FRI0309 INFLUENCE OF GENDER ON CLINICAL EXPRESSION, HANDICAP, QUALITY OF LIFE AND MOOD IN PATIENTS WITH SYSTEMIC SCLEROSIS: A CROSS-SECTIONAL SURVEY OF 381 PATIENTS
C. Nguyen 1 2,*A. Bérezné 2C. Mestre-Stanislas 2T. Baubet 3F. Rannou 1A. Papelard 1M. Revel 1L. Guillevin 2S. Poiraudeau 1L. Mouthon 2
1Rehabilitation Department, Institut Fédératif de Recherche sur le Handicap, Université Paris Descartes, Cochin Hospital, AP-HP, 2Pôle de Médecine Interne, Centre de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, UPRES EA 4058, Université Paris Descartes, Cochin Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) , Paris, 3Service de Psychopathologie, EA 3413, Université Paris XIII, Avicenne Hospital, AP-HP, Bobigny, France
Background: Systemic sclerosis (SSc) is a connective-tissue disease responsible for skin, tendon, joint, and vessel damage that leads to loss of function, disability and altered health-related quality of life (HRQoL) [1], and is associated with more frequent mood disorders [2]. SSc predominantly affects women, with male gender usually considered as a factor of poor prognosis. However, the differences between genders may not be so clear. Thus, little is known about the influence of gender on some clinical subsets, handicap, health-related quality of life (HRQoL), and mood in SSc patients.
Objectives: To assess the influence of gender on clinical manifestations, handicap, HRQoL, and mood disorders in SSc patients.
Methods: SSc patients fulfilling the American College of Rheumatology and/or the Leroy and Medsger criteria were assessed through a cross-sectional survey for general health status, visceral involvement, global and location-specific handicaps, HRQoL, and mood disorders, using validated and specific outcome measures. Statistical analysis involved Pearson Chi-Square test and two-sample t-test to examine differences between male and female groups. Backward stepwise regression analysis was used to determine independent associations of variables with patients groups.
Results: A total of 381 SSc patients met inclusion criteria (62 males, 16.3%). Mean age and mean disease duration at the time of evaluation were 55.49±13.3, and 9.5±7.8 years, respectively. 34 (8.9%) patients had limited SSc, 187 (49.1%) limited cutaneous SSc, and 149 (39.1%) diffuse cutaneous SSc, without differences between genders. Body mass index (BMI) was higher in men (25.0±4.1 vs 22.9±4.5, p=0.012). Regarding visceral involvement, pulmonary hypertension (systolic PAP >35 mmHg) and interstitial lung disease were more often encountered in men (24% vs 10%, p=0.003, and 55% vs 41%, p=0.05, respectively), whereas women more frequently reported calcinosis (36% vs 21%, p=0.03). In addition, women more frequently display anxious symptoms (52% vs 44%, p=0.007), whereas men were more often free of mood disorders (47% vs 32%, p=0.022). Finally, regarding HRQoL, physical component score of the SF-36 were more altered in men than in women (29.8±26.7 vs 35.9±10.6, p=0.004). On multivariate analysis, factors associated with gender were BMI and pulmonary hypertension.
Conclusion: Consistently with previous studies findings, our data indicate that males with SSc tend to develop more severe visceral involvement and to experience altered physical aspects of HRQoL, whereas women more often display calcinosis as well as mood disorders. Our findings suggest that gender influences SSc features, including clinical manifestations, but also HRQoL and mood disorders.
References: 1. Poole JL, Steen VD. The use of the Health Assessment Questionnaire (HAQ) to determine physical disability in systemic sclerosis. Arthritis Care Res 1991;4(1):27-31.
2. Baubet T, Taïb O, Mehallel S, Moroni C, Belin C, Bricou O, Dumas JL, Pagnoux C, Salama J, Moro MR, Guillevin L, Mouthon L. Suicide risk, affective and anxiety disorders in patients with systemic sclerosis [abstract]. Arthritis and rheumatism 2004;50(S9):S634.
Disclosure of Interest: None declared