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The effect of vitamin D deficiency on fatigue and depression in patients with axial spondyloarthritis

Yıl 2023, Cilt: 28 Sayı: 3, 252 - 258, 28.09.2023

Esma Demirhan Sevgi Atar Muhammed Bilal Özdemir Ömer Kuru

https://doi.org/10.21673/anadoluklin.1341329

Öz

Aim: In this study, we aimed to examine the effect of vitamin D deficiency on fatigue and depression in patients with axial spondyloarthritis (Ax-SpA).

Methods: This cross-sectional study included 141 Ax-SpA patients. Demographic information of the patients was recorded. The Hospital Anxiety and Depression Scale, Visual Analog Scale, Fatigue Severity Scale, and Ankylosing Spondylitis Disease Activity Score were used to evaluate depression, anxiety, pain, fatigue, and disease activity levels, respectively. Vitamin D levels were classified as deficiency (<10 ng/ml), insufficiency (11–20 ng/ml), and normal (>20 ng/ml).

Results: A total of 141 patients enrolled in the study (67 female and 74 male). Vitamin D levels were deficient in 14.2%, insufficient in 56%, and sufficient in 29.8% of cases. In the evaluation of fatigue, 20.6% of the cases were evaluated as normal, 60.3% as tired, and 19.1% as chronically tired. Although fatigue was detected in 79.4% of Ax-SpA patients, fatigue scores were not associated with vitamin D deficiency (p=0.191). There were no significant differences between the vitamin D groups (deficiency, insufficiency, and normal) in fatigue and depression scores, sex, disease duration, and activity.

Conclusion: Vitamin D deficiency is not associated with fatigue, depression, or disease activity in patients with Ax-Spa. Regardless of vitamin D deficiency, patients with depression and fatigue should be evaluated and managed appropriately, and the management of vitamin D deficiency should not be ignored.

