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

Figures & data

Table 1 Inclusionary/exclusionary criteria

Inclusionary criteria	Exclusionary criteria
Women between the ages of 18 and 70 years	Active or recent virus/infection Psychosis or active suicidality
Diagnosed fibromyalgia confirmed by review of medical records	Current severe major depression (BDI-II score >35)
Nonsmokers	Former intravenous drug user
Premenopausal women must have a normal menstrual cycle	Active corticosteroid regimen Needle/blood/injection phobia Sex-steroid dysregulation Self-reported pregnancy Taking β-blockers Taking oral contraception or hormone therapy Inflammatory disease (such as lupus)

Abbreviation: BDI-II, Beck Depression Inventory-Second Version.

Table 2 Means and standard deviations of demographic and psychological variables in premenopausal and postmenopausal women

Study variable	Full sample (N=34)	Premenopausal (N=13)	Postmenopausal (N=21)	Menopausal status t-test
Age (years)	50.32 (12.045)	37.38 (6.36)	58.33 (6.24)	t(32) =−9.446, P<0.001
BMI (kg/m^2)	30.43 (8.08)	31.68 (9.47)	29.69 (7.29)	t(30) =0.669, P=0.509
CES-D	18.32 (10.90)	19.08 (11.62)	17.86 (10.70)	t(32) =0.313, P=0.757
PCS	20.21 (13.44)	27.46 (12.46)	15.71 (12.22)	t(32) =2.703, P=0.011
PASS-40	71.38 (37.73)	86.39 (42.99)	62.10 (31.67)	t(32) =1.895, P=0.067

Abbreviations: BMI, body mass index; CES-D, Center for Epidemiologic Studies Scale-Depression; PCS, Pain Catastrophizing Scale; PASS-40, Pain Anxiety Symptoms Scale 40-Item Version.

Table 3 Means and standard deviations of log-transformed biological variables in premenopausal and postmenopausal women

Study variable	Full sample (N=34)	Premenopausal (N=13)	Postmenopausal (N=21)	Menopausal status t-test
IL-6	2.94 (2.57)	3.60 (3.29)	2.48 (1.91)	t(31) =−0.044, P=0.965
IL-8	7.63 (4.80)	5.86 (2.84)	8.79 (5.50)	t(31) =−1.748, P=0.090
IL-10	25.71 (55.65)	31.41 (52.40)	22.01 (59.70)	t(31) =0.943, P=0.353
IL-6/IL-10 ratio	0.75 (2.08)	0.43 (0.77)	0.96 (2.60)	t(31) =−1.424, P=0.164
TNF-α	11.66 (6.96)	8.33 (4.11)	13.83 (7.64)	t(31) =−2.873, P=0.007
DHEA-S	5.94 (5.67)	8.24 (6.81)	4.74 (4.72)	t(30) =1.705, P=0.099

Notes: All biological variables were log transformed to address non-normality. One participant’s data for IL-6 were excluded due to abnormally high scores.

Abbreviations: IL, interleukin; TNF-α, tumor necrosis factor-α; DHEA-S, dehydroepiandrosterone sulfate.

Table 4 Correlations between biologic variables in premenopausal women (N=13)

Study variable	IL-6	IL-8	IL-10	TNF-α	DHEA-S	PCS	PASS-40	CES-D	Pain intensity
IL-6	1	0.302	0.526†	0.443	−0.391	−0.106	−0.107	−0.027	0.284
IL-8		1	0.346	0.046	0.461	−0.153	0.131	0.173	0.423
IL-10			1	0.488†	−0.075	0.370	0.327	0.379	0.648*
TNF-α				1	0.133	0.409	0.300	0.237	0.370
DHEA-S					1	−0.019	0.164	0.257	0.280
PCS						1	0.851**	0.542†	0.237
PASS-40							1	0.788**	0.472
CES-D								1	0.790**
Pain intensity									1

Notes:

† P<0.10

* P<0.05

** P<0.01. All cytokine variables (IL-6, IL-8, IL-10, TNF-α) were log transformed to address non-normality.

Abbreviations: IL, interleukin; TNF-α, tumor necrosis factor-α; DHEA-S, dehydroepiandrosterone sulfate; PCS, Pain Catastrophizing Scale; PASS-40, Pain Anxiety Symptoms Scale 40-Item Version; CES-D, Center for Epidemiologic Studies Scale-Depression.

Table 5 Correlations between biologic variables in postmenopausal women (N=21)

Study variable	IL-6	IL-8	IL-10	TNF-α	DHEA-S	PCS	PASS-40	CES-D	Pain intensity
IL-6	1	−0.084	0.367	0.266	0.066	−0.051	−0.045	−0.133	−0.494*
IL-8		1	0.140	0.381†	0.187	0.555*	0.559*	0.551*	0.696**
IL-10			1	0.692**	−0.207	0.073	0.010	0.071	0.013
TNF-α				1	−0.184	0.234	0.236	0.215	0.035
DHEA-S					1	0.405†	0.187	−0.027	−0.355
PCS						1	0.830**	0.613**	0.160
PASS-40							1	0.715**	0.288
CES-D								1	0.451*
Pain intensity									1

Notes:

† P<0.10;

* P<0.05;

** P<0.01. All cytokine variables (IL-6, IL-8, IL-10, TNF-α) were log transformed to address non-normality.

Abbreviations: IL, interleukin; TNF-α, tumor necrosis factor-α; DHEA-S, dehydroepiandrosterone sulfate; PCS, Pain Catastrophizing Scale; PASS-40, Pain Anxiety Symptoms Scale 40-Item Version; CES-D, Center for Epidemiologic Studies Scale-Depression.