Introduction
Methods and patients
Study population
UCLA GIT 2.0 questionnaire and study outcomes
Statistical analysis
Results
Patients and baseline characteristics
N | |||
---|---|---|---|
Age (years): median (Q1–Q3) | 346 | 63 | (51–72) |
Disease duration (years): median (Q1–Q3) | 346 | 10 | (7–17) |
BMI (kg/m2): median (Q1–Q3) | 310 | 23.4 | (21–27) |
Male sex: N (%) | 346 | 60 | (17.3) |
Diffuse cutaneous subset: n (%) | 283 | 65 | (23) |
Raynaud’s phenomenon: n (%) | 342 | 327 | (95.6) |
Digital ulcers ever: n (%) | 335 | 114 | (34.0) |
mRSS: median (Q1–Q3) | 337 | 3 | (0–8) |
Joint synovitis: n (%) | 344 | 61 | (17.7) |
Joint contractures: n (%) | 340 | 99 | (29.1) |
Esophageal symptoms (reflux, dysphagia): n (%) | 344 | 185 | (53.8) |
Stomach symptoms (early satiety, vomiting): n (%) | 341 | 102 | (29.9) |
Intestinal symptoms (diarrhea, bloating, constipation): n (%) | 344 | 124 | (36) |
Malabsorption syndrome: n (%) | 306 | 7 | (2.3) |
Intestinal pseudo-obstruction: n (%) | 311 | 4 | (1.3) |
Barrett’s esophagus | 343 | 9 | (2.6) |
Pulmonary hypertension: n (%) | 331 | 35 | (10.6) |
Thorax HRCT: lung fibrosis: n (%) | 328 | 135 | (41.2) |
FVC: median (Q1–Q3) | 339 | 97 | (84–110) |
Renal crisis: n (%) | 343 | 6 | (1.7) |
ANA positive: n (%) | 345 | 340 | (98.6) |
Anti-centromere positive: n (%) | 327 | 155 | (47.4) |
Anti-topoisomerase I positive: n (%) | 332 | 84 | (25.3) |
Anti-RNA polymerase III positive: n (%) | 310 | 36 | (11.6) |
CRP (mg/dl): median (Q1–Q3) | 312 | 1.6 | (0.7–4) |
ESR (mm/h): median (Q1–Q3) | 329 | 12 | (6–23.5) |
Hb (g/dl): median (Q1–Q3) | 310 | 13.2 | (12.4–14.1) |
n | % | ||
---|---|---|---|
Heartburn | 323 | (35.2) | |
Regurgitation | 123 | (13.4) | |
Dysphagia | 184 | (20.1) | |
Early satiety | 106 | (11.6) | |
Vomiting | 34 | (3.7) | |
Upper abdomen pain | 26 | (2.8) | |
Bloating | 157 | (17.1) | |
Diarrhea | 84 | (9.2) | |
Constipation | 109 | (11.9) | |
Fecal incontinence | 58 | (6.3) | |
UCLA GIT 2.0 subscales | Median | Q1, Q3 | Range |
Reflux | 0.25 | 0.00, 0.63 | (0–3) |
Distention/bloating | 0.50 | 0.00, 1.00 | (0–3) |
Fecal soilage | 0.00 | 0.00, 0.00 | (0–3) |
Diarrhea | 0.00 | 0.00, 0.50 | (0–2) |
Social functioning | 0.00 | 0.00, 0.33 | (0–2.5) |
Emotional wellbeing | 0.00 | 0.00, 0.22 | (0–3) |
Constipation | 0.00 | 0.00, 0.50 | (0–2.5) |
Total score of UCLA GIT 2.0 | 0.22 | 0.07, 0.49 | (0–2.4) |
Evaluation of the UCLA GIT 2.0 as a potential decision-aiding instrument for EGD
Referral to EGD Median (Q1, Q3) | No referral to EGD Median (Q1, Q3) | p* | |
---|---|---|---|
Age | 63 (52, 70.5) | 63 (53, 72) | 0.759 |
Disease duration | 11 (7, 20) | 10 (6,16) | 0.086 |
mRSS | 3 (0, 8) | 2 (0, 6) | 0.009 |
FVC | 98 (85, 109) | 97 (85, 110) | 0.813 |
