洛桑中年人群疲劳的患病率及相关因素：一项基于人群的横断面调查。
Prevalence and factors associated with fatigue in the Lausanne middle-aged population: a population-based, cross-sectional survey.
机构信息
Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
出版信息
BMJ Open. 2019 Aug 24;9(8):e027070. doi: 10.1136/bmjopen-2018-027070.
OBJECTIVE
To assess the prevalence and factors associated with fatigue in the general population.
DESIGN
Population-based, cross-sectional survey performed between May 2014 and April 2017.
SETTING
General population of the city of Lausanne, Switzerland.
PARTICIPANTS
2848 participants (53.2% women, age range 45-86 years).
PRIMARY OUTCOME MEASURE
Prevalence of fatigue the previous week, defined as a score of ≥4 using the Fatigue Severity Scale.
RESULTS
The prevalence of fatigue was 21.9% (95% CI 20.4% to 23.4%) in the total sample. On bivariate analysis, participants with fatigue were younger, had a higher body mass index, a lower handgrip strength and lower ferritin levels. Participants with fatigue were more frequently women, had a lower educational level, presented more frequently with clinical insomnia, diabetes, anaemia, depression and low thyroid stimulating hormone (TSH) values, had a higher consumption of antihistamines, antidepressants and hypnotics, and rated more frequently their health as bad or very bad. Multivariable analysis showed that obesity (OR 1.40 (95% CI 1.03 to 1.91)), insomnia categories (p value for trend <0.001), depression (OR 3.26 (95% CI 2.38 to 4.46)), anaemia (OR 1.70 (95% CI 1.00 to 2.89)) and low self-rated health status (p value for trend <0.001) were positively associated with fatigue, while older age (p value for trend 0.002) was negatively associated with fatigue. Conversely, no association was found for diabetes, TSH levels, antihistamines or hypnotics.
CONCLUSION
In a population-based sample aged 45-86, fatigue was present in one out of five subjects. Regarding clinical factors, sleep disturbances such as insomnia and sleep apnoea should be assessed first, followed by depression. Regarding biological factors, anaemia should be ruled out, while screening for hypothyroidism is not recommended as a first step. Sleep complaints and fatigue in older subjects are not due to ageing and should prompt identification of the underlying cause.
目的
评估一般人群中疲劳的患病率及相关因素。
设计
2014 年 5 月至 2017 年 4 月进行的基于人群的横断面调查。
地点
瑞士洛桑市的一般人群。
参与者
2848 名参与者（53.2%为女性，年龄 45-86 岁）。
主要结局测量指标
使用疲劳严重程度量表（Fatigue Severity Scale）评估前一周的疲劳发生率，得分≥4 定义为疲劳。
结果
在总样本中，疲劳的患病率为 21.9%（95%CI 20.4%至 23.4%）。在单变量分析中，疲劳患者年龄较小，体质指数较高，握力较低，铁蛋白水平较低。疲劳患者中女性较多，教育程度较低，更常出现临床失眠、糖尿病、贫血、抑郁和促甲状腺激素（TSH）值较低，抗组胺药、抗抑郁药和催眠药的使用率较高，且自我报告的健康状况更差或非常差。多变量分析显示肥胖（OR 1.40（95%CI 1.03 至 1.91））、失眠类别（p 值趋势<0.001）、抑郁（OR 3.26（95%CI 2.38 至 4.46））、贫血（OR 1.70（95%CI 1.00 至 2.89））和自我报告的健康状况较差（p 值趋势<0.001）与疲劳呈正相关，而年龄较大（p 值趋势 0.002）与疲劳呈负相关。相反，糖尿病、TSH 水平、抗组胺药或催眠药与疲劳无相关性。
结论
在 45-86 岁的人群中，有五分之一的人存在疲劳。关于临床因素，应首先评估失眠和睡眠呼吸暂停等睡眠障碍，然后再评估抑郁。关于生物因素，应排除贫血，而筛查甲状腺功能减退症则不建议作为第一步。老年患者的睡眠主诉和疲劳不是由于衰老引起的，应查明潜在原因。
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