P172 Clinical and biological predictors of fatigue in Inflammatory Bowel Disease patients
A. Villoria*1, V. García2, A. Dosal3, L. Moreno3, A. Montserrat1, A. Figuerola1, X. Calvet1
1Corporació Sanitària Universitària Parc Taulí, Digestive Disease Department. Departament de Medicina. Universitat Autònoma de Barcelona. CIBEREHD – Instituto de Salud Carlos III, Sabadell, Spain, 2Corporació Sanitària Universitària Parc Taulí, Digestive Disease Department., Sabadell, Spain, 3Corporació Sanitària Universitària Parc Taulí, Digestive Disease Department, Sabadell, Spain
Fatigue is a common and bothersome symptom that inflammatory bowel disease (IBD) patients have to face even in remission. Many psychological and biological factors have been related to fatigue. The aim of the study is to determine the role of different biological and psychological factors in IBD-related fatigue.
All IBD patients followed at our Gastroenterology Day Hospital between January and December 2013 were included. Patients complete Functional Assessment of Chronic Illness Therapy-Fatigue score (FACITC-F) as well as psychological scores (Beck for depression, Stai for anxiety, Epworth for sleep disturbances and IBDQ-9 for quality of life) and IBD activity scores. Biological parameters (Interleukin 5, 8, 12, complete blood count, ferritin, C-reactive protein, erythrocyte sedimentation rate and micronutrients) were tested by appropriate blood tests.
A total of 219 were studied and at the end of the study 177 patients (mean age, 39 ± 12 years, 28% ulcerative colitis and 72% crohn's disease) were included for the analysis. The median Fatigue score (38, range (1-52)) was lower that than in general population. Twenty-eight (16%) patients had moderate-to-severe fatigue determined as fatigue score of 22 or lower. In the univariate analysis, fatigue differed significatively with gender, type of IBD, Harvey and Mayo score, articular disease, body mass Index (BMI), psychological tests, thiopurine and biological treatment. All these variables were included in the multivariate analysis. Female gender (ß -6.61, p<0.001), BMI (ß -0.61, p<0.001) and higher depression (ß -0.43, p<0.001) and anxiety (ß -0.18, p<0.001) scores were predictors of increased fatigue. IBDQ-9 (ß 0.51, p<0.001) was independently related to lower fatigue.
Fatigue was prevalent in our IBD patients and was related to high levels of anxiety and depression and low quality of life. None of the biological factors evaluated including pro-inflammatory interleukins or micronutrient deficiencies was associated with fatigue.