Assessment of novel inflammatory markers, central sensitization, depression and anxiety in patients with juvenile fibromyalgia: single-center cross-sectional study

Background: This study aimed to evaluate central sensitization, psychological symptoms, and systemic inflammatory markers in adolescents with juvenile fibromyalgia syndrome (JFMS) by comparing them with healthy controls and to examine the associations of these variables with JFMS.Methods: A total of 84 adolescents were included: 42 patients diagnosed with JFMS and 42 healthy controls.The Central Sensitization Inventory (CSI) and Revised Children's Anxiety and Depression Scale (RCADS) were administered to all participants.From blood samples of all participants, the Systemic Immune-Inflammation Index (SII) and Systemic Inflammatory Response Index (SIRI) were calculated.Results: Body mass index, SII, and SIRI were significantly higher in the JFMS group compared with healthy controls (P = 0.029, P < 0.001, P = 0.003, respectively), while school attendance was significantly lower in patients with JFMS (P = 0.005).Adolescents with JFMS exhibited markedly higher levels of central sensitization, with mean CSI scores of 46.93 ± 18.59 compared to 16.02 ± 13.23 in healthy controls (P < 0.001).Psychological distress was also significantly increased in the JFMS group, as reflected by higher mean RCADS total scores (58.26 ± 28.56 vs. 22.14 ± 19.03, P < 0.001).In multivariable logistic regression analysis, higher SII levels and school absenteeism remained independently associated with JFMS.Conclusions: These findings indicate that adolescents with JFMS demonstrate higher systemic inflammatory indices, greater central sensitization, and increased psychological distress compared with controls.Higher SII levels and school absenteeism were independently associated with JFMS; however, due to the cross-sectional design, causality cannot be inferred.