Background
Methods
Study patients
Assessment of HRQoL
Assessment of disease activity and global disability
Statistical analysis
Results
Baseline characteristics
Group | ||||||
---|---|---|---|---|---|---|
SSc (n = 120) | RA (n = 120) | SLE (n = 120) | SjS (n = 120) | Control (n = 600) | P value* | |
Age, years, mean (SD) | 57.2 (11.2) | 58.3 (12.1) | 43.0 (14.1) | 58.7 (10.9) | 44.9 (15.3) | < 0.001 |
Female, n (%) | 106 (88.3) | 107 (89.2) | 107 (89.2) | 116 (96.7) | 303 (50.5) | < 0.001 |
Disease duration, years, mean (SD) | 11.7 (23.2) | 7.6 (6.5) | 8.3 (5.6) | 6.4 (4.9) | NA | < 0.001 |
Comorbidities, n (%) | ||||||
Hypertension | 39 (32.5) | 38 (31.7) | 24 (20.0) | 24 (20.0) | 99 (16.5) | < 0.001 |
Diabetes mellitus | 12 (10.0) | 8 (6.7) | 8 (6.7) | 7 (5.8) | 39 (6.5) | 0.713 |
Dyslipidemia | 10 (8.3) | 17 (14.2) | 19 (15.8) | 12 (10.0) | 31 (5.2) | < 0.001 |
Ischemic heart disease | 6 (5.0) | 3 (2.5) | 0 (0) | 4 (3.3) | 5 (0.8) | 0.004 |
Chronic liver diseases | 3 (2.5) | 4 (3.3) | 7 (5.8) | 3 (2.5) | 10 (1.7) | 0.098 |
Renal diseases | 0 (0) | 2 (1.7) | 33 (27.5) | 4 (3.3) | 4 (0.7) | < 0.001 |
Thyroid diseases | 12 (10.0) | 8 (6.7) | 8 (6.7) | 13 (10.8) | 6 (1.0) | < 0.001 |
Education, n (%) | < 0.001 | |||||
University | 39 (32.5) | 45 (37.5) | 69 (57.5) | 51 (42.5) | 221 (36.8) | |
High school | 30 (25.0) | 45 (37.5) | 37 (30.8) | 43 (35.8) | 278 (46.3) | |
Middle school | 17 (14.2) | 13 (10.8) | 7 (5.8) | 14 (11.7) | 49 (8.2) | |
Primary school | 21 (17.5) | 12 (10.0) | 4 (3.3) | 11 (9.2) | 52 (8.7) | |
Uneducated | 0 (0) | 1 (0.8) | 1 (0.8) | 1 (0.8) | 0 (0) | |
BMI, kg/m2, mean (SD) | 20.6 (4.5) | 22.8 (3.0) | 22.8 (3.9) | 22.6 (5.1) | 23.4 (13.2) | 0.127 |
Alcohol, n (%) | 16 (13.6) | 24 (20.0) | 32 (26.7) | 18 (15.0) | < 0.001 | |
Smoking, n (%) | 8 (6.8) | 11 (9.2) | 11 (9.2) | 4 (3.3) | 0.252 | |
Laboratory findings, mean (SD) | ||||||
WBC, mm3 | 7258.6 (202.3) | 8079.2 (11,302.2) | 5598.1 (2399.8) | 5427.7 (1852.2) | 0.001 | |
Hemoglobin, g/dL | 12.4 (1.4) | 12.7 (1.2) | 12.4 (1.5) | 12.4 (1.2) | 0.229 | |
Platelet, mm3 | 240.3 (66.9) | 266.2 (64.5) | 224.3 (75.2) | 217.9 (71.9) | < 0.001 | |
AST, IU/L | 23.3 (8.6) | 22.6 (9.5) | 24.3 (15.2) | 24.6 (8.1) | 0.473 | |
ALT, IU/L | 18.0 (12.3) | 20.0 (13.5) | 22.6 (24.4) | 19.2 (10.9) | 0.159 | |
BUN, mg/dL | 13.8 (8.2) | 14.4 (5.8) | 13.7 (6.6) | 14.5 (6.3) | 0.731 | |
Creatinine, mg/dL | 0.9 (1.1) | 0.9 (1.6) | 0.8 (0.3) | 0.9 (1.2) | 0.810 | |
ESR, mm/h | 30.6 (21.2) | 30.6 (20.7) | 27.4 (21.5) | 27.9 (23.6) | 0.520 | |
Hs-CRP, mg/L | 0.5 (1.1) | 0.6 (1.0) | 0.3 (0.5) | 0.4 (1.7) | 0.378 |
Systemic sclerosis | n = 120 |
HAQ-DI, mean (SD) | 0.99 (0.85) |
SHAQ score, mean (SD) | 0.87 (0.68) |
Digestive VAS, mean (SD) | 0.54 (0.79) |
