To evaluate the association between clinically significant fatigue, organ damage, and body mass index (BMI) in patients with systemic lupus erythematosus (SLE).
Key Findings:
52% of patients reported clinically significant fatigue.
Patients with fatigue had higher organ damage scores (mean SLICC/ACR DI: 1.9 vs 1.1) and higher BMI (mean: 30 vs 28).
Disease activity scores were similar between fatigued and non-fatigued patients.
Racial differences in fatigue reporting were noted, with non-Hispanic White patients more likely to report fatigue than Black patients (71% vs 40%).
Fatigue was independently associated with pulmonary fibrosis, neuropathy, and higher BMI.
Interpretation:
Fatigue in SLE appears to be more closely linked to cumulative organ damage and comorbid factors rather than current disease activity.
Limitations:
Single-center, cross-sectional design.
Modest sample size.
Reliance on patient-reported fatigue at a single time point.
Lack of assessment for factors like physical activity, pain, sleep, and psychosocial variables.
Conclusion:
Organ damage accrual, particularly pulmonary fibrosis and neuropathy, along with high BMI, are associated with clinically significant fatigue in SLE. Further longitudinal and mechanistic studies are warranted.