BMI | 23.7 (21.4–26.7) | 23.4 (21, 27) | 0.712 |
Hemoglobin | 13.1 (12, 14.2) | 13.3 (12.4, 14.1) | 0.118 |
ESR | 16 (9, 26) | 12 (6, 22) | 0.013 |
n (%) | n (%) | p# | |
Subset of SSc | Diffuse 38 (24.4) Limited 118 (75.6) | Diffuse 156 (25.2) Limited 464 (74.8) | 0.836 |
Heartburn | 105 (60.7) | 207 (29) | < 0.001 |
Regurgitation | 41 (23.7) | 78 (10.9) | < 0.001 |
Dysphagia | 65 (38.5) | 112 (15.6) | < 0.001 |
Vomiting | 10 (5.9) | 22 (3.1) | 0.074 |
Esophageal symptoms | 109 (72.2) | 283 (43.5) | < 0.001 |
Stomach symptoms | 66 (44.3) | 139 (21.4) | < 0.001 |
Barrett’s esophagus | 17 (10.1) | 5 (0.7) | < 0.001 |
PPI therapy | 76 (62.3) | 18 (81.8) | 0.077 |
Digital ulcers | 16 (16) | 65 (15) | 0.811 |
Joint contractures | 46 (31.1) | 226 (35.1) | 0.354 |
UCLA GIT 2.0 subscales | Median (Q1, Q3) | Median (Q1, Q3) | p* |
Reflux | 0.50 (0.13, 0.88) | 0.14 (0.00, 0.50) | < 0.001 |
Distention/bloating | 0.75 (0.25, 1.46) | 0.25 (0.00, 1.00) | < 0.001 |
Fecal soilage | 0.00 (0.00, 1.00) | 0.00 (0.00, 0.00) | 0.067 |
Diarrhea | 0.00 (0.00, 0.50) | 0.00 (0.00, 0.50) | 0.028 |
Social functioning | 0.33 (0.00, 0.60) | 0.00 (0.00, 0.33) | < 0.001 |
Emotional wellbeing | 0.11 (0.00, 0.75) | 0.00 (0.00, 0.22) | < 0.001 |
Constipation | 0.25 (0.00, 0.75) | 0.00 (0.00, 0.50) | 0.004 |
Total score of UCLA GIT 2.0 | 0.35 (0.17, 0.70) | 0.19 (0.05, 0.44) | < 0.001 |
Multivariable GLMM | |||||
---|---|---|---|---|---|
Parameters | Models* | OR | 95% CI | p | AUC (95% CI) |
Age | Model 1 | 0.99 | 0.97–1.01 | 0.269 | 0.75 (0.69–0.80) |
Sex | 0.66 | 0.33–1.33 | 0.242 | ||
Disease duration | 1.00 | 0.98–1.02 | 0.926 | ||
SSc subset | 1.27 | 0.67–2.40 | 0.471 | ||
mRSS | 1.05 | 1.00–1.10 | 0.030 | ||
Hb | 0.89 | 0.74–1.07 | 0.218 | ||
PPI | 0.80 | 0.49–1.30 | 0.363 | ||
BMI | 1.03 | 0.97–1.09 | 0.294 | ||
FVC | 1.00 | 0.99–1.01 | 0.948 | ||
ESR | 1.00 | 0.99–1.02 | 0.943 | ||
Barrett’s esophagus | 24.4 | 2.43–245.18 | 0.007 | ||
Heartburn | Model 2 | 2.23 | 1.35–3.69 | 0.002 | 0.71 (0.65–0.76) |
Regurgitation | 2.09 | 1.14–3.81 | 0.017 | ||
Dysphagia | 3.01 | 1.79–5.05 | < 0.001 | ||
Vomiting | 1.98 | 0.62–6.25 | 0.247 | ||
Esophageal symptoms | Model 3 | 1.91 | 1.14–3.18 | 0.013 | 0.68 (0.62–0.74) |
Stomach symptoms | 2.12 | 1.24–3.61 | 0.006 | ||
Reflux subscale | Model 4 | 1.86 | 1.19–2.90 | 0.006 | 0.68 (0.62–0.74) |
Distention/bloating subscale | Model 5 | 1.50 | 1.12–2.01 | 0.007 | 0.70 (0.65–0.76) |
Social functioning | Model 6 | 2.57 | 1.56–4.23 | < 0.001 | 0.65 (0.59–0.71) |
Emotional wellbeing | Model 7 | 1.32 | 0.80–2.19 | 0.274 | 0.68 (0.62–0.74) |
Total UCLA GIT 2.0 score | Model 8 | 2.16 | 1.21–3.83 | 0.009 | 0.64 (0.58–0.70) |
Evaluation of the UCLA GIT 2.0 as a potential predictor of endoscopic esophagitis and pathologic EGD