Pulmonary VAS, mean (SD) | 0.63 (1.09) |
Raynaud’s VAS, mean (SD) | 0.78 (0.78) |
Digital ulcer VAS, mean (SD) | 0.41 (0.71) |
Overall disease severity VAS, mean (SD) | 1.05 (0.88) |
ANA, n (%) | 105 (87.5) |
Anti-topoisomerase I antibody, n (%) | 49 (40.8) |
Anti-centromere antibody, n (%) | 23 (19.2) |
Rheumatoid arthritis | n = 120 |
DAS28 (ESR), mean (SD) | 3.56 (0.12) |
Patient global health, mean (SD) | 35.21 (2.17) |
Rheumatoid factor, n (%) | 109 (90.8) |
Anti-citrullinated protein antibody, n (%) | 76 (63.3) |
Systemic lupus erythematosus | n = 120 |
SLEDAI-2K, mean (SD) | 6.26 (1.22) |
ANA, n (%) | 116 (96.7) |
Anti-Smith antibody, n (%) | 47 (39.2) |
Anti-ds DNA antibody, n (%) | 90 (75.0) |
C3, mg/dL, mean (SD) | 74.22 (4.15) |
C4, mg/dL, mean (SD) | 12.78 (1.15) |
Sjogren’s syndrome | n = 120 |
ESSDAI, mean (SD) | 1.52 (0.22) |
ANA, n (%) | 110 (91.7) |
Anti-SSA/Ro autoantibody, n (%) | 69 (57.5) |
Anti-SSB/La autoantibody, n (%) | 81 (67.5) |
HRQoL in patients with systemic rheumatic diseases and in healthy controls
Group | Post hoc P value | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
SSc (n = 120) | RA (n = 120) | SLE (n = 120) | SjS (n = 120) | Control (n = 600) |
P
| SSc vs. RA | SSc vs. SLE | SSc vs. SjS | SSc vs. control | |
PF | 70.5 (2.2) | 70.3 (2.2) | 68.2 (2.2) | 73.9 (2.2) | 82.4 (1.0) | < 0.001 | 0.952 | 0.464 | 0.265 |
< 0.001
|
RP | 67.8 (2.3) | 70.5 (2.3) | 65.8 (2.3) | 68.6 (2.4) | 86.5 (1.1) | < 0.001 | 0.393 | 0.541 | 0.801 |
< 0.001
|
BP | 61.1 (2.2) | 61.4 (2.2) | 66.1 (2.2) | 63.1 (2.3) | 81.4 (1.0) | < 0.001 | 0.920 | 0.114 | 0.499 |
< 0.001
|
GH | 41.4 (1.8) | 51.3 (1.8) | 44.2 (1.8) | 45.8 (1.8) | 63.9 (0.8) | < 0.001 |
< 0.001
| 0.261 | 0.074 |
< 0.001
|
VT | 53.2 (1.9) | 51.8 (1.9) | 49.7 (1.9) | 45.8 (1.9) | 64.6 (0.9) | < 0.001 | 0.610 | 0.196 | 0.005 |
< 0.001
|
SF | 72.4 (2.1) | 77.8 (2.1) | 74.6 (2.1) | 71.3 (2.1) | 87.3 (1.0) | < 0.001 | 0.058 | 0.440 | 0.703 |
< 0.001
|
RE | 68.4 (2.3) | 77.2 (2.3) | 72.7 (2.3) | 69.6 (2.4) | 87.7 (1.1) | < 0.001 | 0.006 | 0.199 | 0.713 |
< 0.001
|
MH | 61.3 (1.8) | 71.7 (1.8) | 67.2 (1.8) | 63.7 (1.8) | 75.2 (0.8) | < 0.001 |
< 0.001
| 0.020 | 0.326 |
< 0.001
|
PCS | 44.6 (0.8) | 45.3 (0.8) | 44.8 (0.8) | 46.9 (0.8) | 51.0 (0.4) | < 0.001 | 0.511 | 0.827 | 0.025 |
< 0.001
|
MCS | 43.0 (0.9) | 48.9 (0.9) | 46.6 (0.9) | 44.2 (0.9) | 50.8 (0.4) | < 0.001 |
< 0.001
| 0.006 | 0.316 |
< 0.001
|
SF-6D | 0.70 (0.01) | 0.73 (0.01) | 0.72 (0.01) | 0.71 (0.01) | 0.79 (0.00) | < 0.001 | 0.056 | 0.310 | 0.669 |
< 0.001
|
EQ-5D-3 L | 63.98 (1.55) | 69.95 (1.56) | 67.49 (1.55) | 64.84 (1.58) | 77.88 (0.72) | < 0.001 | 0.005 | 0.110 | 0.684 |
< 0.001
|
Group | Post hoc P value | |||||||
---|---|---|---|---|---|---|---|---|
SSc (n = 120) | RA (n = 120) | SLE (n = 120) | SjS (n = 120) |
