ArticleBMC rheumatology2026
Inflammatory biomarker alterations in patients with fibromyalgia: a systematic review and meta-analysis.
Article in BMC rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
objectiveTo analyze the available scientific evidence on differences in inflammatory biomarker levels between patients with fibromyalgia and healthy controls.
methodsA systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Methodological quality was assessed using the Newcastle-Ottawa Scale. Inflammatory, neuroendocrine, and oxidative stress biomarkers were analyzed, along with their association with clinical symptoms.
resultsEighteen observational studies (case-control and cross-sectional) involving a total of 1,605 participants were included. Of these 18 studies, quantitative data suitable for meta-analysis could be extracted from only 10 studies. The fibromyalgia group showed elevated levels of p =high sensitive C-reactive protein (hsCRP) levels confirmed by meta-analysis too (SMD = 0.34; 95% CI: 0.16 to 0.52; p = 0.0002). In the quantitative synthesis, only hsCRP reached statistical significance, whereas the meta-analyses of hair cortisol, IL-6 and IFN-γ showed no significant between-group differences. In the qualitative synthesis were observed alterations in oxidative stress markers (including MDA and glutathione) and dysregulation of the hypothalamic-pituitary-adrenal axis (cortisol, adrenaline, and serotonin), with lower serotonin levels compared to healthy subjects. These biomarkers were associated with greater severity of clinical symptoms, including pain, fatigue, sleep disturbances, anxiety, and depression. Overall methodological quality was moderate, and heterogeneity between studies was high.
conclusionsSignificant differences in hsCRP levels were observed between patients with fibromyalgia and healthy controls, supporting a role of low-grade inflammatory mechanism in the pathophysiology of the disease. However, methodological heterogeneity limits direct clinical applicability. Further well-designed studies with better control of confounding factors are needed to advance the diagnostic and therapeutic use of these biomarkers.
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