[Sex disparities in clinical characteristics of Chinese patients with systemic sclerosis].

Y Y Hou X W Duan Q Li H B Li J X Zhou Y Hou M T Li J L Zhao Q Wang D Xu Xiaofeng Zeng

Zhonghua Nei Ke Za Zhi

Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases, Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing 100730, China.

Published: April 2022

- The study analyzed 1,844 Chinese systemic sclerosis (SSc) patients from 2008-2020, revealing a significant gender imbalance with a male to female ratio of about 1:5.4 and differences in clinical characteristics between genders.
- Male patients had earlier onset age (48.6 years vs. 45.5 years), shorter disease duration, and higher prevalence of diffuse cutaneous SSc (63% vs. 44.2%), while female patients experienced more common symptoms like Raynaud's phenomenon and higher positivity rates for certain antibodies.
- Despite males having more severe skin involvement and higher global assessment scores, there were no significant differences in interstitial lung disease between genders, highlighting the complex

To evaluate the differences in clinical characteristics between different genders of Chinese patients with systemic sclerosis(SSc). The data of SSc patients registered in Chinese Rheumatism Data Center between August 2008 and June 2020 were retrospectively analyzed. A total of 1 844 patients with SSc were enrolled in the study. The ratio of males to females was 289 to 1 555. The onset age was (48.6±13.7) years in males and (45.5±13.1) years in females(0.001). Male patients represented shorter disease duration [2.0(0.0, 4.0)years vs.3.0(1.0, 7.0) years, 0.001],higher proportion of diffuse cutaneous SSc (dcSSc) [63.0% (182/289)vs.44.2%(688/1 555), 0.001]. Although more man patients experienced smoking [47.4%(137/289) vs. 1.7%(27/1 555), 0.001] and exposure to harmful environments [7.6%(22/289) vs. 2.1%(33/1 555), 0.001], there was no statistically significant difference in interstitial lung disease between male and female patients [69.3%(181/261) vs. 74.5%(1 085/1 457), 0.084].Otherwise, Raynaud's phenomenon [87.7% (1 364/1 555) vs.75.4%(218/289), 0.001], arthritis [11.1%(173/1 555) vs.6.9%(20/289), 0.032], gastroesophageal reflux disease [22.0%(342/ 1 555) vs.13.1%(38/289), 0.001], and leucopoenia [10.7(161/1 511)% vs. 6.1%(17/279), 0.019] were more common in female patients, but finger ulcer was less common [22.5%(350/1 555) vs. 30.4%(88/289), 0.004]. Antinuclear antibody(ANA) positivity rate [85.6%(1 310/1 531) vs. 78.6%(221/281), 0.003], anti-RNP antibody positivity rate [23.1%(342/1 479) vs.14.0%(38/271), 0.001], anti-SSA antibody positivity rate [28.2%(419/1 487) vs.13.9%(38/274), 0.001] were higher in female patients. Physician's global assessment(PGA) scores [1.4 (1.0, 2.0) vs. 1.0 (0.3, 1.6), 0.001] and modified Rodnan Skin Score(mRSS) [18.0 (9.5, 28.0) vs. 14.0 (5.0, 28.0), 0.003] were higher in males. Even though male SSc patients account for a small proportion, more extensive skin involvement, finger ulcers and higher PGA are manifested in males. Physicians need pay attention to these clinical disparities between different genders in SSc.