Iaquinta Francesco Salvatore, Grembiale Rosa Daniela, Mauro Daniele, Pantano Ilenia, Naty Saverio, Cosco Cristina, Iacono Daniela, Gaggiano Emanuela, Ruggiero Annarita, Ciccia Francesco, Doldo Patrizia, Spagnuolo Rocco
Department of Health Sciences, Magna Græcia University of Catanzaro, 88100 Catanzaro, Italy.
Department of Precision Medicine, L. Vanvitelli University of Campania, 80131 Naples, Italy.
J Clin Med. 2022 Apr 27;11(9):2455. doi: 10.3390/jcm11092455.
Fatigue is a main symptom of chronic diseases, including immune-mediated inflammatory diseases (IMIDs), such as inflammatory bowel disease (IBD) and inflammatory arthritis (IA); however, the pathophysiological mechanisms are not completely understood. The aim of this study was to assess the prevalence of fatigue and the associated factors in an IMIDs population. A control group, IBD, and IA patients, were enrolled. The PROMIS® fatigue questionnaire was used to evaluate the symptoms. Information on demographics, anthropometrics, disease characteristics, and medications was collected for each participant. A total of 471 subjects (137 with IBD, 103 with IA, and 206 controls) were enrolled. IBD and IA patients reported greater fatigue than controls (p < 0.001, each). In univariate regression, patients with anxiety and depression were more likely to report fatigue (p = 1.40 × 10−9 and p = 3.80 × 10−11, respectively). Males, holding a high school diploma, and being employed were inversely correlated to the domain (p = 1.3 × 10−5; p = 0.003 and p = 0.005, respectively). The use of steroids and disease activity determined increased fatigue (p = 0.014 and p = 0.019; respectively). In the multivariate analysis, anxiety and depression remained associated (p = 0.002 and p = 1.3 × 10−5, respectively). IMIDs patients present increased fatigue compared with healthy subjects. Anxiety and depression are the main associated factors, suggesting a psychological component of the symptom; thus, a holistic management should be established.
疲劳是包括免疫介导的炎症性疾病（IMIDs）在内的慢性疾病的主要症状，如炎症性肠病（IBD）和炎症性关节炎（IA）；然而，其病理生理机制尚未完全明确。本研究旨在评估IMIDs人群中疲劳的患病率及相关因素。纳入了一个对照组、IBD患者和IA患者。使用PROMIS®疲劳问卷评估症状。为每位参与者收集了人口统计学、人体测量学、疾病特征和用药信息。共纳入471名受试者（137名IBD患者、103名IA患者和206名对照）。IBD和IA患者报告的疲劳程度高于对照组（均为p < 0.001）。在单因素回归分析中，焦虑和抑郁患者更有可能报告疲劳（分别为p = 1.40 × 10−9和p = 3.80 × 10−11）。男性、拥有高中文凭和就业与该领域呈负相关（分别为p = 1.3 × 10−5；p = 0.003和p = 0.005）。使用类固醇和疾病活动度决定了疲劳程度增加（分别为p = 0.014和p = 0.019）。在多因素分析中，焦虑和抑郁仍然相关（分别为p = 0.002和p = 1.3 × 10−5）。与健康受试者相比，IMIDs患者的疲劳程度增加。焦虑和抑郁是主要的相关因素，提示该症状存在心理成分；因此，应建立整体管理方案。
