Hou Y Y, Duan X W, Li Q, Li H B, Zhou J X, Hou Y, Li M T, Zhao J L, Wang Q, Xu D, Zeng Xiaofeng
Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases, Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing 100730, China.
Department of Rheumatology and Immunology, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China.
Zhonghua Nei Ke Za Zhi. 2022 Apr 1;61(4):403-408. doi: 10.3760/cma.j.cn112138-20210825-00586.
To evaluate the differences in clinical characteristics between different genders of Chinese patients with systemic sclerosis(SSc). The data of SSc patients registered in Chinese Rheumatism Data Center between August 2008 and June 2020 were retrospectively analyzed. A total of 1 844 patients with SSc were enrolled in the study. The ratio of males to females was 289 to 1 555. The onset age was (48.6±13.7) years in males and (45.5±13.1) years in females(0.001). Male patients represented shorter disease duration [2.0(0.0, 4.0)years vs.3.0(1.0, 7.0) years, 0.001],higher proportion of diffuse cutaneous SSc (dcSSc) [63.0% (182/289)vs.44.2%(688/1 555), 0.001]. Although more man patients experienced smoking [47.4%(137/289) vs. 1.7%(27/1 555), 0.001] and exposure to harmful environments [7.6%(22/289) vs. 2.1%(33/1 555), 0.001], there was no statistically significant difference in interstitial lung disease between male and female patients [69.3%(181/261) vs. 74.5%(1 085/1 457), 0.084].Otherwise, Raynaud's phenomenon [87.7% (1 364/1 555) vs.75.4%(218/289), 0.001], arthritis [11.1%(173/1 555) vs.6.9%(20/289), 0.032], gastroesophageal reflux disease [22.0%(342/ 1 555) vs.13.1%(38/289), 0.001], and leucopoenia [10.7(161/1 511)% vs. 6.1%(17/279), 0.019] were more common in female patients, but finger ulcer was less common [22.5%(350/1 555) vs. 30.4%(88/289), 0.004]. Antinuclear antibody(ANA) positivity rate [85.6%(1 310/1 531) vs. 78.6%(221/281), 0.003], anti-RNP antibody positivity rate [23.1%(342/1 479) vs.14.0%(38/271), 0.001], anti-SSA antibody positivity rate [28.2%(419/1 487) vs.13.9%(38/274), 0.001] were higher in female patients. Physician's global assessment(PGA) scores [1.4 (1.0, 2.0) vs. 1.0 (0.3, 1.6), 0.001] and modified Rodnan Skin Score(mRSS) [18.0 (9.5, 28.0) vs. 14.0 (5.0, 28.0), 0.003] were higher in males. Even though male SSc patients account for a small proportion, more extensive skin involvement, finger ulcers and higher PGA are manifested in males. Physicians need pay attention to these clinical disparities between different genders in SSc.