Comparison of clinical characteristics and life quality in ankylosing spondylitis(AS)-related thoracolumbar kyphosis between male and female patients

English Keywords:Ankylosing spondylitis  Thoracolumbar kyphosis  Sex  Clinical characteristics  Quality of life

English Abstract:

  【Abstract】 Objectives: To investigate the differences in ankylosing spondylitis(AS) -related thoracolumbar kyphosis between male and female patients in terms of clinical characteristics and life quality. Methods: From May 2009 to February 2013, 51 AS patients(31 males and 20 females) with an average age of 40.6 years(21-62 years) were included in the study. All patients were completed Oswestry disability index(ODI), Bath ankylosing spondylitis disease activity index(BASDAI), Bath ankylosing spondylitis functional index(BASFI), Bath ankylosing spondylitis metrology index(BASMI), Bath ankylosing spondylitis global score(BAS-G), Bath ankylosing spondylitis radiology index(BASRI) and SF-36. Additionally, age at onset, disease duration, erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and HLA-B27 were recorded. Sagittal parameters were measured on standing lateral full-spine radiographs, including thoracic kyphosis(TK), global kyphosis(GK), lumbar lordosis(LL), sagittal vertical axis(SVA), pelvic incidence(PI), pelvic tilting(PT) and sacral slope(SS). A comparison was conducted in terms of age at onset, disease duration, ESR, CRP, HLA-B27, TK, LL, GK, SVA, PI, PT, SS, ODI, BASDAI, BASFI, BASMI, BAS-G, BASRI and SF-36 between male and female patients. Results: The ratio of male/female was 1.6∶1. Compared with male patients, female patients had an older mean age at disease onset, a shorter mean time of disease duration, a higher mean baseline of ESR and CRP and a lower proportion of HLA-B27 positive(P<0.05). Additionally, females had higher ODI, BASAI and BASDRI scores than males; however, females exhibited lower BASMI score(P<0.05). No significant differences were observed in BASFI and BSA-G between the two groups(P＞0.05). In sagittal spinopelvic parameters, females had higher GK and SVA(P<0.05), whereas there was no difference in TK, LL, PI, PT or SS between the two groups(P＞0.05). With respect to the domains of SF-36, females showed lower role emotional score and mental health score than males; whereas females had higher physical functioning score and social functioning score(P<0.05). No significant differences were noted in role physical, bodily pain, general health and vitality between the two groups(P＞0.05). Conclusions: In AS patients requiring surgical correction, the male/female ratio of 1.6∶1 is observed. Compared with male AS patients, female patients have a higher burden of disease and a later disease onset of shorter duration. Moreover, notable limitations of physical functioning and social functioning are found in male AS patients. While obvious damages of role emotional and mental health are observed in females AS patients.