Villoria Albert, García Víctor, Dosal Angelina, Moreno Laura, Montserrat Antònia, Figuerola Ariadna, Horta Diana, Calvet Xavier, Ramírez-Lázaro María José
Servei Aparell Digestiu, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí, Sabadell, Spain.
Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain.
PLoS One. 2017 Jul 27;12(7):e0181435. doi: 10.1371/journal.pone.0181435. eCollection 2017.
Fatigue is a common and bothersome symptom in inflammatory bowel disease (IBD) patients. The study was aimed to determine the relationship of biological and psychological factors with IBD-related fatigue.
Consecutive clinically inactive IBD outpatients receiving immunosuppressants or biological drugs were enrolled between January and December 2013. Patients completed a Fatigue score (FACIT-F), various psychological, quality of life (IBDQ-9), and IBD activity scores. Biological parameters were assessed, including levels of interleukins (IL-5, IL-8 and IL-12) and micronutrients.
We prospectively recruited 202 patients (28% ulcerative colitis and 72% Crohn's disease) for the study. Fatigue measured by FACIT-F score was prevalent in the studied population (54%, 96/177) and higher than in the general population. In the univariate analysis no relation was found between IL levels or micronutrient deficiencies and fatigue. Fatigue was significantly related to female sex, Crohn's disease, joint disorders, body mass index (BMI), psychological tests, thiopurine use, and anti-TNF treatment. All these variables were included in the multivariate analysis. Female sex (OR: 4.8), high BMI (OR:1.2) and higher depression rates (OR:1.2) were predictors of increased fatigue. High IBDQ-9 score (OR: 0.82) was significantly related to lower degrees of fatigue.
Fatigue was prevalent in quiescent IBD patients with moderate-to-severe disease. It was associated with high levels of depression, low quality of life, and female sex. No association was found with the other biological and psychological factors evaluated.
疲劳是炎症性肠病（IBD）患者常见且令人困扰的症状。本研究旨在确定生物学和心理因素与IBD相关疲劳之间的关系。
2013年1月至12月，连续纳入接受免疫抑制剂或生物药物治疗的临床非活动期IBD门诊患者。患者完成疲劳评分（FACIT-F）、各种心理、生活质量（IBDQ-9）和IBD活动评分。评估生物学参数，包括白细胞介素（IL-5、IL-8和IL-12）水平和微量营养素。
我们前瞻性招募了202例患者（28%为溃疡性结肠炎，72%为克罗恩病）进行研究。通过FACIT-F评分测量的疲劳在研究人群中很普遍（54%，96/177），且高于一般人群。单因素分析未发现IL水平或微量营养素缺乏与疲劳之间存在关联。疲劳与女性、克罗恩病、关节疾病、体重指数（BMI）、心理测试、硫唑嘌呤使用和抗TNF治疗显著相关。所有这些变量都纳入了多因素分析。女性（OR：4.8）、高BMI（OR：1.2）和较高的抑郁率（OR：1.2）是疲劳增加的预测因素。高IBDQ-9评分（OR：0.82）与较低程度的疲劳显著相关。
疲劳在中度至重度静止期IBD患者中很普遍。它与高抑郁水平、低生活质量和女性性别有关。未发现与评估的其他生物学和心理因素存在关联。
