Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Gastroenterology, Østfold Hospital Trust, Sarpsborg, Norway.
J Crohns Colitis. 2023 Nov 24;17(11):1781-1790. doi: 10.1093/ecco-jcc/jjad094.
Although fatigue is common in inflammatory bowel disease [IBD], its pathogenesis remains unclear. This study aimed to determine the prevalence of fatigue and its associated factors in a cohort of patients newly diagnosed with IBD.
Patients ≥18 years old were recruited from the Inflammatory Bowel Disease South-Eastern Norway [IBSEN III] study, a population-based, observational inception cohort. Fatigue was assessed using the Fatigue Questionnaire and compared with data from a Norwegian general population. Univariate and multivariate linear and logistic regression analyses were performed to evaluate the associations of total fatigue [TF; continuous score] and substantial fatigue [SF; dichotomized score ≥4] with sociodemographic, clinical, endoscopic, laboratory, and other relevant patient data.
In total, 983/1509 [65.1%] patients with complete fatigue data were included (ulcerative colitis [UC], 68.2%; Crohn's disease [CD], 31.8%). The prevalence of SF was higher in CD [69.6%] compared with UC [60.2%] [p < 0.01], and in both diagnoses when compared to the general population [p < 0.001]. In multivariate analyses, depressive symptoms, pain intensity, and sleep disturbances were associated with increased TF for both diagnoses. In addition, increased clinical disease activity and Mayo endoscopic score were significantly associated with TF in UC, whereas all disease-related variables were insignificant in CD. Similar findings were observed for SF, except regarding the Mayo endoscopic score.
SF affects approximately two-thirds of patients newly diagnosed with IBD. Fatigue was associated with depressive symptoms, sleep disturbances, and increased pain intensity in both diagnoses, while clinical and endoscopic activity were associated factors only in UC.
尽管疲劳是炎症性肠病（IBD）的常见症状，但其发病机制仍不清楚。本研究旨在确定新诊断为 IBD 的患者队列中疲劳的患病率及其相关因素。
从炎症性肠病挪威东南部（IBSEN III）研究中招募了≥18 岁的患者，这是一项基于人群的观察性发病队列研究。使用疲劳问卷评估疲劳，并与挪威一般人群的数据进行比较。采用单变量和多变量线性和逻辑回归分析，评估总疲劳[TF；连续评分]和显著疲劳[SF；二分类评分≥4]与社会人口统计学、临床、内镜、实验室和其他相关患者数据的关联。
共有 983/1509（65.1%）名完成疲劳数据的患者被纳入研究（溃疡性结肠炎[UC]，68.2%；克罗恩病[CD]，31.8%）。CD 的 SF 患病率（69.6%）高于 UC（60.2%）[p < 0.01]，且在两种诊断中均高于一般人群[p < 0.001]。在多变量分析中，抑郁症状、疼痛强度和睡眠障碍与两种诊断的 TF 增加相关。此外，临床疾病活动度和 Mayo 内镜评分增加与 UC 的 TF 显著相关，而在 CD 中，所有疾病相关变量均不显著。SF 也存在类似的发现，除了 Mayo 内镜评分。
SF 影响大约三分之二的新诊断为 IBD 的患者。疲劳与抑郁症状、睡眠障碍和疼痛强度增加在两种诊断中均相关，而临床和内镜活动度仅与 UC 相关。
