Sex-related Differences in Systemic Sclerosis: A Multicenter Cross-sectional Study From the National Registry of the Italian Society for Rheumatology

被引：17

作者：

De Angelis, Rossella

Giuggioli, Dilia ^{[2
]}

Bajocchi, Gianluigi ^{[3
]}

Dagna, Lorenzo ^{[4
]}

Zanframundo, Giovanni ^{[5
]}

Foti, Rosario ^{[6
]}

Cacciapaglia, Fabio ^{[7
]}

Cuomo, Giovanna ^{[8
]}

Ariani, Alarico ^{[9
]}

Rosato, Edoardo ^{[10
]}

Guiducci, Serena ^{[11
]}

Girelli, Francesco ^{[12
]}

Riccieri, Valeria ^{[13
]}

Zanatta, Elisabetta ^{[14
]}

Bosello, Silvia ^{[15
]}

Cavazzana, Ilaria ^{[16
]}

Ingegnoli, Francesca ^{[17
,18
]}

De Santis, Maria ^{[19
]}

Murdaca, Giuseppe ^{[20
]}

Abignano, Giuseppina ^{[21
]}

Romeo, Nicoletta ^{[22
]}

Della Rossa, Alessandra ^{[23
]}

Caminiti, Maurizio ^{[24
]}

Iuliano, Annamaria ^{[25
]}

Ciano, Giovanni ^{[26
]}

Beretta, Lorenzo ^{[27
]}

Bagnato, Gianluca ^{[28
]}

Lubrano, Ennio ^{[29
]}

De Andres, Ilenia ^{[30
]}

Giollo, Alessandro ^{[31
]}

Saracco, Marta ^{[32
]}

Agnes, Cecilia ^{[33
]}

Lumetti, Federica ^{[2
]}

Spinella, Amelia ^{[2
]}

Magnani, Luca ^{[3
]}

Campochiaro, Corrado ^{[4
]}

De Luca, Giacomo ^{[4
]}

Codullo, Veronica ^{[4
,5
]}

Visalli, Elisa

Masini, Francesco ^{[8
]}

Gigante, Antonietta ^{[10
]}

Bellando-Randone, Silvia ^{[11
]}

Pellegrino, Greta ^{[13
]}

Pigatto, Erika ^{[34
]}

Dall'Ara, Francesca

Lazzaroni, Maria Grazia

Generali, Elena ^{[19
]}

Mennillo, Gianna

Barsotti, Simone

Mariano, Giuseppa Pagano

机构：

[1] Polytech Univ Marche, Dept Clin & Mol Sci, Rheumatol Unit, Ancona, Italy

[2] Univ Modena & Reggio Emilia, Sch Med, Rheumatol Unit, Modena, Italy

[3] IRCCS Inst, S Maria Hosp USL, Rheumatol Unit, Reggio Emilia, Italy

[4] Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Unit Immunol Rheumatol Allergy & Rare Dis UnIRAR, Milan, Italy

[5] Policlin San Matteo, Dept Rheumatol, Pavia, Italy

[6] AOU Policlin Vittorio Emanuele, Catania, Italy

[7] Univ Bari, Dept Emergency Surg & Organ Transplantat, Rheumatol Unit, Bari, Italy

[8] Luigi Vanvitelli Univ, Naples, Italy

[9] Azienda Osped Univ Parma, Dept Med, Internal Med & Rheumatol, Parma, Italy

[10] Sapienza Univ Rome, Dept Translat & Precis Med, Rome, Italy

[11] Univ Florence, Dept Rheumatol, Florence, Italy

[12] Osped GB Morgagni & L Pierantoni, Dept Med, Rheumatol Unit, Forli, Italy

[13] Sapienza Univ Rome, Dept Rheumatol, Rome, Italy

[14] Univ Padua, Dept Rheumatol, Padua, Italy

[15] Univ Cattolica Sacro Cuore, Inst Rheumatol & Affine Sci, Div Rheumatol, Rome, Italy

