Association of Systemic Inflammation and Fatigue in Osteoarthritis: 2007−2010 National Health and Nutrition Examination Survey

• Published in: Biological research for nursing 2019-10, Vol.21 (5), p.532-543
• Main Authors: Hackney, Alisha J., Klinedinst, N. Jennifer, Resnick, Barbara, Johantgen, Meg
• Format: Article
• Language: English
• Subjects: Adult; Biomarkers - blood; C-Reactive Protein - analysis; Comorbidity; Cross-Sectional Studies; Fatigue - blood; Fatigue - etiology; Female; Humans; Inflammation - blood; Inflammation - etiology; Male; Middle Aged; Nursing; Nutrition Surveys; Osteoarthritis - blood; Osteoarthritis - complications; Retrospective Studies
• ISSN: 1099-8004; 1552-4175
• DOI: 10.1177/1099800419859091

Background/Purpose: Mechanistic insight into osteoarthritis fatigue is needed as clinical management of this condition is nonspecific. Systemic inflammation is associated with fatigue in other chronic diseases. The purpose of this study was to explore the relationship between systemic inflammation and fatigue in osteoarthritis, while controlling for covariates. Method: This secondary analysis with a cross-sectional, multiyear retrospective design used data from the 2007−2010 National Health and Nutrition Examination Survey. Adults with self-reported osteoarthritis who participated in an examination at a mobile center and had no comorbidities associated with fatigue or systemic inflammation were included (n = 296). Complex sample analysis, independent samples t tests, and χ2 tests of independence were used to explore differences between nonfatigued and fatigued adults with osteoarthritis. Adjusted hierarchical logistic regression models were used to calculate odds of fatigue as a function of two systemic inflammatory markers, C-reactive protein (CRP), and white blood cell (WBC) count. Results: Fatigued adults with osteoarthritis had significantly higher CRP levels and WBC counts compared to nonfatigued adults with osteoarthritis. In adjusted logistic regression models, increased CRP was associated with higher odds of fatigue when controlling for age, days affected by pain, depressive symptoms, sleep quantity, and body mass index (Odds ratio [OR] = 3.38, 95% CI [1.18, 9.69]). WBC count was not associated with higher odds of fatigue when controlling for these variables (OR = 1.10, 95% CI [0.92, 1.32]). Conclusion: Systemic inflammation may have a relationship with fatigue in osteoarthritis. Future work is necessary to replicate these findings in more robust studies.