P
| SSc vs. RA | SSc vs. SLE | SSc vs. SjS | |
Physical function | 66.2 (2.3) | 67.6 (2.3) | 67.3 (2.6) | 61.3 (2.4) | 0.245 | 0.682 | 0.773 | 0.136 |
Role–physical | 64.7 (2.5) | 70.3 (2.6) | 66.7 (2.9) | 58.0 (2.7) | 0.011 | 0.123 | 0.621 | 0.062 |
Bodily pain | 56.3 (2.3) | 59.7 (2.3) | 69.6 (2.6) | 51.9 (2.4) | < 0.001 | 0.302 |
< 0.001
| 0.185 |
General health | 37.1 (1.8) | 48.1 (1.8) | 46.8 (2.1) | 38.3 (1.9) | < 0.001 |
< 0.001
|
0.001
| 0.632 |
Vitality | 48.7 (2.0) | 48.8 (2.1) | 50.4 (2.3) | 38.3 (2.1) | < 0.001 | 0.960 | 0.592 |
< 0.001
|
Social function | 70.1 (2.5) | 77.1 (2.5) | 76.0 (2.8) | 64.2 (2.6) | 0.002 | 0.042 | 0.128 | 0.095 |
Role–emotional | 66.4 (2.7) | 76.8 (2.7) | 74.4 (3.0) | 60.7 (2.8) | < 0.001 | 0.005 | 0.057 | 0.129 |
Mental health | 58.3 (2.0) | 69.8 (2.0) | 68.6 (2.3) | 58.2 (2.1) | < 0.001 |
< 0.001
|
0.001
| 0.947 |
Physical component score | 42.8 (0.8) | 44.3 (0.8) | 45.3 (0.9) | 42.3 (0.8) | 0.068 | 0.164 | 0.042 | 0.675 |
Mental component score | 41.8 (1.1) | 48.3 (1.1) | 47.4 (1.2) | 41.5 (1.1) | < 0.001 |
< 0.001
|
0.001
| 0.846 |
SF-6D | 0.68 (0.01) | 0.72 (0.01) | 0.72 (0.01) | 0.66 (0.01) | < 0.001 | 0.015 | 0.010 | 0.082 |
EQ-5D-3 L | 0.74 (0.02) | 0.81 (0.02) | 0.83 (0.02) | 0.76 (0.02) | < 0.001 |
< 0.001
|
< 0.001
| 0.212 |
Factors associated with HRQoL
SF-36 | EQ-5D-3 L | ||||||||
---|---|---|---|---|---|---|---|---|---|
Physical component score | Mental component score | ||||||||
Slope (SE) | Beta |
P
| Slope (SE) | Beta |
P
| Slope (SE) | Beta |
P
| |
Age | − 0.06 (0.06) | − 0.05 | 0.352 | 0.05 (0.10) | 0.04 | 0.629 | − 0.001 (0.002) | − 0.06 | 0.430 |
Sex | 0.44 (2.02) | 0.01 | 0.829 | 1.83 (3.33) | 0.05 | 0.583 | 0.039 (0.062) | 0.04 | 0.534 |
BMI | 0.32 (0.14) | 0.13 | 0.022 | − 0.17 (0.22) | − 0.07 | 0.448 | 0.005 (0.004) | 0.10 | 0.199 |
Disease duration | − 0.08 (0.03) | − 0.15 | 0.009 | − 0.03 (0.05) | − 0.06 | 0.516 | − 0.002 (0.001) | − 0.13 | 0.072 |
Subset (lcSSc) | 4.13 (1.39) | 0.16 | 0.004 | 4.34 (2.29) | 0.17 | 0.061 | 0.090 (0.043) | 0.15 | 0.039 |
mRSS | − 0.25 (0.07) | − 0.21 | 0.001 | − 0.28 (0.12) | − 0.24 | 0.021 | − 0.005 (0.002) | − 0.19 | 0.021 |
Raynaud’s VAS | − 1.15 (0.95) | − 0.08 | 0.229 | − 2.40 (1.57) | − 0.16 | 0.129 | − 0.016 (0.029) | 0.05 | 0.579 |
Digestive VAS | − 3.69 (1.02) | − 0.24 | < 0.001 | 0.11 (1.69) | 0.01 | 0.947 | − 0.051 (0.031) | − 0.14 | 0.105 |
Pulmonary VAS | − 2.68 (0.90) | − 0.19 | 0.004 | − 0.04 (1.48) | − 0.01 | 0.979 | − 0.051 (0.028) | − 0.15 | 0.066 |
Digital ulcer VAS | − 0.68 (0.91) | − 0.04 | 0.455 | 3.23 (1.50) | 0.20 | 0.084 | 0.015 (0.028) | 0.04 | 0.581 |
Disease severity VAS | − 3.18 (1.04) | − 0.22 | 0.003 | − 3.18 (1.70) | − 0.23 | 0.064 | − 0.098 (0.032) | − 0.30 | 0.003 |