Evidence for aerobic insufficiency in women with systemic lupus erythematosus

Objective To determine if fatigue is associated with diminished aerobic capacity in women with systemic lupus erythematosus (SLE). Methods Eighteen women (age 35 ± 9 years) with mild SLE (Systemic Lupus Activity Measure = 3.1 ± 2.1) and 16 healthy but sedentary controls (age 38 ± 8 years) completed...

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Published in:	Arthritis and rheumatism Vol. 49; no. 1; pp. 16 - 22
Main Authors:	Keyser, Randall E., Rus, Violeta, Cade, William Todd, Kalappa, Neeta, Flores, Raymond H., Handwerger, Barry S.
Format:	Journal Article
Language:	English
Published:	New York Wiley Subscription Services, Inc., A Wiley Company 15-02-2003 Lippincott Williams and Wilkins
Subjects:	Adult Aerobic capacity Aerobic impairment Anaerobic Threshold Biological and medical sciences Exercise Exercise Test Exercise testing Fatigue Fatigue - diagnosis Fatigue - physiopathology Female Humans Lupus Lupus Erythematosus, Systemic - diagnosis Lupus Erythematosus, Systemic - metabolism Lupus Erythematosus, Systemic - physiopathology Medical sciences Middle Aged Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis Physical exercise Human Lupus Immunopathology Connective tissue disease Skin disease Pathophysiology Autoimmune disease Oxygen consumption Fatigue Symptomatology Physical fitness Correlation analysis Exercise testing Systemic disease Lupus erythematosus Aerobic capacity Disseminated Aerobic impairment
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Summary:	Objective To determine if fatigue is associated with diminished aerobic capacity in women with systemic lupus erythematosus (SLE). Methods Eighteen women (age 35 ± 9 years) with mild SLE (Systemic Lupus Activity Measure = 3.1 ± 2.1) and 16 healthy but sedentary controls (age 38 ± 8 years) completed peak treadmill exercise tests to determine aerobic capacity and Fatigue Severity Scales to quantify the severity of fatigue. Measures of oxygen consumption (VO2) were recorded during the treadmill tests. Results Peak VO2 was lower in patients with SLE (19.2 ± 4.4 ml/kg/minute) as compared with controls (27.4 ± 4.7 ml/kg/minute) and expected values (30.7 ± 3.1 ml/kg/minute; P < 0.0006 versus controls and P < 0.0001 versus expected). Functional aerobic impairment was observed in 14 of the 18 patients with SLE. In patients with SLE, ventilatory threshold, a marker for the onset of lactic acidemia, was observed at the lowest energy requirement for instrumental activities of daily living. Peak VO2 in the patients with SLE was similar to the highest energy requirements for instrumental activities of daily living, leaving little or no reserve for more intense occupational and recreational activities. Peak VO2 was significantly higher (P < 0.0001) than the activity of daily living requirements in controls, providing a substantial energy reserve. Fatigue severity score (FSS) was 5.0 ± 1.4 in patients with SLE, with 14 of the 18 patients having scores above 4.0, a score indicating that fatigue severity limited physical activity. Of the 14, 12 had functional aerobic impairment. An FSS of greater than 4.0 was not observed in controls (mean = 2.5 ± 0.7). Conclusion In women with SLE, aerobic capacity was diminished to levels that were insufficient for engaging in activities of daily living and below those expected to result from physiologic deconditioning. This functional aerobic impairment was strongly correlated with the perception of severe, activity‐limiting fatigue.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0004-3591 0893-7524 1529-0131 1529-0123
DOI:	10.1002/art.10926