Evidence mapPaperPMID 40868993Full record

ArticleInternational journal of molecular sciences2025

Circulating FGF-21 as a Disease-Modifying Factor Associated with Distinct Symptoms and Cognitive Profiles in Myalgic Encephalomyelitis and Fibromyalgia.

Ghazaleh Azimi, Wesam Elremaly, Mohamed Elbakry, Anita Franco, Christian Godbout, Alain Moreau

Abstract read
In one paragraph

Article in International journal of molecular sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ghazaleh AzimiViscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Azrieli Research Center, CHU Sainte-Justine, 3175 Cote-Ste-Catherine Road, Montreal, QC H3T 1C5, Canada.
Wesam ElremalyViscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Azrieli Research Center, CHU Sainte-Justine, 3175 Cote-Ste-Catherine Road, Montreal, QC H3T 1C5, Canada.ORCID 0000-0002-3577-3551
Mohamed ElbakryViscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Azrieli Research Center, CHU Sainte-Justine, 3175 Cote-Ste-Catherine Road, Montreal, QC H3T 1C5, Canada.ORCID 0000-0002-3301-069X
Anita FrancoViscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Azrieli Research Center, CHU Sainte-Justine, 3175 Cote-Ste-Catherine Road, Montreal, QC H3T 1C5, Canada.
Christian GodboutICanCME Research Network, Azrieli Research Center, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada.
Alain MoreauViscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Azrieli Research Center, CHU Sainte-Justine, 3175 Cote-Ste-Catherine Road, Montreal, QC H3T 1C5, Canada.

Funding

Sibylla-Hesse Foundation NAThe National MEFM Action Network NAThe Open Medicine Foundation Canada NA
6 · The paper itself

Abstract

Myalgic encephalomyelitis (ME) and fibromyalgia (FM) are overlapping syndromes characterized by persistent fatigue, cognitive difficulties, and post-exertional malaise (PEM), yet they lack objective biomarkers for diagnosis and treatment. Fibroblast growth factor 21 (FGF-21), a stress-responsive metabolic hormone, may offer a promising avenue to distinguish subtypes within these patient populations. In this cross-sectional study, plasma FGF-21 levels were measured in 250 patients (FM = 47; ME = 99; ME + FM = 104) and 54 healthy controls. Participants were categorized based on FGF-21 levels into three groups: low (0-50 pg/mL), normal (51-200 pg/mL), and high (>200 pg/mL). Symptoms burden and cognitive function were assessed using validated questionnaires (SF-36, MFI-20, DSQ, DPEMQ) and the BrainCheck platform. A standardized mechanical provocation maneuver was used to induce PEM. Results showed that elevated FGF-21 levels were frequently observed in ME and ME + FM but varied widely across all groups. Stratification by circulating FGF-21 levels, rather than diagnosis alone, revealed distinct symptom and cognitive profiles. Low FGF-21 levels were linked to worsened PEM perception in FM, increased PEM severity and immune/autonomic symptoms in ME, and poorer mental health in ME + FM. Conversely, high FGF-21 levels correlated with better cognition in ME but greater fatigue in ME + FM. These findings suggest that FGF-21 may serve as a valuable biomarker for identifying clinically meaningful subtypes within ME and FM, supporting the development of personalized treatments. Furthermore, discrepancies between DSQ and DPEMQ highlight the need for objective PEM assessment tools. Overall, FGF-21 shows potential as a biomarker to guide precision medicine in these complex conditions.

Indexed as

CognitionFibroblast Growth FactorsFibromyalgiaAdultBiomarkersCase-Control StudiesCross-Sectional StudiesFemaleHumansMaleMiddle AgedBiomarkersFGF21 protein, humanfibroblast growth factor 21Fibroblast Growth FactorsbiomarkerscognitionFGF-21fibromyalgiamyalgic encephalomyelitissymptoms

Identifiers

PMID40868993
PMCPMC12386925

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.