Correlation of hematological indices and ratios derived from them with FIQR scores in fibromyalgia
Open accessAbstract
Objectives: To determine the hematological indices and ratios derived from them in patients with fibromyalgia and to correlate the scores of Fibromyalgia Impact Questionnaire Revised (FIQR) with the ratios.Methods: This case control study was performed in the College of Pharmacy at Hawler Medical University in Erbil-Iraq, from November 2016 to June 2017, and it included 40 healthy subjects (Group I) and 150 newly diagnosed FM (Group II). The American College of Rheumatology -10 (ACR-10) diagnostic criteria were used in the diagnosis of FM. The scores of the Revised Fibromyalgia Questionnaire Impact (FIQR), and tender points were calculated, and the hematological indices and ratios were determined.Results: Group II showed significantly higher mean values of hematological indices and the ratios of neutrophil to lymphocyte (NLR), derived neutrophil to lymphocyte (dNLR) and platelet to lymphocyte (PLR). Group II patients have a significant higher score of FIQR. A significant correlation between the total score of FIQR with the hematological ratios (F=4.143, R=0.355, R2=0.126, p=0.002) with a variability of 12.6%.Conclusion: We conclude that the hematological indices are significantly altered and they are significantly correlated with the total score of fibromyalgia impact questionnaire revised.doi: https://doi.org/10.12669/pjms.345.15169How to cite this: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):1219-1224.
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Some studies do not support the use of neutrophil-to-lymphocyte ratio as a reliable neutrophil-related indicator.
“However, given the variability of NLR levels among FMS patients with FMS, some studies do not support the use of NLR as a reliable neutrophil-related indicator (66, 67).”
From Nociplastic pain: the prominent role of non-neuronal cells in central and peripheral sensitization (2026) · cites this paper as [66]
The Discussion says the opposite of the attributed claim: NLR could be a good marker for distinguishing fibromyalgia from other painful conditions, and its area under the curve indicates it is a good diagnostic discriminator. Although the paper reports a lower NLR in its fibromyalgia group, it does not use that finding to reject NLR as a reliable indicator. (LLM, conf=0.88)
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Cites
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The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties
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Nociplastic pain: the prominent role of non-neuronal cells in central and peripheral sensitization
Lai, W., Tang, X., Chen, S., Zhou, Y., Qi, Z., Cao, M., Yuan, C., Yu, J., & Wen, C. (2026) · Frontiers in Immunology · doi:10.3389/fimmu.2026.1677310 · Cited by 4 · see citing works
“However, given the variability of NLR levels among FMS patients with FMS, some studies do not support the use of NLR as a reliable neutrophil-related indicator (66, 67).”
- Authors
- Al-Nimer, M. S. M., & Mohammad, T. A. M.
- Affiliations
- Hawler Medical University (IQ)
- Corresponding author
- Al-Nimer, Marwan S.M.
- Venue
- Pakistan Journal of Medical Sciences
- Publisher
- Pakistan Journal of Medical Sciences
- Published
- 2018-10-02
- Volume
- 34
- Issue
- 5
- Pages
- 1219-1224
- ISSN
- 1681-715X (ISSN-L)
- 1682-024X
- PMC
- PMC6191799
- OpenAlex
- W2892861160
- Cited by
- 22
- References
- 3
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 7 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 2
- FWCI
- 1.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Pakistan Journal of Medical Sciences (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Blood properties and coagulation
- Keywords
- fibromyalgia, hematological parameters, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, derived neutrophil-to-lymphocyte ratio, disease impact, inflammatory markers, tender points
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