Association of Gender with Clinical Expression, Quality of Life, Disability, and Depression and Anxiety in Patients with Systemic Sclerosis

Abstract

ObjectivesTo assess the association of gender with clinical expression, health-related quality of life (HRQoL), disability, and self-reported symptoms of depression and anxiety in patients with systemic sclerosis (SSc).MethodsSSc patients fulfilling the American College of Rheumatology and/or the Leroy and Medsger criteria were assessed for clinical symptoms, disability, HRQoL, self-reported symptoms of depression and anxiety by specific measurement scales.ResultsOverall, 381 SSc patients (62 males) were included. Mean age and disease duration at the time of evaluation were 55.9 (13.3) and 9.5 (7.8) years, respectively. One-hundred-and-forty-nine (40.4%) patients had diffuse cutaneous SSc (dcSSc). On bivariate analysis, differences were observed between males and females for clinical symptoms and self-reported symptoms of depression and anxiety, however without reaching statistical significance. Indeed, a trend was found for higher body mass index (BMI) (25.0 [4.1] vs 23.0 [4.5], p = 0.013), more frequent dcSSc, echocardiography systolic pulmonary artery pressure >35 mmHg and interstitial lung disease in males than females (54.8% vs 37.2%, p = 0.010; 24.2% vs 10.5%, p = 0.003; and 54.8% vs 41.2%, p = 0.048, respectively), whereas calcinosis and self-reported anxiety symptoms tended to be more frequent in females than males (36.0% vs 21.4%, p = 0.036, and 62.3% vs 43.5%, p = 0.006, respectively). On multivariate analysis, BMI, echocardiography PAP>35 mmHg, and anxiety were the variables most closely associated with gender.ConclusionsIn SSc patients, male gender tends to be associated with diffuse disease and female gender with calcinosis and self-reported symptoms of anxiety. Disease-associated disability and HRQoL were similar in both groups.

Quality of life in systemic sclerosis

“…In a study, Nguyen et al [27] found no association with gender concerning perceived health status, HR-QoL and reported global and location-specific disability were not found. In the same study, women also have more self-reported symptoms of anxiety, while men were free of self-reported symptoms of both anxiety and depression [27]. The authors [27] concluded that gender is not a major determinant of perceived disability and impaired HR-QoL in SSc, but functional and social issues should be considered as severe in both.…”

“…Women more often exhibit arthralgias, calcinosis and lcSSc [27]. In a study, Nguyen et al [27] found no association with gender concerning perceived health status, HR-QoL and reported global and location-specific disability were not found. In the same study, women also have more self-reported symptoms of anxiety, while men were free of self-reported symptoms of both anxiety and depression [27].…”

“…Generally male gender is considered a factor of poor prognosis in SSc [27][28][29]. While men's concern is work or study, women have more concern about daily and leisure activities [16].…”

“…While men's concern is work or study, women have more concern about daily and leisure activities [16]. Men were found to have more often renal failure, increased blood pressure, arrhythmia, inflammatory myopathy, myositis, dcSSc, positive nucleolar antinuclear antibodies, echocardiography pulmonary artery pressure N 35 mm Hg, interstitial lung disease (the last one at the time of diagnosis and during followup) [27,30] and higher risk to develop lung cancer [31], and less often sicca syndrome and anti-centromere antibodies [27]. Women more often exhibit arthralgias, calcinosis and lcSSc [27].…”

“…Men were found to have more often renal failure, increased blood pressure, arrhythmia, inflammatory myopathy, myositis, dcSSc, positive nucleolar antinuclear antibodies, echocardiography pulmonary artery pressure N 35 mm Hg, interstitial lung disease (the last one at the time of diagnosis and during followup) [27,30] and higher risk to develop lung cancer [31], and less often sicca syndrome and anti-centromere antibodies [27]. Women more often exhibit arthralgias, calcinosis and lcSSc [27]. In a study, Nguyen et al [27] found no association with gender concerning perceived health status, HR-QoL and reported global and location-specific disability were not found.…”