Anahtar Kelimeler

Depression fatigue spondyloarthritis vitamin D deficiency

Kaynakça

  • Bedaiwi M, Sari I, Thavaneswaran A, Ayearst R, Haroon N, Inman RD. Fatigue in ankylosing spondylitis and nonradiographic axial spondyloarthritis: analysis from a longitudinal observation cohort. J Rheumatol. 2015;42(12):2354-60.
  • Li T, Zhou L, Zhao H, et al. Fatigue in ankylosing spondylitis is associated with psychological factors and brain gray matter. Front Med. 2019:6:271.
  • Shim J, Dean LE, Karabayas M, Jones GT, Macfarlane GJ, Basu N. Quantifying and predicting the effect of anti-TNF therapy on axSpA-related fatigue: results from the BSRBR-AS registry and meta-analysis. Rheumatolgy. 2020;59(11):3408-14.
  • Pennisi M, Malaguarnera G, Di Bartolo G, et al. Decrease in serum vitamin D level of older patients with fatigue. Nutrients. 2019;11(10):2531.
  • Sandıkçı SC, Özbalkan Z. Fatigue in rheumatic diseases. Eur J Rheumatol. 2015;2(3):109-13.
  • Reddy KN, Sabu N, Pandey N, Raut A, Joag K, Patil P. Anxiety and depression among patients with axial spondyloarthritis. Eur J Rheumatol. 2022;9(1):8-13.
  • Kilic G, Kilic E, Ozgocmen S. Relationship between psychiatric status, self-reported outcome measures, and clinical parameters in axial spondyloarthritis. Medicine. 2014;93(29):e337
  • de Oliveira DL, Hirotsu C, Tufik S, Andersen ML. The interfaces between vitamin D, sleep and pain. J Endocrinol. 2017;234(1):R23-36.
  • Wu Z, Malihi Z, Stewart AW, Lawes C, Scragg R. Effect of vitamin D supplementation on pain: a systematic review and meta-analysis. Pain physician. 2016;19(7):415-27.
  • Roy S, Sherman A, Monari-Sparks MJ, Schweiker O, Hunter K. Correction of low vitamin D improves fatigue: effect of correction of low vitamin D in fatigue study (EViDiF Study). N Am J Med Sci. 2014;6(8):396-402.
  • Sieper J, van der Heijde D, Landewé R, et al. New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS). Ann Rheum Dis. 2009;68(6):784-8.
  • Gencay-Can A, Can SS. Validation of the Turkish version of the fatigue severity scale in patients with fibromyalgia. Rheumatol Int. 2012;32(1):27-31.
  • Aydemir O. Validity and Reliability of Turkish Version of Hospital Anxiety and Depression Scale. Turk Psikiyatri Derg. 1997;8:280-7.
  • van der Heijde D, Lie E, Kvien TK, et al. ASDAS, a highly discriminatory ASAS-endorsed disease activity score in patients with ankylosing spondylitis. Ann Rheum Dis. 2009;68(12):1811-1818.
  • Scott J, Huskisson E. Graphic representation of pain. Pain. 1976;2(2):175-84.
  • Zhao S, Duffield SJ, Moots RJ, Goodson NJ. Systematic review of association between vitamin D levels and susceptibility and disease activity of ankylosing spondylitis. Rheumatology. 2014;53(9):1595-603.
  • Wu Q, Inman RD, Davis KD. Fatigue in ankylosing spondylitis is associated with the brain networks of sensory salience and attention. Arthritis Rheumatol.. 2014;66(2):295-303.
  • Fernandes S, Etcheto A, van der Heijde D, et al. Vitamin D status in spondyloarthritis: results of the ASAS-COMOSPA international study. Clin Exp Rheumatol. 2018;36(2):210-214.
  • Havdahl A, Mitchell R, Paternoster L, Davey Smith G. Investigating causality in the association between vitamin D status and self-reported tiredness. Sci Rep. 2019;9(1):1-8.
  • Knippenberg S, Bol Y, Damoiseaux J, Hupperts R, Smolders J. Vitamin D status in patients with MS is negatively correlated with depression, but not with fatigue. Acta Neurol Scand. 2011;124(3):171-5.
  • Frigstad SO, Høivik ML, Jahnsen J, et al. Fatigue is not associated with vitamin D deficiency in inflammatory bowel disease patients. World J Gastroenterol. 2018;24(29):3293-301.
  • Jelsness-Jørgensen LP, Grøvle L, Julsrud Haugen A. Association between vitamin D and fatigue in patients with rheumatoid arthritis: a cross-sectional study. BMJ Open. 2020;10(2):e034935.
  • Tekaya R, Hamdi O, Jemmali I, Tekaya AB, Rouached L, Saidane O, vd. Influence of Vitamin D Status on Fatigue in Ankylosing Spondylitis. Acta Med Iran. 2022;60(5):283-92.
  • Günaydin R, Göksel Karatepe A, Çeşmeli N, Kaya T. Fatigue in patients with ankylosing spondylitis: relationships with disease-specific variables, depression, and sleep disturbance. Clin Rheumatol. 2009;28:1045-51.
  • Anglin RE, Samaan Z, Walter SD, McDonald SD. Vitamin D deficiency and depression in adults: systematic review and meta-analysis. Br J Psychiatry. 2013;202:100-7.
  • Lázaro Tomé A, Reig Cebriá MJ, González-Teruel A, Carbonell-Asíns JA, Cañete Nicolás C, Hernández-Viadel M. Efficacy of vitamin D in the treatment of depression: a systematic review and meta-analysis. Actas Esp Psiquiatr. 2021;49(1):12-23.
  • Klingberg E, Oleröd G, Hammarsten O, Forsblad-d’Elia H. The vitamin D status in ankylosing spondylitis in relation to intestinal inflammation, disease activity, and bone health: a cross-sectional study. Osteoporos Int. 2016;27:2027-33.
  • Deng S, He Y, Nian X, Sun E, Li L. Relationship between Vitamin D levels and pain and disease activity in patients with newly diagnosed axial spondyloarthritis. Int J Nurs Sci. 2020;7(1):54-9.
  • Harth M, Nielson WR. Pain and affective distress in arthritis: relationship to immunity and inflammation. Expert Rev Clin Immunol. 2019;15(5):541-552.

Aksiyal spondiloartritli hastalarda D vitamini eksikliğinin yorgunluk ve depresyon üzerine etkisi

Yıl 2023, Cilt: 28 Sayı: 3, 252 - 258, 28.09.2023

Esma Demirhan Sevgi Atar Muhammed Bilal Özdemir Ömer Kuru

https://doi.org/10.21673/anadoluklin.1341329

Öz

Amaç: Bu çalışmada aksiyal spondiloartrit (Ax-SpA) hastalarında D vitamini eksikliğinin yorgunluk ve depresyon üzerine etkisini incelemeyi amaçladık.

