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Predictive Ability of Serum Amino Acid Levels to Differentiate Fibromyalgia Patients from Healthy Subjects

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Abstract

Background

Fibromyalgia is a complex illness to diagnose and treat.

Objectives

To evaluate a broad range of circulating free amino acid (AA) levels in fibromyalgia patients as well as the ability of the AAs to differentiate fibromyalgia patients from healthy subjects.

Design

We carried out a case-control study to evaluate AA levels in 62 patients with fibromyalgia and 78 healthy subjects. This study adheres to the STROBE guidelines.

Methods

AAs content was assayed by HPLC in serum samples. The predictive value of AA levels in fibromyalgia was determined by receiver operating characteristic (ROC) curve and forward binary logistic regression analyses.

Results

Fibromyalgia patients showed higher serum levels of aspartic acid, glutamic acid, aminoadipic acid, asparagine, histidine, 3-methyl-histidine, 5-methyl-histidine, glycine, threonine, taurine, tyrosine, valine, methionine, isoleucine, phenylalanine, leucine, ornithine, lysine, branched chain AAs (BCAAs), large neutral AAs, essential AAs (EAAs), non-essential AAs (NEAAs), basic AAs, EAAs/NEAAs ratio, phenylalanine/tyrosine ratio, and global arginine bioavailability ratio than the controls. Serum alanine levels were lower in patients than in controls. According to ROC analysis, most of these AAs may be good markers for differentiating individuals with fibromyalgia from healthy subjects. Results of logistic regression showed that the combination of glutamic acid, histidine, and alanine had the greatest predictive ability to diagnose fibromyalgia.

Conclusions

Our results show an imbalance in serum levels of most AAs in patients with fibromyalgia, which suggest a metabolic disturbance. The determination of serum levels of these AAs may aid in the diagnosis of fibromyalgia, in combination with clinical data of the patient.

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Acknowledgements

The authors would like to thank AGRAFIM (Association of Fibromyalgia of Granada, Spain) and AFIXA (Association of Fibromyalgia of Jaén, Spain) for participating in this study. This article is part of the Ph.D. thesis developed by José Alberto López-Sánchez, who is included in the Official Ph.D. Program of Biomedicine from the University of Granada, Spain.

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Authors and Affiliations

  1. Department of Cell Biology, University of Granada, Avenida de la Fuentenueva, s/n, 18071, Granada, Spain

    Alma Rus, José Alberto López-Sánchez, Francisco Molina & María Encarnación Aguilar-Ferrándiz

  2. Instituto de Investigación Biosanitaria ibs.GRANADA, 18012, Granada, Spain

    Alma Rus & José Alberto López-Sánchez

  3. Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain

    José Alberto López-Sánchez, Francisco Molina & María Encarnación Aguilar-Ferrándiz

  4. Department of Health Science, University of Jaén, Campus Las Lagunillas s/n, 23071, Jaén, Spain

    José Manuel Martínez-Martos & María Jesús Ramírez-Expósito

  5. Department of Nursing, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain

    María Correa-Rodríguez

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Funding

This work has been supported by FEDER/Junta de Andalucía-Consejería de Transformación Económica, Industria, Conocimiento y Universidades (Spain)/Grant number: A-CTS-120-UGR20.

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All authors declare that they have no conflict of interest.

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The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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This case–control study was carried out in accordance with the Declaration of Helsinki of the World Medical Association (WMA). The study was approved by the Ethics Committee of the University of Granada (Spain) (approval number: 1797-N-17).

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All participants provided written informed consent and did not receive financial incentive.

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Author contributions

Alma Rus contributed to analysis and interpretation of results, drafted the manuscript, critically revised the manuscript, and gave final approval. José Alberto López-Sánchez contributed to analysis of results, critically revised the manuscript, and gave final approval. José Manuel Martínez-Martos and María Jesús Ramírez-Expósito performed the laboratory experiments, critically revised the manuscript, and gave final approval. Francisco Molina contributed to conception and data acquisition, critically revised the manuscript, and gave final approval. María Correa-Rodríguez and María Encarnación Aguilar-Ferrándiz contributed to conception and design, data acquisition, critically revised the manuscript, and gave final approval.

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Rus, A., López-Sánchez, J.A., Martínez-Martos, J.M. et al. Predictive Ability of Serum Amino Acid Levels to Differentiate Fibromyalgia Patients from Healthy Subjects. Mol Diagn Ther 28, 113–128 (2024). https://doi.org/10.1007/s40291-023-00677-8

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