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Is Fatigue an Inflammatory Variable in Rheumatoid Arthritis (RA)? Analyses of Fatigue in RA, Osteoarthritis, and Fibromyalgia
Journal article   Open access   Peer reviewed

Is Fatigue an Inflammatory Variable in Rheumatoid Arthritis (RA)? Analyses of Fatigue in RA, Osteoarthritis, and Fibromyalgia

Martin J. Bergman, Shadi S. Shahouri, Timothy S. Shaver, James D. Anderson, David N. Weidensaul, Ruth E. Busch, Shirley Wang and Frederick Wolfe
Journal of rheumatology, v 36(12), pp 2788-2794
01 Dec 2009
DOI: https://doi.org/10.3899/jrheum.090561
PMID: 19918042
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.3899/jrheum.090561View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Life Sciences & Biomedicine Rheumatology Science & Technology
Objective. To investigate whether fatigue is an inflammatory (rheumatoid arthritis; RA) variable, the contributions of RA variables to fatigue, and the levels of fatigue in RA compared with osteoarthritis (OA) and fibromyalgia (FM). Methods. We studied 2096 RA patients, 1440 with OA, and 1073 with FM in a clinical setting, and 14,607 RA, 3173 OA, and 2487 patients with FM in Survey research. We partitioned variables into inflammatory and noninflammatory factors and examined variable contribution to fatigue (0-10 visual analog scale). Results. Factor analysis identified Disease Activity Score-28 (DAS28) and swollen (SJC) and tender joint count (TJC) as a physician-inflammation factor, and patient global assessment, pain, Health Assessment Questionnaire, and fatigue as patient components. Fatigue demonstrated weak correlations with erythrocyte sedimentation rate (ESR; r = 0.071) and SIC (r = 0.112), weak to fair correlations with TJC (r = 0.294), physician global assessment of RA activity (r = 0.384), and DAS28 (r = 0.399), but strong correlation with patient global assessment of severity (r = 0.567). In hierarchical regression analysis, patient global explained 43.1% of DAS28 fatigue variance; when SIC, TIC, and ESR were entered, the explained variance increased to 43.7%. In reverse order, SJC, TIC, and ESR explained 9.2% of the variance, but explained variance increased to 43.7% when patient global was added. The mean clinic fatigue scores were RA 4.9, OA 4.8, FM 7.6; mean survey scores were RA 4.5, OA 4.4 FM 6.3. Adjusted for age and sex, RA and OA fatigue scores were not significantly different. Conclusion. Inflammatory components of the DAS28 contribute minimally to fatigue. RA and OA fatigue levels do not differ. Fatigue is not an inflammatory variable and has no unique association with RA or RA therapy. (First Release Nov 15 2009; J Rheumatol 2009;36:2788-94, doi: 10.3899/jrheum.090561)

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Collaboration types
Domestic collaboration
Web of Science research areas
Rheumatology
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