Aurrecoechea E, Llorca Díaz J, Diez Lizuain M L, McGwin G, Calvo-Alen J
Reumatology Section, Hospital Universitario Sierrallana, Manuel Teira s.n., 39300, Torrelavega, Cantabria, Spain.
Division of Epidemiology and Computational Biology, School of Medicine, Universidad de Cantabria, Santander, Spain.
Rheumatol Int. 2017 Apr;37(4):479-485. doi: 10.1007/s00296-016-3628-7. Epub 2016 Dec 16.
GENIRA [Gender in Rheumatoid Arthritis (RA)] is a comprehensive project aimed at studying gender differences in RA patients and how these differences impact on these patient outcomes. We are now reporting such data. Seventy RA patients of each gender were cross-sectionally evaluated following a preestablished protocol. Univariate and multivariate analyses focused in the different gender-associated comorbidity profiles and how they impact in the quality of life and disability of RA patients as assessed by the SF-36 and the Modified Health Assessment Questionnaire (M-HAQ), respectively. Both groups were comparable regarding their main demographic and clinical features. Different comorbidity profiles were found in both genders, with higher frequencies of diabetes mellitus, peptic ulcer, ischemic heart disease, smoking and chronic obstructive pulmonary disease among men and of depression and osteoporosis among women. The M-HAQ was lower in women than in men (0.89 ± 2.6 vs 0.22 ± 0.9, p = 0.04) as there were some sub-scales of the SF-36 [mental health (63.7 ± 22.0 vs 71.8 ± 21.1; p = 0.02), general health (41.3 ± 21.7 vs 50.0 ± 24.3; p = 0.02), physical functioning (PF) (57.7 ± 22.1 vs 67.3 ± 22.7; p = 0.01) and the physical summary component (PSC) (39.3 ± 8.9 vs 42.4 ± 9.3, p = 0.04)]. Multivariate analysis indicated the independent association between depression and osteoporosis rather than gender with the M-HAQ, PSC and PF and of only depression with the MH and GH. Women with RA present significantly worse disability and QOL outcomes than men; these differences can be explained by female gender-associated comorbidities such as depression and osteoporosis rather than gender per se.
GENIRA（类风湿性关节炎中的性别因素）是一个综合性项目，旨在研究类风湿性关节炎（RA）患者的性别差异以及这些差异如何影响患者的预后。我们现在报告此类数据。按照既定方案对70名男性和70名女性RA患者进行了横断面评估。单变量和多变量分析聚焦于不同的性别相关合并症概况，以及它们如何分别影响通过SF-36和改良健康评估问卷（M-HAQ）评估的RA患者的生活质量和残疾情况。两组在主要人口统计学和临床特征方面具有可比性。在男女两性中发现了不同的合并症概况，男性中糖尿病、消化性溃疡、缺血性心脏病、吸烟和慢性阻塞性肺疾病的发生率较高，而女性中抑郁症和骨质疏松症的发生率较高。女性的M-HAQ低于男性（0.89±2.6对0.22±0.9，p = 0.04），SF-36的一些子量表也是如此[心理健康（63.7±22.0对71.8±21.1；p = 0.02）、总体健康（41.3±21.7对50.0±24.3；p = 0.02）、身体功能（PF）（57.7±22.1对67.3±22.7；p = 0.01）和身体总结成分（PSC）（39.3±8.9对42.4±9.3，p = 0.04）]。多变量分析表明，抑郁症和骨质疏松症与M-HAQ、PSC和PF之间存在独立关联，而不是性别，只有抑郁症与心理健康（MH）和总体健康（GH）存在独立关联。患有RA的女性的残疾和生活质量预后明显比男性差；这些差异可以用女性性别相关合并症如抑郁症和骨质疏松症来解释，而不是性别本身。
