Börje Jonefjäll1,2, Magnus Simrén1,3, Anders Lasson4, Lena Öhman1,5,6, Hans Strid1,4. 1. Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Department of Internal Medicine and Clinical Nutrition, Gothenburg, Sweden. 2. Department of Internal Medicine, Kungälv Hospital, Kungälv, Sweden. 3. Center for Functional GI and Motility Disorders, University of North Carolina, Chapel Hill, NC, USA. 4. Department of Internal Medicine, Södra Älvsborgs Hospital, Borås, Sweden. 5. Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Department of Microbiology and Immunology, Gothenburg, Sweden. 6. School of Health and Education, University of Skövde, Skövde, Sweden.
Abstract
BACKGROUND: Patients with ulcerative colitis often report fatigue. OBJECTIVES: To investigate prevalence of and risk factors for fatigue in patients with ulcerative colitis with active disease and during deep remission. METHODS: In this cross-sectional study, disease activity was evaluated with endoscopy and calprotectin, and patients were classified as having active disease (n = 133) or being in deep remission (n = 155). Blood samples were analysed to assess anaemia, iron deficiency and systemic immune activity. Patients completed questionnaires to assess fatigue, psychological distress, gastrointestinal symptoms and quality of life. RESULTS: The prevalence of high fatigue (general fatigue ≥ 13, Multidimensional Fatigue Inventory) was 40% in the full study population. Among patients with high fatigue, female gender and iron deficiency were more prevalent, and these patients had more severe disease activity and reported higher levels of anxiety, depression and decreased quality of life compared with patients with no/mild fatigue. A logistic regression analysis identified probable psychiatric disorder (odds ratio (OR) (confidence interval) 6.1 (3.1-12.2)), iron deficiency (OR 2.5 (1.2-5.1)), active disease (OR 2.2 (1.2-3.9)) and female gender (OR 2.1 (1.1-3.7)) as independent risk factors for high fatigue. Similar results were found concerning psychological distress, gender and quality of life, but immune markers did not differ in patients in deep remission with high vs. no/mild fatigue. CONCLUSIONS: Probable psychiatric disorder, iron deficiency, active disease and female gender are independent risk factors for high fatigue in patients with ulcerative colitis. Low-grade immune activity does not seem to be the cause of fatigue among patients in deep remission.
BACKGROUND: Patients with ulcerative colitis often report fatigue. OBJECTIVES: To investigate prevalence of and risk factors for fatigue in patients with ulcerative colitis with active disease and during deep remission. METHODS: In this cross-sectional study, disease activity was evaluated with endoscopy and calprotectin, and patients were classified as having active disease (n = 133) or being in deep remission (n = 155). Blood samples were analysed to assess anaemia, iron deficiency and systemic immune activity. Patients completed questionnaires to assess fatigue, psychological distress, gastrointestinal symptoms and quality of life. RESULTS: The prevalence of high fatigue (general fatigue ≥ 13, Multidimensional Fatigue Inventory) was 40% in the full study population. Among patients with high fatigue, female gender and iron deficiency were more prevalent, and these patients had more severe disease activity and reported higher levels of anxiety, depression and decreased quality of life compared with patients with no/mild fatigue. A logistic regression analysis identified probable psychiatric disorder (odds ratio (OR) (confidence interval) 6.1 (3.1-12.2)), iron deficiency (OR 2.5 (1.2-5.1)), active disease (OR 2.2 (1.2-3.9)) and female gender (OR 2.1 (1.1-3.7)) as independent risk factors for high fatigue. Similar results were found concerning psychological distress, gender and quality of life, but immune markers did not differ in patients in deep remission with high vs. no/mild fatigue. CONCLUSIONS: Probable psychiatric disorder, iron deficiency, active disease and female gender are independent risk factors for high fatigue in patients with ulcerative colitis. Low-grade immune activity does not seem to be the cause of fatigue among patients in deep remission.
Authors: Mark S Silverberg; Jack Satsangi; Tariq Ahmad; Ian D R Arnott; Charles N Bernstein; Steven R Brant; Renzo Caprilli; Jean-Frédéric Colombel; Christoph Gasche; Karel Geboes; Derek P Jewell; Amir Karban; Edward V Loftus; A Salvador Peña; Robert H Riddell; David B Sachar; Stefan Schreiber; A Hillary Steinhart; Stephan R Targan; Severine Vermeire; B F Warren Journal: Can J Gastroenterol Date: 2005-09 Impact factor: 3.522
Authors: Magnus Simrén; Jenny Axelsson; Rolf Gillberg; Hasse Abrahamsson; Jan Svedlund; Einar S Björnsson Journal: Am J Gastroenterol Date: 2002-02 Impact factor: 10.864
Authors: Lesley A Graff; Ian Clara; John R Walker; Lisa Lix; Rachel Carr; Norine Miller; Linda Rogala; Charles N Bernstein Journal: Clin Gastroenterol Hepatol Date: 2013-04-16 Impact factor: 11.382
Authors: Anthony O'Connor; Raguprakash Ratnakumaran; Lisa Warren; Debbie Pullen; Anna Errington; David J Gracie; Rebecca C Sagar; P John Hamlin; Alexander C Ford Journal: Ther Adv Chronic Dis Date: 2019-03-26 Impact factor: 5.091
Authors: Arno R Bourgonje; Sietse J Wichers; Shixian Hu; Hendrik M van Dullemen; Marijn C Visschedijk; Klaas Nico Faber; Eleonora A M Festen; Gerard Dijkstra; Janneke N Samsom; Rinse K Weersma; Lieke M Spekhorst Journal: Sci Rep Date: 2022-08-26 Impact factor: 4.996