Sjögren Sendromu Tanılı Hastalarda Kronik Yorgunluğun Uyku Durumu ve Melatonin Düzeyi ile İlişkisi

Öz

Amaç: Primer Sjögren sendromu (pSS), sistemik bir otoimmün hastalıktır ve hastaların çoğu yorgunluk ve uykusuzluk yaşamaktadır. Melatonin, uyku kalitesini ve süresini iyileştirmenin yanı sıra birçok farklı işlevi olan bir hormondur. Bu çalışmanın amacı, yorgunluk ve uykusuzluk arasındaki ilişkiyi ve melatonin seviyelerinin yorgunluk ve uykusuzluk ile olan bağlantısını pSS hastalarında araştırmaktır. Materyal ve Metod: Bu kesitsel kohort çalışmasına 116 hasta ve 27 sağlıklı kontrol dahil edilmiştir. Epworth Uykululuk Ölçeği (ESS), Yorgunluk Şiddeti Ölçeği (FSS) ve SF-36 anketleri hastalardan elde edilmiştir. Hastaların serum melatonin seviyeleri ELISA yöntemiyle ölçülmüştür. Bulgular: pSS hastaları kontrol grubuna kıyasla daha fazla yorgunluk göstermiştir. Ayrıca, gündüz aşırı uykululuğu olan hastalar, olmayanlara göre daha yüksek yorgunluk seviyelerine sahipti. Yorgunluğu olan hastalarda medyan melatonin seviyesi 239 ng/L (189-460) iken, yorgunluğu olmayan hastalarda 266 ng/L (219-552) olarak ölçülmüştür (p=0.11). Gündüz aşırı uykululuğu olan ve olmayan hastaların mela-tonin seviyeleri benzer bulunmuştur. Sağlıklı bireylerde medyan melatonin seviyesi 429 ng/L (268-774) iken, pSS hastalarında 254 ng/L (197-491) olarak ölçülmüştür (p=0.0098). SF-36 ile ölçülen yaşam kali-tesi, yorgunluğu olan hastalarda tüm alt gruplarda yorgunluğu olmayanlara kıyasla anlamlı derecede daha kötüydü. Melatonin seviyeleri ile SF-36’nın alt parametreleri arasında bir korelasyon bulunmamış-tır. Sonuç: Yorgunluk, hem yaşam kalitesi hem de uyku hali üzerinde olumsuz etkiye sahiptir. Gündüz uykululuğu yaşayan hastalar daha düşük yaşam kalitesine sahiptir. pSS hastalarında sabah erken saatler-de ölçülen serum melatonin seviyeleri daha düşük bulunmuştur. Yorgunluğu olan ve olmayan hastalar arasında serum melatonin seviyeleri açısından anlamlı bir fark saptanmamıştır. Ayrıca, serum melatonin seviyeleri ile yaşam kalitesi arasında bir korelasyon bulunmamıştır.

Anahtar Kelimeler

• Sjögren sendromu
• Yorgunluk
• Uykululuk
• Melatonin
• Yaşam kalitesi

The Relationship Between Chronic Fatigue, Sleep quality, and Melatonin Levels in Sjogren's Syndrome

Öz

Background: Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease and majority of pa-tients have fatigue and insomnia. Melatonin has many functions in addition to improving sleep quality and duration.The aim of this study was to explore the relationship between fatigue and insomnia, and the association of melatonin levels with fatigue and insomnia in patients with pSS. Materials and Methods: This cross-sectional cohort study included 116 patients and 27 healthy con-trols. Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS) and SF-36 questionnaires were ob-tained from patients. Melatonin was measured by ELISA from the patients' serum. Results: Patients with pSS exhibited greater fatigue compared to the control group, additionally, pa-tients with somnolence exhibited higher levels of fatigue compared to those without somnolence. The median melatonin level was 239 ng/L (189-460) in patients with fatigue and 266 ng/L (219-552) in patients without fatigue (p=0.11). Patients with and without daytime sleepiness had similar melatonin levels, too. The median melatonin level was 429 ng/L (268-774) in healthy controls compared to 254 ng/L (197-491) in patients with PSS (p=0.0098) The quality of life, as measured by the SF-36, was signif-icantly worse in patients with fatigue across all subgroups compared to those without fatigue. There was no correlation between melatonin levels and the subparameters of the SF-36. Conclusions: Fatigue had a negative impact on both quality of life and sleepiness. Those who experi-enced sleepiness had a poorer quality of life. Early morning serum melatonin levels were lower in PSS patients. There was no significant difference in mean serum melatonin levels between patients with and without fatigue. No correlation was found between serum melatonin levels and quality of life.

Anahtar Kelimeler

• Sjogren
• Fatigue
• Sleepiness
• Melatonin
• Quality of life

Kaynakça

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