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Its pathophysiological mechanisms remain poorly understood, and effective diagnosis and treatments are lacking. This study aimed to identify significantly changed biosignatures in FM and propose a novel classification for FM based on pain and soreness (sng) symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Urine and serum samples from 30 FM patients and 25 controls underwent metabolomic and proteomic profiling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with controls, FM patients showed significant differential expression of three metabolites in urine and five metabolites and eight proteins in serum. Of them, DETP, 4\u2010guanidinobutanoic acid, SM(d18:1\/18:0), PC(20:1(11Z)\/18:0), S100A7, SERPINB3, galectin\u20107 and LYVE1 were first reported as potential biomarkers for FM. Furthermore, lactate, 2\u2010methylmaleate and cotinine in urine and lactate, SM(d18:1\/25:1), SM(d18:1\/26:1) and prostaglandin D2 (PGD2) and PCYOX1, ITIH4, PFN1, LRG1, C8G, C8A, CP, CDH5 and DBH in serum could differentiate pain\u2010 (PG) and sng\u2010dominant groups (SG). Lactate, 2\u2010methylmaleate, cotinine, PCYOX1, ITIH4, PFN1 and DBH have a higher level in SG. SM(d18:1\/25:1), SM(d18:1\/26:1), PGD2, LRG1, C8G, C8A, CP and CDH5 in SG are lower than PG. The omics results indicated disordered free radical scavenging, and lipid and amino acid metabolism networks and resulting NF\u2010\u03baB\u2010dependent cytokine generation in FM. Lactate level was altered simultaneously in urine and serum and significantly higher in sng\u2010dominant patients than others.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this study, we identified potential biomarkers from FM patients. The selected biomarkers could discriminate sng and pain phenotypes in FM patients. These results could help elucidate the underlying pathological mechanisms for more effective diagnosis and therapy for FM.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1871","type":"journal-article","created":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T08:57:57Z","timestamp":1633510677000},"page":"445-462","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Metabolomic and proteomic characterization of sng and pain phenotypes in fibromyalgia"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5468-5859","authenticated-orcid":false,"given":"Wei\u2010Hsiang","family":"Hsu","sequence":"first","affiliation":[{"name":"Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources China Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Der\u2010Sheng","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation National Taiwan University Hospital Bei\u2010Hu Branch  Taipei Taiwan"},{"name":"Community and Geriatric Medicine Research Center National Taiwan University Hospital Bei\u2010Hu Branch  Taipei Taiwan"},{"name":"Department of Physical Medicine and Rehabilitation National Taiwan University College of Medicine  Taipei Taiwan"},{"name":"Health Science and Wellness Center National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010Chi","family":"Ku","sequence":"additional","affiliation":[{"name":"School of Medicine College of Medicine Fu Jen Catholic University  New Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen\u2010Ming","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources China Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Cheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Sciences Academia Sinica  Taipei Taiwan"},{"name":"Neuroscience Program of Academia Sinica Academia Sinica  Taipei Taiwan"},{"name":"Taiwan Mouse Clinic Biomedical Translation Research Center Academia Sinica  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun\u2010Lian","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources China Medical University  Taichung Taiwan"},{"name":"Department of Pharmacy National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2010.0738"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002565"},{"key":"e_1_2_11_4_1","first-page":"167","article-title":"The role of the arginine metabolome in pain: Implications for sickle cell disease","volume":"9","author":"Bakshi N.","year":"2016","journal-title":"Journal of Pain Research"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41370-018-0062-9"},{"key":"e_1_2_11_6_1","first-page":"1048","article-title":"Urine cotinine screening detects nearly ubiquitous tobacco smoke exposure in urban adolescents","volume":"19","author":"Benowitz N. 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