Caruso Mazzolani Bruna, Infante Smaira Fabiana, Mendes Sieczkowska Sofia, Romero Marina, Toledo Ribeiro Thainá, Cordeiro Amarante Milla, Pasoto Sandra, de Sá Pinto Ana Lúcia, Rodrigues Lima Fernanda, Braga Benatti Fabiana, Bonfa Eloísa, Roschel Hamilton, Gualano Bruno
Applied Physiology and Nutrition Research Group; Laboratory of Assessment and Conditioning in Rheumatology; Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil.
School of Applied Sciences, Universidade Estadual de Campinas, São Paulo, Brazil.
Lupus. 2023 Oct;32(11):1287-1295. doi: 10.1177/09612033231202582. Epub 2023 Sep 12.
Systemic lupus erythematosus (SLE) patients report worse health-related quality of life (HRQL), fatigue, anxiety, depression, and sleep quality, when compared to the general population and other chronic diseases. Furthermore, cardiometabolic diseases are highly prevalent in SLE and are also associated with these parameters. Thus, it is plausible to suggest that SLE patients with a high cardiovascular risk may report worse results for these parameters. The aim of the study is to describe HRQL, fatigue, anxiety and depression symptoms, and sleep quality in a sample of SLE patients with a high cardiovascular risk profile (i.e., BMI between 25 and 40 kg/m and/or dyslipidemia, hypertension, or diabetes). This was a cross-sectional study where patients were assessed for (i) demographic, anthropometric, and disease-related parameters, (ii) HRQL, (iii) fatigue, (iv) anxiety and depression symptoms, and (v) sleep quality. One-hundred patients completed the study; however, only 87 patients were assessed for sleep quality data. Patients averaged 41.7 ± 9 years, and most patients were classified as overweight/obese (87%). SF-36 scores for physical and mental components summary were 51.3 ± 9.6 and 54.2 ± 15.6, respectively, with "bodily pain" and "role emotional" presenting the lower scores. The total SLEQOL score was 105.1 ± 42.0, with lower scores reported for "self-image" and "mood." Fatigue score was 30.8 ± 8.9, and 78% and 93% reported severe symptoms of anxiety and depression, respectively. The average sleep effectiveness was 82.9 ± 6.6%. Sleep latency, total time in bed (TTiB), and total sleep time (TST) were 8.4 ± 8.9, 495.8 ± 79.7, and 409.7 ± 69.9 min, respectively. Patients reported an average of 17.8 ± 6.2 WE, with 4.5 ± 1.5 min duration and a WASO of 77.7 ± 36.6 min. Despite similar HRQL, fatigue, and sleep quality parameters to those reported by other SLE populations, SLE patients with a high cardiovascular risk had a higher prevalence of depression and anxiety. Understanding SLE patients' quality of life and psychological symptoms is of utmost importance to improve disease management. The findings of this study highlight the need for more intensive and global care regarding mental health when considering a high cardiovascular risk in SLE.
与普通人群和其他慢性病患者相比,系统性红斑狼疮(SLE)患者报告的健康相关生活质量(HRQL)、疲劳、焦虑、抑郁和睡眠质量较差。此外,心血管代谢疾病在SLE中高度流行,并且也与这些参数相关。因此,有理由认为心血管风险高的SLE患者在这些参数上可能报告更差的结果。本研究的目的是描述具有高心血管风险特征(即体重指数在25至40kg/m之间和/或血脂异常、高血压或糖尿病)的SLE患者样本中的HRQL、疲劳、焦虑和抑郁症状以及睡眠质量。这是一项横断面研究,对患者进行了以下评估:(i)人口统计学、人体测量学和疾病相关参数;(ii)HRQL;(iii)疲劳;(iv)焦虑和抑郁症状;(v)睡眠质量。100名患者完成了研究;然而,只有87名患者的睡眠质量数据得到评估。患者平均年龄为41.7±9岁,大多数患者被归类为超重/肥胖(87%)。身体和心理成分总结的SF-36评分分别为51.3±9.6和54.2±15.6,“身体疼痛”和“角色情感”得分较低。SLEQOL总评分为105.1±42.0,“自我形象”和“情绪”得分较低。疲劳评分为30.8±8.9,分别有78%和93%的患者报告有严重的焦虑和抑郁症状。平均睡眠效率为82.9±6.6%。入睡潜伏期、卧床总时间(TTiB)和总睡眠时间(TST)分别为8.4±8.9、495.8±79.7和409.7±69.9分钟。患者平均报告有17.8±6.2次夜间觉醒,每次持续时间为4.5±1.5分钟,夜间觉醒总时间为77.7±36.6分钟。尽管HRQL、疲劳和睡眠质量参数与其他SLE人群报告的相似,但心血管风险高的SLE患者抑郁和焦虑的患病率更高。了解SLE患者的生活质量和心理症状对于改善疾病管理至关重要。本研究结果强调,在考虑SLE患者的高心血管风险时,需要对其心理健康进行更全面、深入的护理。