Esophagitis Median (Q1, Q3) | No esophagitis Median (Q1, Q3) | p* | |
---|---|---|---|
Age | 62 (51, 69.5) | 64 (56, 72) | 0.086 |
Disease duration | 10 (6, 19) | 12 (7, 19) | 0.487 |
mRSS | 5 (0, 11.75) | 2 (0, 6) | 0.002 |
FVC | 93.5 (76.5, 110.8) | 99 (84, 108) | 0.528 |
BMI | 23.2 (21.6, 25.9) | 23.8 (21.1, 28.1) | 0.407 |
Hb | 13.6 (12.4, 14.6) | 12.9 (11.6, 13.7) | 0.006 |
ESR | 18 (8, 28) | 16 (10, 28) | 0.888 |
n (%) | n (%) | p# | |
Subset of SSc | Diffuse 13 (26.5) Limited 36 (73.5) | Diffuse 24 (22) Limited 85 (78) | 0.536 |
Barrett’s esophagus | 9 (17.3) | 15 (12) | 0.347 |
Heartburn | 32 (64) | 62 (50.4) | 0.104 |
Regurgitation | 13 (26) | 25 (20.3) | 0.414 |
Dysphagia | 18 (36) | 46 (37.4) | 0.863 |
Vomiting | 5 (10) | 5 (4.1) | 0.129 |
Esophageal symptoms | 40 (81.6) | 67 (60.4) | 0.008 |
Stomach symptoms | 22 (46.8) | 39 (35.5) | 0.163 |
PPI therapy | 30 (57.7) | 89 (72.4) | 0.057 |
Digital ulcers | 9 (27.3) | 11 (15.7) | 0.217 |
Joint contractures | 16 (33.3) | 32 (29.1) | 0.594 |
UCLA GIT 2.0 subscales | Median (Q1, Q3) | Median (Q1, Q3) | p* |
Reflux | 0.50 (0.25, 0.84) | 0.38 (0.13, 0.88) | 0.534 |
Distention/bloating | 0.50 (0.06, 1.00) | 0.75 (0.25, 1.50) | 0.069 |
Fecal soilage | 0.00 (0.00, 0.00) | 0.00 (0.00, 1.00) | 0.535 |
Diarrhea | 0.00 (0.00, 0.50) | 0.00 (0.00, 0.50) | 0.708 |
Social functioning | 0.17 (0.00, 0.50) | 0.17 (0.00, 0.50) | 0.283 |
Emotional wellbeing | 0.00 (0.00, 0.33) | 0.11 (0.00, 0.44) | 0.337 |
Constipation | 0.00 (0.00, 0.50) | 0.25 (0.00, 0.75) | 0.404 |
Total score of UCLA GIT 2.0 | 0.27 (0.16, 0.61) | 0.37 (0.13, 0.74) | 0.452 |
Multivariable GLMM | |||||
---|---|---|---|---|---|
Parameters | Models* | OR | 95% CI | p | AUC (95%CI) |
Age | Model 1 | 0.98 | 0.96–1.01 | 0.289 | 0.69 (0.60–0.79) |
Sex | 0.89 | 0.34–2.31 | 0.803 | ||
Disease duration | 1.00 | 0.96–1.03 | 0.925 | ||
PPI | 0.50 | 0.21–1.23 | 0.133 | ||
mRSS | Model 2 | 1.11 | 1.04–1.18 | 0.003 | 0.76 (0.67–0.84) |
Hb | Model 3 | 1.33 | 1.00–1.77 | 0.051 | 0.89 (0.83–0.95 |
Heartburn | Model 4 | 1.71 | 0.76–3.83 | 0.193 | 0.64 (0.55–0.73) |
Regurgitation | 1.43 | 0.59–3.46 | 0.433 | ||
Dysphagia | 1.01 | 0.46–2.18 | 0.987 | ||
Esophageal symptoms | Model 5 | 3.25 | 1.00–10.54 | 0.049 | 0.61 (0.52–0.71) |
Stomach symptoms | 1.43 | 0.57–3.60 | 0.443 | ||
Reflux subscale | Model 6 | 1.17 | 0.60–2.26 | 0.644 | 0.60 (0.51–0.69) |
Distention/bloating subscale | Model 7 | 0.69 | 0.43–1.12 | 0.135 | 0.66 (0.58–0.75) |
Social functioning | Model 8 | 0.70 | 0.33–1.50 | 0.362 | 0.59 (0.50–0.68) |
Emotional wellbeing | Model 9 | 0.91 | 0.43–1.95 | 0.810 | 0.64 (0.55–0.73) |
Total UCLA GIT 2.0 score | Model 10 | 0.82 | 0.33–2.02 | 0.659 | 0.68 (0.59–0.77) |