{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:50:13Z","timestamp":1790682613007,"version":"4.1.0"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,12,21]],"date-time":"2015-12-21T00:00:00Z","timestamp":1450656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Stavros Niarchos Foundation Research Grant"},{"name":"IKY Fellowship of Excellence for Postgraduate Studies in Greece-Siemens Programme"},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Hellenic Rheumatology Association"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify independent contributors of fatigue in primary Sj\u00f6gren's syndrome (SS) patients, taking into account clinical, laboratory, and psychological features, and to explore the potential role of interferon (IFN)\u2013induced gene indoleamine 2,3\u2010dioxygenase (IDO\u20101), anti\u201321\u2010hydroxylase (anti\u201021[OH]) antibodies, and soluble BAFF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Detailed clinical and laboratory characteristics were recorded for 106 primary SS patients. The Functional Assessment of Chronic Illness Therapy\u2013Fatigue, Zung Depression Scale, State\u2010Trait Anxiety Inventory, Eysenck Personality Questionnaire Scale, and Athens Insomnia Scale were adopted to assess fatigue, depression, anxiety, and sleep disturbances, respectively. Peripheral whole blood expression levels of IDO\u20101, as well as type I and II IFN\u2010induced genes were calculated using quantitative reverse transcriptase\u2013polymerase chain reaction. Serum anti\u201021(OH) antibodies and soluble BAFF levels were determined by a radioimmunoassay and an enzyme\u2010linked immunosorbent assay, respectively. Univariate and multivariate models were performed to identify determinants of fatigue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fatigue was detected in 32 of 106 (30.2%) primary SS patients. In univariate analysis, fatigue was associated with arthralgias\/myalgias, fibromyalgia hydroxychloroquine therapy, both state and trait anxiety scores, depression, and neuroticism, as well as impaired sleep patterns. Multivariate analysis revealed neuroticism (odds ratio [OR] 6.9, [95% confidence interval (95% CI) 1.7\u201328.0]), depression (OR 3.0 [95% CI 0.8\u201311.0]), and fibromyalgia (OR 5.5 [95% CI 1.1\u201327.7]) as independent fatigue contributors. Soluble BAFF levels, anti\u201021(OH) autoantibodies, and IDO\u20101 messenger RNA expression did not significantly differ between fatigued and nonfatigued primary SS patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Depression, neuroticism, and fibromyalgia play a major role in primary SS\u2013associated fatigue and should be addressed in clinical practice, with active collaboration between rheumatologists and mental health professionals. Further studies are warranted in order to explore underlying pathophysiologic pathways that might explain fatigue in the setting of primary SS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.22720","type":"journal-article","created":{"date-parts":[[2015,8,28]],"date-time":"2015-08-28T10:40:45Z","timestamp":1440758445000},"page":"123-131","source":"Crossref","is-referenced-by-count":61,"title":["Fatigue in Primary Sj\u00f6gren's Syndrome: Clinical, Laboratory, Psychometric, and Biologic Associations"],"prefix":"10.1002","volume":"68","author":[{"given":"Theofanis","family":"Karageorgas","sequence":"first","affiliation":[{"name":"National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Fragioudaki","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens Athens 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