Mehta S, Rice D, Janzen S, Pope J E, Harth M, Shapiro A P, Teasell R W
Western University, London, ON, Canada N6A 3K7; St. Joseph's Health Care London, London, ON, Canada N6A 4V2; Lawson Health Research Institute, London, ON, Canada N6C 0A7.
St. Joseph's Health Care London, London, ON, Canada N6A 4V2; Lawson Health Research Institute, London, ON, Canada N6C 0A7.
Pain Res Manag. 2016;2016:7241856. doi: 10.1155/2016/7241856. Epub 2016 Apr 17.
Objective. The current study aimed to identify and characterize distinct RA subgroups based on their level of EA and AS and compares the difference among the subgroups in mood, disability, and quality of life. Methods. Individuals with chronic pain for at least 3 months were recruited from an academic rheumatoid clinic. Participants were assessed for demographic, psychosocial, and personality measures. A two-step cluster analysis was conducted to identify distinct subgroups of patients. Differences in clinical outcomes were compared using the Multivariate ANOVA based on cluster membership. Results. From a total of 223 participants, three distinct subgroups were formed based on cluster analysis. Cluster 1 (N = 78) included those with low levels of both EA and AS. Cluster 2 (N = 81) consisted of individuals with moderate levels of EA and low levels AS. Cluster 3 (N = 64) included those with moderate levels of EA and high AS. Compared to those in Cluster 1, those in Cluster 3 had significantly higher levels of mood impairment and disability and lower quality of life (p < 0.05). Significantly lower levels of mood impairment were seen in Cluster 1 compared to Cluster 2 (p < 0.05). However, no significant difference in disability or quality of life was seen between the two groups. Conclusions. The three subgroups differed significantly in levels of impairment in mood, disability, and quality of life. However, levels of EA had a greater impact on disability and quality of life than AS.
目的。本研究旨在根据疾病活动度（EA）和抗环瓜氨酸肽抗体（AS）水平识别并描述不同的类风湿关节炎（RA）亚组，并比较各亚组在情绪、功能障碍和生活质量方面的差异。方法。从一家学术性类风湿关节炎诊所招募患有慢性疼痛至少3个月的个体。对参与者进行人口统计学、心理社会和人格测量评估。进行两步聚类分析以识别不同的患者亚组。基于聚类成员身份，使用多变量方差分析比较临床结局的差异。结果。在总共223名参与者中，通过聚类分析形成了三个不同的亚组。第1组（N = 78）包括EA和AS水平均较低的个体。第2组（N = 81）由EA水平中等且AS水平较低的个体组成。第3组（N = 64）包括EA水平中等且AS水平较高的个体。与第1组相比，第3组的情绪障碍和功能障碍水平显著更高，生活质量更低（p < 0.05）。与第2组相比，第1组的情绪障碍水平显著更低（p < 0.05）。然而，两组在功能障碍或生活质量方面没有显著差异。结论。这三个亚组在情绪、功能障碍和生活质量的损害水平上存在显著差异。然而，EA水平对功能障碍和生活质量的影响比AS更大。