Yöntemler: Bu kesitsel çalışmaya 141 Ax-SpA hastası dahil edildi. Hastaların demografik bilgileri kaydedildi. Hastaların depresyon, anksiyete, ağrı, yorgunluk ve hastalık aktivite düzeylerini değerlendirmek için, sırasıyla Hastane Anksiyete ve Depresyon Ölçeği, Görsel Analog Ölçeği, Yorgunluk Şiddeti Ölçeği ve Ankilozan Spondilit Hastalık Aktivite Skoru kullanıldı. D vitamini düzeyleri eksiklik (<10 ng/ml), yetersizlik (11-20 ng/ml) ve normal (>20 ng/ml) olarak sınıflandırıldı.

Bulgular: Araştırmaya toplam 141 hasta (67 kadın, 74 erkek) katılmıştır. D vitamini düzeyi olguların %14.2’sinde eksik, %56’sında yetersiz ve %29.8’inde yeterliydi. Yorgunluk değerlendirmesinde olguların %20,6’sı normal, %60,3’ü yorgun, %19,1’i kronik yorgun olarak değerlendirildi. Ax-SpA hastalarının %79,4’ünde yorgunluk tespit edilmesine rağmen yorgunluk skorlarının D vitamini eksikliği ile ilişkili olmadığı görüldü (p=0,191). D vitamini grupları (eksiklik, yetersizlik ve normal) arasında yorgunluk ve depresyon skorları, cinsiyet, hastalık süresi ve aktivitesi açısından anlamlı fark yoktu.

Sonuç: Ax-Spa’lı hastalarda D vitamini eksikliği yorgunluk, depresyon veya hastalık aktivitesi ile ilişkili değildir. D vitamini eksikliğinden bağımsız olarak, depresyon ve yorgunluk şikayeti olan hastalar uygun şekilde değerlendirilmeli ve tedavi edilmeli, D vitamini eksikliğinin tedavisi de göz ardı edilmemelidir.