[16] Spedali Civili Brescia, Dept Rheumatol, Brescia, Italy

[17] Univ Milan, Div Clin Rheumatol, ASST Pini, Dept Clin Sci, Milan, Italy

[18] Univ Milan, Community Hlth Res Ctr Adult & Pediat Rheumat Dis, Res Ctr Environm Hlth, Milan, Italy

[19] IRCCS, Humanitas Clin & Res Ctr, Milan, Italy

[20] Univ Genoa, S Martino Hosp, Genoa, Italy

[21] S Croce Carle Hosp, Cuneo, Italy

[22] Sapienza Univ Rome, Dept Translat & Precis Med, Rome, Italy

[23] Univ Pisa, Dept Rheumatol, Pisa, Italy

[24] Grande Osped Metropolitano, Dept Rheumatol Unit, Reggio Di Calabria, Italy

[25] San Camillo Forlanini Hosp, Rheumatol Unit, Rome, Italy

[26] Local Hlth Dept, Avellino, Italy

[27] Fdn IRCCS Ca Granda, Osped Maggiore Policlin Milano, Referral Ctr Syst Autoimmune Dis, Milan, Italy

[28] Univ Messina, Dept Clin & Expt Med, Messina, Italy

[29] Univ Molise, Dept Rheumatol, Campobasso, Italy

[30] Azienda Osped Rilievo Nazl Alta Specializza, Rheumatol Unit, Catania, Italy

[31] Univ Verona, Rheumatol Sect, Dept Med, Verona, Italy

[32] Mauriziano Umberto Hosp, Rheumatol Unit, Turin, Italy

[33] San Lorenzo Hosp, Quezon City, Philippines

[34] Villa Salus Hosp, Dept Med, Venice, Italy

[35] Univ Ferrara, Dept Med Sci, Rheumatol Unit, Ferrara, Italy

[36] Azienda Osped Univ S Anna Ferrara, Ferrara, Italy

[37] Citta Salute Sci, Rheumatol Unit, Turin, Italy

[38] Italian Soc Rheumatol, Epidemiol Unit, Milan, Italy

[39] Univ Ferrara S Anna Hosp, Rheumatol Unit, Ferrara, Italy

[40] Colletta Hosp, Dept Musculoskeletal Sci, Rheumatol Unit, Local Hlth Trust 3, Genoa, Italy

[41] Univ Vita Salute San Raffaele, Unit Immunol Rheumatol Allergy & Rare Dis UnIRAR, IRCCS San Raffaele Sci Inst, Milan, Italy

[42] Univ Florence, Dept Rheumatol, Florence, Italy

来源：

JOURNAL OF RHEUMATOLOGY | 2022年 / 49卷 / 02期

关键词：

sex; scleroderma; systemic sclerosis; DIGITAL ULCERS; SCLERODERMA; DIAGNOSIS; SURVIVAL; FEATURES; DISEASE; COHORT; RISK; TIME; MEN;

D O I：

10.3899/jrheum.210794

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective. There is still a great deal to learn about the influence of sex in systemic sclerosis (SSc). In this respect, national registries provide large and homogeneous patient cohorts for analytical studies. We therefore investigated a wide-ranging and well-characterized SSc series with the aim of identifying sex differences in disease expression, with a special focus on demographic, clinical, and serological characteristics. Methods. A multicenter SSc cohort of 2281 patients, including 247 men, was recruited in the Italian Systemic sclerosis PRogression INvestiGation (SPRING) registry. Demographic data, disease manifestations, serological profile, and internal organ involvement were compared. Results. The overall female/male ratio was 8.2:1. Female/male ratios for limited cutaneous SSc, diffuse cutaneous SSc, and SSc sine scleroderma subsets were 8.7:1, 4.9:1, and 10.7:1, respectively. A shorter time from onset of Raynaud phenomenon to SSc diagnosis, an increased prevalence of the diffuse cutaneous subset, renal crisis, and digital ulcers were found in males, whereas a significantly higher percentage of sicca syndrome, serum antinuclear antibodies, antiextractable nuclear antigens, anti-La/SSB, and anticentromere protein B was detected in the female group. Males exhibited lower left ventricular ejection fraction, as well as higher prevalence of conduction blocks, arrhythmias, ground glass, and honeycombing. Moreover, forced vital capacity and total lung capacity were medially lower in men than in women. Finally, males were more frequently treated with immunosuppressive drugs. Conclusion. Our study further supports the presence of several sex-related differences in patients with SSc. These differences were pronounced in the severity of cutaneous, peripheral vascular, and cardiopulmonary involvement for male patients, whereas an increased prevalence of sicca syndrome and a specific autoantibody profile characterized the female sex.

