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Sex differences in disease severity among patients with systemic lupus erythematosus.

Abstract

BACKGROUND

Systemic lupus erythematosus (SLE), a prototypical autoimmune disease, often results in comorbidities from exposure to medications as well as from chronic inflammation. Identification of gender-based differences in comorbidities and disease severity may assist health practitioners in providing optimum care for those living with SLE.

OBJECTIVE

The purpose of this study, which utilized hospital discharge data collected during a 7-year period to garner a large SLE patient sample, was to determine the effect of gender on SLE comorbidities and disease severity.

METHODS

Patients were hospitalized in the Dallas-Fort Worth metropolitan statistical area between 1999 and 2005 and had a diagnosis of SLE. The sample consisted of 14,829 patients with SLE, 10% of which were male. ANOVAs were conducted to test for differences between males and females for disease severity, age, length of stay in the hospital, total hospital charges, and number of autoimmune diseases. Disease severity was measured with the SLE comorbidity index, which weights 14 conditions in SLE. We identified the top 30 comorbidities as well as the odds of experiencing the secondary illnesses by gender.

RESULTS

Male patients had significantly greater disease severity compared with female patients. Additionally, female patients had more autoimmune diagnoses compared with male patients. Male patients were more likely to have cardiovascular and renal comorbidities compared with female patients. Female patients had significantly greater odds of diagnoses of urinary tract infection, hypothyroidism, depression, esophageal reflux, asthma, and fibromyalgia.

CONCLUSIONS

Although the prevalence of SLE among males is rare, male patients have the potential for greater disease severity and are more likely to suffer from cardiovascular and renal disease. Gender differences in disease severity should be further evaluated, but with the added recommendation to develop an index with conditions more indicative of active SLE.

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  • Authors+Show Affiliations

    ,

    Department of Health Studies, Texas Woman's University, Denton, Texas 76204-5499, USA. kcrosslin@twu.edu

    Source

    Gender medicine 8:6 2011 Dec pg 365-71

    MeSH

    Adult
    Aged
    Comorbidity
    Coronary Artery Disease
    Depression
    Diabetes Mellitus
    Female
    Fibromyalgia
    Heart Failure
    Humans
    Hypothyroidism
    Kidney Failure, Chronic
    Lupus Erythematosus, Systemic
    Male
    Middle Aged
    Pleurisy
    Prevalence
    Retrospective Studies
    Risk Factors
    Severity of Illness Index
    Sex Distribution
    Sex Factors
    United States
    Women's Health

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    22153881

    Citation

    Crosslin, Katie L., and Kristin L. Wiginton. "Sex Differences in Disease Severity Among Patients With Systemic Lupus Erythematosus." Gender Medicine, vol. 8, no. 6, 2011, pp. 365-71.
    Crosslin KL, Wiginton KL. Sex differences in disease severity among patients with systemic lupus erythematosus. Gend Med. 2011;8(6):365-71.
    Crosslin, K. L., & Wiginton, K. L. (2011). Sex differences in disease severity among patients with systemic lupus erythematosus. Gender Medicine, 8(6), pp. 365-71. doi:10.1016/j.genm.2011.10.003.
    Crosslin KL, Wiginton KL. Sex Differences in Disease Severity Among Patients With Systemic Lupus Erythematosus. Gend Med. 2011;8(6):365-71. PubMed PMID: 22153881.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Sex differences in disease severity among patients with systemic lupus erythematosus. AU - Crosslin,Katie L, AU - Wiginton,Kristin L, PY - 2011/04/30/received PY - 2011/09/02/revised PY - 2011/10/19/accepted PY - 2011/12/14/entrez PY - 2011/12/14/pubmed PY - 2012/4/20/medline SP - 365 EP - 71 JF - Gender medicine JO - Gend Med VL - 8 IS - 6 N2 - BACKGROUND: Systemic lupus erythematosus (SLE), a prototypical autoimmune disease, often results in comorbidities from exposure to medications as well as from chronic inflammation. Identification of gender-based differences in comorbidities and disease severity may assist health practitioners in providing optimum care for those living with SLE. OBJECTIVE: The purpose of this study, which utilized hospital discharge data collected during a 7-year period to garner a large SLE patient sample, was to determine the effect of gender on SLE comorbidities and disease severity. METHODS: Patients were hospitalized in the Dallas-Fort Worth metropolitan statistical area between 1999 and 2005 and had a diagnosis of SLE. The sample consisted of 14,829 patients with SLE, 10% of which were male. ANOVAs were conducted to test for differences between males and females for disease severity, age, length of stay in the hospital, total hospital charges, and number of autoimmune diseases. Disease severity was measured with the SLE comorbidity index, which weights 14 conditions in SLE. We identified the top 30 comorbidities as well as the odds of experiencing the secondary illnesses by gender. RESULTS: Male patients had significantly greater disease severity compared with female patients. Additionally, female patients had more autoimmune diagnoses compared with male patients. Male patients were more likely to have cardiovascular and renal comorbidities compared with female patients. Female patients had significantly greater odds of diagnoses of urinary tract infection, hypothyroidism, depression, esophageal reflux, asthma, and fibromyalgia. CONCLUSIONS: Although the prevalence of SLE among males is rare, male patients have the potential for greater disease severity and are more likely to suffer from cardiovascular and renal disease. Gender differences in disease severity should be further evaluated, but with the added recommendation to develop an index with conditions more indicative of active SLE. SN - 1878-7398 UR - https://www.unboundmedicine.com/medline/citation/22153881/Sex_differences_in_disease_severity_among_patients_with_systemic_lupus_erythematosus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-8579(11)00222-1 DB - PRIME DP - Unbound Medicine ER -