Anahtar Kelimeler

Depresyon D vitamini eksikliği spondiloartrit yorgunluk

Kaynakça

  • Bedaiwi M, Sari I, Thavaneswaran A, Ayearst R, Haroon N, Inman RD. Fatigue in ankylosing spondylitis and nonradiographic axial spondyloarthritis: analysis from a longitudinal observation cohort. J Rheumatol. 2015;42(12):2354-60.
  • Li T, Zhou L, Zhao H, et al. Fatigue in ankylosing spondylitis is associated with psychological factors and brain gray matter. Front Med. 2019:6:271.
  • Shim J, Dean LE, Karabayas M, Jones GT, Macfarlane GJ, Basu N. Quantifying and predicting the effect of anti-TNF therapy on axSpA-related fatigue: results from the BSRBR-AS registry and meta-analysis. Rheumatolgy. 2020;59(11):3408-14.
  • Pennisi M, Malaguarnera G, Di Bartolo G, et al. Decrease in serum vitamin D level of older patients with fatigue. Nutrients. 2019;11(10):2531.
  • Sandıkçı SC, Özbalkan Z. Fatigue in rheumatic diseases. Eur J Rheumatol. 2015;2(3):109-13.
  • Reddy KN, Sabu N, Pandey N, Raut A, Joag K, Patil P. Anxiety and depression among patients with axial spondyloarthritis. Eur J Rheumatol. 2022;9(1):8-13.
  • Kilic G, Kilic E, Ozgocmen S. Relationship between psychiatric status, self-reported outcome measures, and clinical parameters in axial spondyloarthritis. Medicine. 2014;93(29):e337
  • de Oliveira DL, Hirotsu C, Tufik S, Andersen ML. The interfaces between vitamin D, sleep and pain. J Endocrinol. 2017;234(1):R23-36.
  • Wu Z, Malihi Z, Stewart AW, Lawes C, Scragg R. Effect of vitamin D supplementation on pain: a systematic review and meta-analysis. Pain physician. 2016;19(7):415-27.
  • Roy S, Sherman A, Monari-Sparks MJ, Schweiker O, Hunter K. Correction of low vitamin D improves fatigue: effect of correction of low vitamin D in fatigue study (EViDiF Study). N Am J Med Sci. 2014;6(8):396-402.
  • Sieper J, van der Heijde D, Landewé R, et al. New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS). Ann Rheum Dis. 2009;68(6):784-8.
  • Gencay-Can A, Can SS. Validation of the Turkish version of the fatigue severity scale in patients with fibromyalgia. Rheumatol Int. 2012;32(1):27-31.
  • Aydemir O. Validity and Reliability of Turkish Version of Hospital Anxiety and Depression Scale. Turk Psikiyatri Derg. 1997;8:280-7.
  • van der Heijde D, Lie E, Kvien TK, et al. ASDAS, a highly discriminatory ASAS-endorsed disease activity score in patients with ankylosing spondylitis. Ann Rheum Dis. 2009;68(12):1811-1818.
  • Scott J, Huskisson E. Graphic representation of pain. Pain. 1976;2(2):175-84.
  • Zhao S, Duffield SJ, Moots RJ, Goodson NJ. Systematic review of association between vitamin D levels and susceptibility and disease activity of ankylosing spondylitis. Rheumatology. 2014;53(9):1595-603.
  • Wu Q, Inman RD, Davis KD. Fatigue in ankylosing spondylitis is associated with the brain networks of sensory salience and attention. Arthritis Rheumatol.. 2014;66(2):295-303.
  • Fernandes S, Etcheto A, van der Heijde D, et al. Vitamin D status in spondyloarthritis: results of the ASAS-COMOSPA international study. Clin Exp Rheumatol. 2018;36(2):210-214.
  • Havdahl A, Mitchell R, Paternoster L, Davey Smith G. Investigating causality in the association between vitamin D status and self-reported tiredness. Sci Rep. 2019;9(1):1-8.
  • Knippenberg S, Bol Y, Damoiseaux J, Hupperts R, Smolders J. Vitamin D status in patients with MS is negatively correlated with depression, but not with fatigue. Acta Neurol Scand. 2011;124(3):171-5.
  • Frigstad SO, Høivik ML, Jahnsen J, et al. Fatigue is not associated with vitamin D deficiency in inflammatory bowel disease patients. World J Gastroenterol. 2018;24(29):3293-301.
  • Jelsness-Jørgensen LP, Grøvle L, Julsrud Haugen A. Association between vitamin D and fatigue in patients with rheumatoid arthritis: a cross-sectional study. BMJ Open. 2020;10(2):e034935.
  • Tekaya R, Hamdi O, Jemmali I, Tekaya AB, Rouached L, Saidane O, vd. Influence of Vitamin D Status on Fatigue in Ankylosing Spondylitis. Acta Med Iran. 2022;60(5):283-92.
  • Günaydin R, Göksel Karatepe A, Çeşmeli N, Kaya T. Fatigue in patients with ankylosing spondylitis: relationships with disease-specific variables, depression, and sleep disturbance. Clin Rheumatol. 2009;28:1045-51.
  • Anglin RE, Samaan Z, Walter SD, McDonald SD. Vitamin D deficiency and depression in adults: systematic review and meta-analysis. Br J Psychiatry. 2013;202:100-7.
  • Lázaro Tomé A, Reig Cebriá MJ, González-Teruel A, Carbonell-Asíns JA, Cañete Nicolás C, Hernández-Viadel M. Efficacy of vitamin D in the treatment of depression: a systematic review and meta-analysis. Actas Esp Psiquiatr. 2021;49(1):12-23.
  • Klingberg E, Oleröd G, Hammarsten O, Forsblad-d’Elia H. The vitamin D status in ankylosing spondylitis in relation to intestinal inflammation, disease activity, and bone health: a cross-sectional study. Osteoporos Int. 2016;27:2027-33.
  • Deng S, He Y, Nian X, Sun E, Li L. Relationship between Vitamin D levels and pain and disease activity in patients with newly diagnosed axial spondyloarthritis. Int J Nurs Sci. 2020;7(1):54-9.
  • Harth M, Nielson WR. Pain and affective distress in arthritis: relationship to immunity and inflammation. Expert Rev Clin Immunol. 2019;15(5):541-552.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Romatoloji ve Artrit
Bölüm ORJİNAL MAKALE
Yazarlar

Esma Demirhan 0000-0001-7581-9406

Sevgi Atar 0000-0003-3767-7448

Muhammed Bilal Özdemir 0000-0001-7965-5453

Ömer Kuru 0000-0001-5677-3924

Yayımlanma Tarihi 28 Eylül 2023
Kabul Tarihi 3 Eylül 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 28 Sayı: 3

Kaynak Göster

Vancouver Demirhan E, Atar S, Özdemir MB, Kuru Ö. The effect of vitamin D deficiency on fatigue and depression in patients with axial spondyloarthritis. Anadolu Klin. 2023;28(3):252-8.
 Kapak Resmi İndir

13151 This Journal licensed under a CC BY-NC (Creative Commons Attribution-NonCommercial 4.0) International License.