系统性硬化症中的疲劳水平及相关因素：对2385名SPIN队列参与者的横断面研究
Fatigue levels and associated factors in systemic sclerosis: a cross-sectional study of 2385 SPIN Cohort participants.
作者信息
Kwakkenbos Linda, Levis Brooke, Henry Richard S, Virgili-Gervais Gabrielle, Carrier Marie-Eve, Bartlett Susan J, Gietzen Amy, Gottesman Karen, Guillot Geneviève, Lawrie-Jones Amanda, Hummers Laura K, Malcarne Vanessa L, Mayes Maureen D, Richard Michelle, Wojeck Robyn K, Worron-Sauvé Maureen, Hudson Marie, Mouthon Luc, Benedetti Andrea, Thombs Brett D
机构信息
Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.
Department of IQ Health, Radboud University Medical Center, Nijmegen, the Netherlands.
出版信息
Rheumatology (Oxford). 2025 May 1;64(5):2810-2820. doi: 10.1093/rheumatology/keae570.
OBJECTIVES
The objectives of this study were to compare fatigue in a large multinational SSc cohort with general population data and identify associated sociodemographic, lifestyle and SSc disease factors.
METHODS
Scleroderma Patient-centered Intervention Network Cohort participants completed the Patient-Reported Outcomes Measurement Information System-29 v2.0 fatigue domain. T-scores were compared with the USA general population (mean = 50; s.d. = 10). Multivariable linear regression was used to assess associations with sociodemographic, lifestyle, and disease-related variables.
RESULTS
Among the 2385 participants [mean age 54.9 (s.d. = 12.6) years, 87% female, 38% dcSSc], the mean fatigue T-score was 54.6 (s.d. = 11.0); 438 (18%) reported mild fatigue, 641 (27%) moderate fatigue, and 180 (8%) severe fatigue. Fatigue was independently associated with sociodemographic factors age [-0.10 points per year, (95% CI -0.14, -0.07)], male sex [-1.67 points, (-2.96, -0.37)], non-married status [0.97 points (0.04, 1.89)] and country [reference USA; France -2.35 points (-3.48, -1.21) and UK 2.38 points (0.80, 3.97)], and lifestyle factors smoking [4.16 points (2.52, 5.80)], alcohol consumption [-0.18 points per drink per week (-0.28, -0.07)] and BMI [0.34 points per unit (0.27, 0.42)]. Fatigue was associated with disease-related factors, including gastrointestinal involvement [4.21 points (2.99, 5.43)], digital ulcers [1.51 points, (0.25, 2.77)], moderate small joint contractures (1.41 points [0.13, 2.69]), RA [4.34 points (2.37, 6.31)] and SS [1.89 points (0.23, 3.55)]. When pain was included in the model, its association was large [2.19 points (2.03, 2.34)], and interstitial lung disease was also associated [1.21 points (0.42, 2.00)].
CONCLUSION
In people with SSc, fatigue scores were substantially higher than in the general population and associated with multiple disease factors, including gastrointestinal involvement, several painful disease manifestations, and lung involvement.
目的
本研究的目的是将一个大型跨国硬皮病队列中的疲劳情况与普通人群数据进行比较，并确定相关的社会人口学、生活方式和硬皮病疾病因素。
方法
硬皮病患者中心干预网络队列的参与者完成了患者报告结局测量信息系统29 v2.0疲劳领域的调查。将T分数与美国普通人群（平均值=50；标准差=10）进行比较。采用多变量线性回归来评估与社会人口学、生活方式和疾病相关变量的关联。
结果
在2385名参与者中[平均年龄54.9（标准差=12.6）岁，87%为女性，38%为弥漫性皮肤型硬皮病（dcSSc）]，平均疲劳T分数为54.6（标准差=11.0）；438人（18%）报告有轻度疲劳，641人（27%）报告有中度疲劳，180人（8%）报告有重度疲劳。疲劳与社会人口学因素年龄[每年-0.10分，（95%置信区间-0.14，-0.07）]、男性[-1.67分，（-2.96，-0.37）]、未婚状态[0.97分（0.04，1.89）]和国家[以美国为参照；法国-2.35分（-3.48，-1.21），英国2.38分（0.80，3.97）]，以及生活方式因素吸烟[4.16分（2.52，5.80）]、每周饮酒量[-0.18分/杯（-0.28，-0.07）]和体重指数[每单位0.34分（0.27，0.42）]独立相关。疲劳与疾病相关因素有关，包括胃肠道受累[4.21分（2.99，5.43）]、指端溃疡[1.51分，（0.25，2.77）]、中度小关节挛缩（1.41分[0.13，2.69]）、类风湿关节炎[4.34分（2.37，6.31）]和干燥综合征[1.89分（0.23，3.55）]。当疼痛纳入模型时，其关联度很大[2.19分（2.03，2.34）]，间质性肺疾病也有关联[1.21分（0.42，2.00）]。
结论
在硬皮病患者中，疲劳评分显著高于普通人群，并与多种疾病因素相关，包括胃肠道受累、几种疼痛性疾病表现和肺部受累。
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