系统性红斑狼疮患者生活质量的性别差异。
Sex Differences in Quality of Life in Patients With Systemic Lupus Erythematosus.
机构信息
Rush University, Chicago, Illinois.
Hospital San Juan Batista, Catamarca, Argentina.
出版信息
Arthritis Care Res (Hoboken). 2019 Dec;71(12):1647-1652. doi: 10.1002/acr.23588. Epub 2018 Dec 20.
OBJECTIVE
Systemic lupus erythematosus (SLE) predominantly affects women. Clinical phenotype and outcomes in SLE may vary by sex and are further complicated by unique concerns that are dependent upon sex-defined roles. We aimed to describe sex differences in disease-specific quality of life (QoL) assessment scores using the Lupus Patient-Reported Outcome (LupusPRO) tool in a large international study.
METHODS
Cross-sectional data from 1,803 patients with SLE on demographics, self-identified sex status, LupusPRO, and disease activity were analyzed. The LupusPRO tool has 2 constructs: health-related QoL (HRQoL) and non-HRQoL. Disease activity and damage were evaluated using the Safety of Estrogens in Lupus Erythematosus National Assessment version of the Systemic Lupus Erythematosus Disease Activity Index and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, respectively. Nonparametric tests were used to compare QoL and disease activity by sex.
RESULTS
A total of 122 men and 1,681 women with SLE participated. The mean age was similar by sex, but the damage scores were greater among men. Men fared worse on the non-HRQoL social support domain than women (P = 0.02). When comparing disease and QoL among men and women ages ≤45 years, men were found to have greater damage and worse social support than women. However, women fared significantly worse on lupus symptoms, cognition, and procreation domains with trends for worse functioning on physical health and pain-vitality domains.
CONCLUSION
In the largest study of a diverse group of SLE patients, utilizing a disease-specific QoL tool, sex differences in QoL were observed on both HRQoL and non-HRQoL constructs. Although men performed worse in the social support domain, women (especially those in the reproductive age group) fared worse in other domains. These observations may assist physicians in appropriately addressing QoL issues in a sex-focused manner.
目的
系统性红斑狼疮（SLE）主要影响女性。SLE 的临床表型和结局可能因性别而异，并且由于依赖于性别定义的角色的独特关注点而更加复杂。我们旨在使用狼疮患者报告结局（LupusPRO）工具描述大型国际研究中疾病特异性生活质量（QoL）评估评分中的性别差异。
方法
对 1803 名 SLE 患者的人口统计学数据、自我认定的性别状况、LupusPRO 和疾病活动进行了横断面数据分析。LupusPRO 工具具有 2 个构建：健康相关 QoL（HRQoL）和非 HRQoL。使用安全性雌激素红斑狼疮国家评估版本的系统性红斑狼疮疾病活动指数和系统性红斑狼疮国际合作临床/美国风湿病学会损伤指数分别评估疾病活动和损伤。使用非参数检验比较性别间的 QoL 和疾病活动。
结果
共纳入 122 名男性和 1681 名女性 SLE 患者。男性和女性的平均年龄相似，但男性的损伤评分更高。男性在非 HRQoL 社会支持领域的表现不如女性（P = 0.02）。当比较年龄≤45 岁的男性和女性的疾病和 QoL 时，发现男性的损伤更大，社会支持比女性差。然而，女性在狼疮症状、认知和生育领域的表现明显更差，并且在身体健康和疼痛-活力领域也有更差的功能趋势。
结论
在最大的、多样化的 SLE 患者群体中进行的研究中，使用疾病特异性 QoL 工具，在 HRQoL 和非 HRQoL 构建中都观察到了 QoL 的性别差异。尽管男性在社会支持领域的表现较差，但女性（尤其是处于生育年龄组的女性）在其他领域的表现更差。这些观察结果可能有助于医生以关注性别的方式适当解决 QoL 问题。
Zotero 插件