{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:46:39Z","timestamp":1792687599458,"version":"4.5.0"},"reference-count":74,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mol Pain"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>\n                    Fibromyalgia (FM) is a complex disorder characterized by chronic pain, fatigue, and functional impairments, with unclear pathological mechanisms. Gut microbiota and plasma metabolites have been implicated in FM, but their causal relationships remain unexplored. This study aims to assess the causal relationships between gut microbiota, plasma metabolites, and FM using Mendelian randomization (MR) analysis and to explore potential mediating mechanisms. Public genome-wide association study data were analyzed using bidirectional MR. Associations between gut microbiota, plasma metabolites, and FM were evaluated, and multivariable MR identified mediating metabolites. Results were validated with inverse variance weighted, MR-Egger, and weighted median methods, with metabolic pathway enrichment analysis for further insights. MR identified protective associations between FM and four taxa (family\n                    <jats:italic toggle=\"yes\">Enterobacteriaceae<\/jats:italic>\n                    , genus\n                    <jats:italic toggle=\"yes\">Butyricicoccus<\/jats:italic>\n                    , genus\n                    <jats:italic toggle=\"yes\">Coprococcus1<\/jats:italic>\n                    , and order\n                    <jats:italic toggle=\"yes\">Enterobacteriales<\/jats:italic>\n                    ) and risk associations with genus\n                    <jats:italic toggle=\"yes\">Eggerthella<\/jats:italic>\n                    and genus\n                    <jats:italic toggle=\"yes\">Ruminococcaceae UCG005<\/jats:italic>\n                    . Additionally, 82 plasma metabolites linked to pathways such as caffeine metabolism, \u03b1-linolenic acid metabolism, GLP-1, and incretin regulation were associated with FM. Mediation analysis revealed\n                    <jats:italic toggle=\"yes\">Enterobacteriaceae<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">Enterobacteriales<\/jats:italic>\n                    influenced FM risk through 2,3-dihydroxypyridine and palmitoylcholine. Personalized dietary interventions, such as limiting caffeine intake, increasing omega-3 fatty acid consumption, adopting a low glycemic index diet, and reducing the intake of high-oxalate foods, may effectively alleviate FM-related symptoms by modulating metabolic pathways, reducing inflammation, and mitigating oxidative stress. This study highlights the intricate interactions between the gut microbiota and metabolic pathways, providing critical scientific evidence and actionable targets for clinical interventions, dietary management, and precision medicine approaches in FM treatment.\n                  <\/jats:p>","DOI":"10.1177\/17448069251332140","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T06:10:07Z","timestamp":1742537407000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Unraveling the role of gut microbiota and plasma metabolites in fibromyalgia: Insights from Mendelian randomization and dietary interventions"],"prefix":"10.1177","volume":"21","author":[{"given":"Mengqi","family":"Niu","sequence":"first","affiliation":[{"name":"Sichuan Provincial Center for Mental Health, Sichuan Provincial People\u2019s Hospital, School of Medicine, University of Electronic Science and 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Chulalongkorn University, and King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, Thailand"},{"name":"Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria"},{"name":"Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria"},{"name":"Research and Innovation Program for the Development of MU \u2013 PLOVDIV \u2013 (SRIPD-MUP), Creation of a Network of Research Higher Schools, National Plan for Recovery and Sustainability, European Union \u2013 NextGenerationEU"},{"name":"Kyung Hee University, Seoul, 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