Fatigue and associated factors among patients with systemic lupus erythematosus in China: a cross-sectional study

This study aimed to evaluate fatigue in systemic lupus erythematosus (SLE) patients and systematically analyze the main factors associated with fatigue.

We recruited potential participants from the Department of Rheumatology and Immunology of two tertiary hospitals in China between August 2021 and January 2022. We used questionnaires to collect research data, including sociodemographic data, disease-related data, fatigue, anxiety and depression, illness perception, social support, sleep quality, physical activity, and disease activity. The independent sample t-test, one-way analysis of variance (ANOVA), non-parametric test, Pearson's/Spearman's correlation analysis, and multiple linear regression analysis were used in this study.

A total of 201 patients with SLE were included in this study. The prevalence of fatigue in SLE patients was 58.7%, with a mean fatigue score of 4.36 ± 1.18. The multiple linear regression analysis revealed that higher depression (β = 0.238, p < 0.001), higher illness perception (β = 0.143, p = 0.005), more pain (β = 0.243, p < 0.001), and worse sleep quality (β = 0.231, p < 0.001) were associated with worse fatigue, but higher social support (β = -0.291, p < 0.001) and physical activity (β = -0.096, p = 0.024) were associated with lower fatigue. Monthly household income per capita and educational level were also associated with fatigue (all p < 0.05).

The prevalence of fatigue in SLE was 58.7%. Fatigue was associated with monthly household income, educational level, depression, illness perception, pain, social support, sleep quality, and physical activity. No significant association was observed between anxiety, disease activity, age, work status, and fatigue. Future fatigue management for SLE patients should prioritize modifiable non-disease-activity-related factors.