الفهرس 
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Abstract
Fibromyalgia (FM) is a common disorder characterized by chronic widespread pain along the body, especially prevalent in women. Beyond the pain as cardinal symptom in specific anatomical sites, FM patients complain of other debilitating conditions such as fatigue, anxiety, depression, and sleep disturbances. Additionally, FM can be present with other comorbidities, including irritable bowel syndrome, interstitial cystitis, chronic fatigue syndrome, and temporomandibular syndrome. Objective Our study aimed to assess serum vitamin D level in patients with FM and to investigate the association between these levels and clinical features of the disease. Subjects and methods Our study conducted on forty FMS patients diagnosed according to American college of rheumatology criteria for diagnosis of FMS 2010 in addition to forty healthy volunteers of matched age and sex who served as control group. The study was conducted in Rheumatology and Rehabilitation department of Mansoura University Hospital, Egypt. All FMS patients were subjected to: 1- Full medical history including demographic data, job, sun exposure, dressing (veiled or nonveiled), diet and somatic symptoms of FMS which including the criteria for diagnosis of FMS 2010. 2- General examination: BMI, complexion. 3- Complete musculoskeletal clinical examination. 4- (FIQ) fibromyalgia impact Questionnaire to evaluate disease severity. 5- Vitamin D status assessment questionnaire. 6- Laboratory investigations: Serum 25-hydroxyvitamin D levels were determined to patients and controls using Enzyme-Linked- Immunosorbent Assay (ELISA). 7- CBC, ESR, liver enzymes (SGOT, SGPT), s.creatinine. Results Serum 25 (OH) D level in FMS patients was significantly less than that in the control group (16.2±6.5ng/ml, 22.5±9.9ng/ml) (p=0.002). The frequency of vitamin D deficiency was (85%) in FMS patients where as in controls, it was (45%), and the frequency of normal vitamin D level in FMS was (5%) whereas in controls, it was (22.5%); the difference between the patients and controls was statistically significant (P<0.001). There was non-significant negative correlation between the age of the cases and serum vitamin D levels while there was a significant negative correlation between the BMI and serum levels of vitamin D (p>0.001). A significant moderate correlation was found between each of duration of having FM, mean WPI score, FIQ score and the serum levels of vitamin D (p <0.001). A strong negative correlation between the mean value of SS score and the serum levels of vitamin D was reported (r = -0.709 and p <0.001). There was a moderate significant negative correlation between part 2b score of SS , fatigue score, waking unrefreshed score and serum levels of vitamin D (p = 0.003, 0.013 and 0.026 respectively). Statistically significant negative correlations were found between cognitive symptoms score, total SS score and serum vitamin D levels p<0.001&.p<0.001respectively.