引用

页码：176 / 185

页数：10

共 40 条

[1] Determinants of Morbidity and Mortality of Systemic Sclerosis in Canada [J].

Al-Dhaher, Firas F. ;

Pope, Janet E. ;

Ouimet, Janine M. .

SEMINARS IN ARTHRITIS AND RHEUMATISM, 2010, 39 (04) :269-277

[2] Prevalence and factors associated with left ventricular dysfunction in the EULAR Scleroderma Trial and Research group (EUSTAR) database of patients with systemic sclerosis [J].

Allanore, Y. ;

Meune, C. ;

Vonk, M. C. ;

Airo, P. ;

Hachulla, E. ;

Caramaschi, P. ;

Riemekasten, G. ;

Cozzi, F. ;

Beretta, L. ;

Derk, C. T. ;

Komocsi, A. ;

Farge, D. ;

Balbir, A. ;

Riccieri, V. ;

Distler, O. ;

Chiala, A. ;

Del Papa, N. ;

Simic, K. Pasalic ;

Ghio, M. ;

Stamenkovic, B. ;

Rednic, S. ;

Host, N. ;

Pellerito, R. ;

Zegers, E. ;

Kahan, A. ;

Walker, U. A. ;

Matucci-Cerinic, M. .

ANNALS OF THE RHEUMATIC DISEASES, 2010, 69 (01) :218-221

[3] Defining a Unified Vascular Phenotype in Systemic Sclerosis [J].

Allanore, Yannick ;

Distler, Oliver ;

Matucci-Cerinic, Marco ;

Denton, Christopher P. .

ARTHRITIS & RHEUMATOLOGY, 2018, 70 (02) :162-170

[4] Cardiovascular Manifestations of Systemic Sclerosis: A Danish Nationwide Cohort Study [J].

Butt, Sheraz A. ;

Jeppesen, Jorgen L. ;

Torp-Pedersen, Christian ;

Sam, Flora ;

Gislason, Gunnar H. ;

Jacobsen, Soren ;

Andersson, Charlotte .

JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2019, 8 (17)

[5]

Cappelli S, 2015, EUR RESPIR REV, V24, P411, DOI 10.1183/16000617.00002915

[6] Pulmonary function tests as outcomes for systemic sclerosis interstitial lung disease [J].

Caron, Melissa ;

Hoa, Sabrina ;

Hudson, Marie ;

Schwartzman, Kevin ;

Steele, Russell .

EUROPEAN RESPIRATORY REVIEW, 2018, 27 (148)

[7]

Carreira Patricia E, 2018, Clin Exp Rheumatol, V36 Suppl 113, P68

[8] The 6-min walk distance in healthy subjects: reference standards from seven countries [J].

Casanova, C. ;

Celli, B. R. ;

Barria, P. ;

Casas, A. ;

Cote, C. ;

de Torres, J. P. ;

Jardim, J. ;

Lopez, M. V. ;

Marin, J. M. ;

Montes de Oca, M. ;

Pinto-Plata, V. ;

Aguirre-Jaime, A. .

EUROPEAN RESPIRATORY JOURNAL, 2011, 37 (01) :150-156

[9] Do the salivary glands of patients with systemic sclerosis show ultrasonographic modifications suggestive of Sjogren's syndrome? [J].

Couderc, Marion ;

Tournadre, Anne ;

Mathieu, Sylvain ;

Pereira, Bruno ;

Soubrier, Martin ;

Dubost, Jean Jacques .

ANNALS OF THE RHEUMATIC DISEASES, 2020, 79 (10)

[10]

Delisle VC, 2014, CLIN EXP RHEUMATOL, V32, pS10

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