Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA 94143-0610, USA.
J Pain Symptom Manage. 2010 Oct;40(4):531-44. doi: 10.1016/j.jpainsymman.2009.12.006. Epub 2010 Jun 8.
Fatigue and sleep disturbance are common problems in oncology patients and their family caregivers (FCs). However, little is known about factors that contribute to interindividual variability in these symptoms or to their underlying biologic mechanisms.
An evaluation was done on whether genetic variation in a prominent proinflammatory cytokine, interleukin-6 (IL-6 c.-6101A>T [rs4719714]), was associated with mean ratings of evening fatigue, morning fatigue, and sleep disturbance, as well as with the trajectories of these symptoms.
Over six months, participants completed standardized measures of fatigue and sleep disturbance. Linear regression was used to assess the effect of the IL-6 genotype and other covariates on mean fatigue and sleep disturbance scores. Hierarchical linear modeling was used to determine the effect of the IL-6 genotype on symptom trajectories.
Common allele homozygotes reported higher levels of evening fatigue (P=0.003), morning fatigue (P=0.09), and sleep disturbance (P=0.003) than minor allele carriers. Predictors of baseline level and trajectories of evening fatigue included age, gender, and genotype (intercepts) and baseline level of evening fatigue (slope). Predictors of baseline level and trajectories of morning fatigue included age and genotype (intercept) and age and baseline level of morning fatigue (slope). Predictors of baseline level and trajectories of sleep disturbance included age and genotype (intercept) and baseline level of sleep disturbance (slope).
Findings provide preliminary evidence of a genetic association between a functional promoter polymorphism in the IL-6 gene and severity of evening fatigue, morning fatigue, and sleep disturbance in oncology patients and their FCs.
疲劳和睡眠障碍是肿瘤科患者及其家属照顾者(FCs)常见的问题。然而,对于导致这些症状个体差异的因素,或其潜在的生物学机制,人们知之甚少。
评估促炎细胞因子白细胞介素 6(IL-6 c.-6101A>T [rs4719714])的一个显著的遗传变异是否与傍晚疲劳、早晨疲劳和睡眠障碍的平均评分以及这些症状的轨迹有关。
在六个月的时间里,参与者完成了疲劳和睡眠障碍的标准化测量。线性回归用于评估 IL-6 基因型和其他协变量对疲劳和睡眠障碍平均评分的影响。分层线性建模用于确定 IL-6 基因型对症状轨迹的影响。
常见等位基因纯合子报告傍晚疲劳(P=0.003)、早晨疲劳(P=0.09)和睡眠障碍(P=0.003)的水平高于次要等位基因携带者。傍晚疲劳的基线水平和轨迹的预测因素包括年龄、性别和基因型(截距)以及傍晚疲劳的基线水平(斜率)。早晨疲劳的基线水平和轨迹的预测因素包括年龄和基因型(截距)以及早晨疲劳的基线水平(斜率)。睡眠障碍的基线水平和轨迹的预测因素包括年龄和基因型(截距)以及睡眠障碍的基线水平(斜率)。
研究结果初步提供了证据,表明 IL-6 基因的一个功能性启动子多态性与肿瘤患者及其 FCs 中傍晚疲劳、早晨疲劳和睡眠障碍的严重程度存在遗传关联。