Systemic lupus erythematosus in three ethnic groups.: VI:: Factors associated with fatigue within 5 years of criteria diagnosis
Systemic lupus erythematosus in three ethnic groups.: VI:: Factors associated with fatigue within 5 years of criteria diagnosis
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DOI：
10.1191/096120300678828046
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发表时间：
2000-01-01
期刊：
影响因子：
2.6
通讯作者：
Alarcón, GS
中科院分区：
文献类型：
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作者：
Zonana-Nacach, A;Roseman, JM;Alarcón, GS
目的：研究初发(小于或等于5年)系统性红斑狼疮(SLE)的西班牙裔(H)、非裔美国人(AA)和高加索人(C)患者在基线评估时疲劳的频率、程度和相关特征。方法：对69例H(n=69)、AA(n=83)酸性C(n=71)患者进行研究。疲劳[疲劳严重程度评分(FSS)]被定义为存在，如果FSS评分大于或等于3.0。在研究开始时，从功能、临床、社会人口学、健康行为、行为、心理和免疫遗传学领域确定变量。结果：86%(85.7%)的患者报告有疲劳(82.6%的H；85.5%的AA；88.7%的C)；FSS评分中值为5.3。来自心理和临床领域的因素主要与FSS有关；免疫遗传特征(HLAII类表型)与FSS无关。疲劳感的增加与身体和精神功能的下降密切相关。在多变量逐步模型中，与基线时显著更大程度的疲劳感相关的变量按所解释的额外部分R-2递减的顺序包括：异常的疾病相关行为、较大的年龄、较高的自我报告疼痛、较大程度的无助感、较大的疾病活跃度、高加索种族以及缺乏医疗保险(模型R-2=37%)。结论：疲劳是所有种族中SLE最常见的临床表现之一。系统性红斑狼疮患者对疲劳严重程度的认知可能是多因素的，包括心理社会因素和疾病活动。如果这些被证明是因果关系，了解它们的作用可能会建议进行治疗和/或行为干预，这可能会改善这种普遍存在的、通常使人丧失能力的系统性红斑狼疮症状。
Objective: To determine the frequency, degree and associated features of fatigue among Hispanic (H), African American (AA) and Caucasian (C) patients with recent onset (less than or equal to 5 yr) systemic lupus erythematosus (SLE) at their baseline evaluation.Methods: H (n = 69), AA (n = 83) acid C (n = 71) patients from the LUMINA (LUpus in MInority populations: NAture vs Nurture) cohort were studied. Fatigue [Fatigue Severity Scale (FSS)] was defined as present if FSS score greater than or equal to 3.0. Variables from functional, clinical, sociodemographic, health behaviors, behavioral and psychological and immunogenetics domains were ascertained at study entry. Associations were examined using regression models.Results: Eighty-six percent (85.7%) of patients reported having fatigue (82.6% H; 85.5% AA; 88.7% C); median FSS score, 5.3. Factors from the psychological and clinical domains were primarily associated with FSS; immunogenetic (HLA Class II phenotypes) features were not. Increased fatigue was strongly associated with decreasing function, both physical and mental. Variables associated with significantly greater degree of fatigue at baseline in the multivariable stepwise model in order of decreasing additional partial R-2 explained included: abnormal illness-related behaviors, older age, higher self-reported pain, greater degree of helplessness, greater disease activity, Caucasian race, and lacking health insurance (model R-2 = 37%).Conclusions: Fatigue is one of the most prevalent clinical manifestations of SLE across all ethnic groups. The perception of fatigue severity in SLE may be multifactorial in origin, including psychosocial factors and disease activity. If these prove causal, knowledge of their contribution may suggest therapeutic and/or behavioral interventions, which could ameliorate this pervasive and often incapacitating symptom of SLE.