Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California 90095, USA.
Biol Psychiatry. 2009 Nov 1;66(9):871-8. doi: 10.1016/j.biopsych.2009.06.008. Epub 2009 Jul 29.
Fatigue is highly prevalent and causes serious disruption in quality of life. Although the underlying biological mechanism is unknown, increases in inflammation have been implicated. This prospective study examined the association between C-reactive protein (CRP), a biomarker of systemic inflammation, and fatigue 5 years later.
The Coronary Artery Risk Development in Young Adults (CARDIA) study is a population-based longitudinal study conducted in four U.S. cities. Highly sensitive CRP concentration and fatigue were measured in 2983 African American and white adults at both year 15 (2000-2001, ages 33-45 years) and year 20 (2005-2006) examinations. Fatigue was assessed using the vitality subscale of the 12-item Short Form Health Survey.
Plasma CRP concentration at baseline (i.e., CARDIA year 15) was a significant predictor of fatigue level 5 years later (unadjusted beta = .126, p < .001). After adjustment for potential confounders, this association remained significant (adjusted beta = .044, p = .033). Additionally, baseline CRP independently predicted fatigue in the subgroup of participants without medical comorbidity (adjusted beta = .051, p = .039). Fatigue was associated with a persistent elevation of CRP at both examinations but not with a transient elevation of CRP at only one of the examinations.
This is the first study to demonstrate a prospective association between an inflammatory marker and fatigue in a general population. Furthermore, the association between low-grade systemic inflammation and fatigue seems primarily driven by persistent immune activation and not explained by the presence or development of medical comorbidity.
疲劳的发病率很高，严重扰乱了生活质量。虽然其潜在的生物学机制尚不清楚，但炎症的增加已被牵涉其中。本前瞻性研究检查了 C 反应蛋白（CRP），一种全身性炎症的生物标志物，与 5 年后疲劳之间的关联。
冠状动脉风险发展在年轻人（CARDIA）研究是一项基于人群的纵向研究，在美国四个城市进行。在 15 年（2000-2001 年，年龄 33-45 岁）和 20 年（2005-2006 年）检查时，2983 名非裔美国人和白人成年人同时测量了高敏 CRP 浓度和疲劳。疲劳使用 12 项简短健康调查的活力子量表进行评估。
基线时的血浆 CRP 浓度（即 CARDIA 年 15 年）是 5 年后疲劳水平的显著预测因子（未调整的β=0.126，p<0.001）。在调整潜在混杂因素后，这种关联仍然显著（调整后的β=0.044，p=0.033）。此外，在没有合并症的参与者亚组中，基线 CRP 独立预测疲劳（调整后的β=0.051，p=0.039）。疲劳与两次检查中 CRP 的持续升高有关，但与仅一次检查中 CRP 的短暂升高无关。
这是第一项在一般人群中证明炎症标志物与疲劳之间存在前瞻性关联的研究。此外，低水平全身炎症与疲劳之间的关联似乎主要是由持续的免疫激活驱动的，而不是由合并症的存在或发展来解释的。
