Wang Ruoyi, Wu Jingchun, Han Yipeng, Zang Sitian, Li Hao, Hou Xiujuan, He Jing
Department of Rheumatology and Immunology, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China.
Department of Rheumatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, 100078, People's Republic of China.
Clin Rheumatol. 2025 Aug 20. doi: 10.1007/s10067-025-07616-4.
Sjӧgren's disease (SjD) is a complex and heterogeneous disease with female predominance. However, gender-related differences in the clinical and immunological profiles of SjD patients have not been fully explored, especially after adjusting for confounding factors such as age and disease duration. This study aims to investigate these gender-specific differences in a Chinese cohort.
To explore the gender-related clinical and immunological differences in patients with SjD by conducting a propensity score-matched (PSM) study, controlling for age and disease duration.
We retrospectively evaluated the medical records of patients with SjD who visited Peking University Peoples Hospital between January 2018 and December 2023. Using propensity scores, we matched females and males 1:1 based on age and disease duration. We then collected various clinical aspects from the medical records and compared them by gender.
Male patients exhibited distinct clinical and immunological profiles compared to females. Clinically, males had a significantly higher prevalence of smoking (P < 0.001), along with lower frequencies of leukopenia (P < 0.001) and peripheral nervous system involvement (P = 0.039). Immunologically, males showed higher white blood cell counts (P = 0.002), lymphocyte counts (P = 0.033), and neutrophils levels (P=0.037), whereas females had elevated antinuclear antibody levels (P = 0.040) and erythrocyte sedimentation rates (P = 0.008). Furthermore, male patients displayed distinct lymphocyte profiles, characterized by reduced proportions of CD8+ T cells (P = 0.016), but increased natural killer cell counts.
This study highlights significant gender-related differences in the clinical and immunological features of primary Sjögren's syndrome in a Chinese cohort. Despite sharing similar sicca symptoms with females, male patients exhibited distinct immunological and hematological profiles. These findings underscore the importance of considering gender when assessing and managing SjD patients in clinical practice. Key Points • Gender differences in SjD were assessed after adjusting for age and disease duration. • Males had less leukopenia and nervous system involvement but similar sicca symptoms. • Males showed higher NK cell counts and lower CD8+ T proportions. • Shared core symptoms but distinct immune profiles support gender-aware management.
干燥综合征（SjD）是一种复杂的异质性疾病，女性更为多见。然而，SjD患者临床和免疫特征方面的性别差异尚未得到充分研究，尤其是在调整年龄和病程等混杂因素之后。本研究旨在调查中国队列中的这些性别特异性差异。
通过进行倾向评分匹配（PSM）研究，控制年龄和病程，探讨SjD患者与性别相关的临床和免疫差异。
我们回顾性评估了2018年1月至2023年12月期间就诊于北京大学人民医院的SjD患者的病历。使用倾向评分，我们根据年龄和病程将女性和男性按1:1进行匹配。然后我们从病历中收集了各种临床信息，并按性别进行比较。
与女性相比，男性患者表现出不同的临床和免疫特征。临床上，男性吸烟率显著更高（P < 0.001），白细胞减少症和周围神经系统受累的发生率更低（P < 0.001和P = 0.039）。免疫方面，男性白细胞计数（P = 0.002）、淋巴细胞计数（P = 0.033）和中性粒细胞水平更高（P = 0.037），而女性抗核抗体水平（P = 0.040）和红细胞沉降率更高（P = 0.008）。此外，男性患者表现出不同的淋巴细胞谱，其特征是CD8 + T细胞比例降低（P = 0.016），但自然杀伤细胞计数增加。
本研究突出了中国队列中原发性干燥综合征临床和免疫特征方面显著的性别相关差异。尽管男性与女性有相似的干燥症状，但男性患者表现出不同的免疫和血液学特征。这些发现强调了在临床实践中评估和管理SjD患者时考虑性别的重要性。要点 • 在调整年龄和病程后评估了SjD的性别差异。 • 男性白细胞减少症和神经系统受累较少，但干燥症状相似。 • 男性自然杀伤细胞计数较高，CD8 + T比例较低。 • 有共同的核心症状但免疫谱不同支持性别意识管理。
