title: Serum dehydroepiandrosterone sulphate levels and laboratory and clinical parameters indicating expression of disease are not associated with fatigue, well-being and functioning in patients with primary Sjögren's syndrome.
abstract: OBJECTIVE
  The aim of this study was to compare serum dehydroepiandrosterone sulphate (DHEAS) levels and clinical and laboratory parameters reflecting expression of disease between female patients with primary Sjögren's syndrome (pSS) and age-matched healthy women and to examine in pSS patients the correlation of these variables with fatigue, well-being, and functioning.
  
  
  METHODS
  Comparisons were made between 60 female pSS patients and 60 age-matched healthy women. We assessed questionnaire scores of general fatigue, depressed mood, mental wellbeing, and physical functioning, tear production (Schirmer I test), tender point counts, serum DHEAS level, haemoglobin concentration, erythrocyte sedimentation rate, and serum immunoglobulin G.
  
  
  RESULTS
  As compared to healthy participants, patients had more fatigue and depressed mood, reduced well-being and functioning, more dryness and pain, lower serum DHEAS levels, and more expression of disease as reflected by laboratory assessments (p≤0.001). In pSS patients, fatigue, well-being, and functioning correlated with tender point counts, but not with the extent of dryness and also not with laboratory assessments including serum DHEAS levels.
  
  
  CONCLUSIONS
  The high prevalence of fatigue and reduced functioning in pSS patients might suggest a mediating role of generalised autoimmune processes. In the present study, clinical observations and laboratory assessments are not correlated with persistent fatigue and reduced functioning. Our results suggest that treatment of fatigue, well-being, and functioning, should target other variables than those examined in this study, preferably psychological variables or perhaps specific immunologic parameters.
authors.affiliation: Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Hartkamp
authors.forename: R
authors.initials: R
authors.lastname: Geenen
authors.forename: A A
authors.initials: AA
authors.lastname: Kruize
authors.forename: E R
authors.initials: ER
authors.lastname: Bossema
authors.forename: G L R
authors.initials: GL
authors.lastname: Godaert
authors.forename: H
authors.initials: H
authors.lastname: Bootsma
authors.forename: J W J
authors.initials: JW
authors.lastname: Bijlsma
authors.forename: R H W M
authors.initials: RH
authors.lastname: Derksen
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D004185:Disability Evaluation; D005221:Fatigue / Q000453:epidemiology / Q000276:immunology* / Q000378:metabolism*; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012859:Sjogren's Syndrome / Q000453:epidemiology / Q000276:immunology* / Q000378:metabolism*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019314:Dehydroepiandrosterone Sulfate