title: Disease activity and damage are not associated with increased levels of fatigue in systemic lupus erythematosus patients from a multiethnic cohort: LXVII.
abstract: OBJECTIVE
  To determine the factors associated with increased levels of fatigue over the course of the disease in systemic lupus erythematosus (SLE) patients from LUpus in MInorities: NAture versus nurture, a longitudinal multiethnic cohort.
  
  
  METHODS
  Patients with SLE (according to the American College of Rheumatology revised and updated criteria) age >/=16 years with a disease duration </=5 years at entry into the cohort, and of Hispanic (Texan or Puerto Rican), African American, or Caucasian ethnicity were studied. The association between socioeconomic/demographic characteristics, health behaviors, behavioral and psychological, functional and clinical characteristics, and fatigue was examined using generalized estimating equations to account for the longitudinal nature of the data.
  
  
  RESULTS
  A total of 515 patients ( approximately 91% female) contributed 2,609 visits to these analyses. Of these patients, 93 (18.1%) were Texan-Hispanic, 101 (19.6%) were Puerto Rican-Hispanic, 169 (32.8%) were African Americans, and 152 (29.5%) were Caucasian. The mean +/- SD patient age and followup time were 37.2 +/- 12.6 years and 4.7 +/- 3.2 years, respectively. Variables associated with increased levels of fatigue in the multivariable analyses were Caucasian ethnicity, the presence of constitutional symptoms (fever, weight loss), and higher levels of pain, abnormal illness-related behaviors, and helplessness (P values between 0.0018 and <0.0001).
  
  
  CONCLUSIONS
  The presence of pain, abnormal illness-related behaviors, helplessness, and constitutional manifestations were associated with increased levels of fatigue. However, SLE-specific measures, such as disease activity and damage, were not. Interventions aimed at decreasing fatigue need to take into account these findings.
authors.affiliation: University of Alabama, Birmingham, AL,USA.
authors.forename: Paula I
authors.initials: PI
authors.lastname: Burgos
authors.forename: Graciela S
authors.initials: GS
authors.lastname: Alarcón
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.forename: Kendra Q
authors.initials: KQ
authors.lastname: Crews
authors.forename: John D
authors.initials: JD
authors.lastname: Reveille
authors.forename: Luis M
authors.initials: LM
authors.lastname: Vilá
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology / Q000523:psychology; D015331:Cohort Studies; D005221:Fatigue / Q000208:ethnology* / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000208:ethnology / Q000523:psychology; D006801:Humans; D055809:Illness Behavior / Q000502:physiology; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000208:ethnology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010146:Pain / Q000503:physiopathology; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D044465:White People / Q000208:ethnology / Q000523:psychology