophil-lymphocyte ratio an independent predictor of knee osteoarthritis severity? Clin Rheumatol 2016;35(6):1579-83.

Ernberg, M., Christidis, N., Ghafouri, B., Bileviciute-Ljungar, I., Löfgren, M., Bjersing, J., ... & Kosek, E. (2018). Plasma Cytokine levels in fibromyalgia and their response to 15 weeks of progressive resistance exercise or relaxation therapy. Mediators of inflammation, 2018.

Gundogdu, I., Mutlu, M., Gunes, A., Ozurk, E. A., Yildirim, G. A., Cakci, A., & Akın, İ. Hearing Abnormalities in Patients with Osteoarthritis.