Influence of gender on Behçet's disease phenotype and irreversible organ damage: Data from the International AIDA Network Behçet's Disease Registry.
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Sota Jurgen, Ragab Gaafar, AlMaglouth Ibrahim, Lopalco Giuseppe, Tufan Abdurrahman, Direskeneli Haner, Hinojosa-Azaola Andrea, Mayrink Giardini Henrique Ayres, Guerriero Silvana, Triggianese Paola, Sfikakis Petros P, Piga Matteo, Ruscitti Piero, Govoni Marcello, Iagnocco Annamaria, Carubbi Francesco, Hernández-Rodríguez José, Laymouna Ahmed Hatem, Mahmoud Ayman Abdel-Monem Ahmed, Ghanema Mahmoud, Aboabat Aos A, Asfina Kazi Nur, Alanazi Fehaid, Morrone Maria, Spedicato Veronica, Kucuk Hamit, Kardas Riza, Alibaz Öner Fatma, Sevik Gizem, Torres-Ruiz Jiram, Kawakami-Campos Perla Ayumi, Parente de Brito Antonelli Isabelle, Dammacco Rosanna, Chimenti Maria Sole, Arida Katerina, Floris Alberto, Gentile Martina, Ruffilli Francesca, Bellis Elisa, Alunno Alessia, Espinosa Gerard, Gentileschi Stefano, Gaggiano Carla, Vitale Antonio, Caggiano Valeria, Lopez Roberta, Tarsia Maria, Monti Sara, Hatemi Gülen, Karakoç Alican, Frassi Micol, Giacomelli Roberto, Tharwat Samar, Thabet Maissa, Ciccia Francesco, Emmi Giacomo, Viapiana Ombretta, Şahin Ali, Sebastiani Gian Domenico, Batu Ezgi Deniz, Ozen Seza, Sener Seher, Opris-Belinski Daniela, Costi Stefania, Conforti Alessandro, Cattalini Marco, Bartoloni Elena, Akkoç Nurullah, Gunduz Ozgul Soysal, Conti Giovanni, Maier Armin, Giardina Annarita, Li Gobbi Francesca, Parronchi Paola, Sarzi Puttini Piercarlo, Breda Luciana, De Paulis Amato, Carreño Ester, La Torre Francesco, Więsik-Scewczyk Ewa, de-la Torre Alejandra, Mejía-Salgado Germán, Shahram Farhad, Guiducci Serena, Maggio Maria Cristina, Aragona Emma, Rigante Donato, Ciavarro Alessandro, Önen Fatos, Erten Şükran, Insalaco Antonella, Del Giudice Emanuela, Barone Patrizia, Gicchino Francesca, Brucato Antonio, Lo Gullo Alberto, Mauro Angela, Karamanakos Anastasios, Balistreri Alberto, Mazzei Maria Antonietta, Frediani Bruno, Fabiani Claudia, Cantarini Luca
Аннотация
METHODS: Data were retrieved from the International AIDA Network Registry for BD. We assessed differences between males and females in terms of Behçet's syndrome Overall Damage Index (BODI), differences in the disease manifestations at onset and in the cumulative manifestations throughout disease course, as well as differences in the cardiovascular risk. Finally, predictive factors leading to major organ involvement were investigated.
RESULTS: In total, 1024 BD patients (567 males, 457 females) were enrolled in the study, with a male-to-female ratio of 1.24/1. Males displayed a significantly higher mean±SD BODI (1.92±2.09) at the last follow-up, compared to female patients (1.25±1.87) (P<0.0001). Uveitis (P<0.0001) and vascular involvement (P=0.0076) were significantly more frequent among males whereas female patients were significantly over-represented in arthralgia (P<0.0001), arthritis (P=0.00025), isolated headache (P<0.0001), central nervous system (CNS) involvement (P=0.040), and gastrointestinal involvement (P=0.00046). Regarding cardiovascular risk, no differences between the two groups emerged (P=0.617). Four variables were associated with the development of major organ involvement: male gender (OR=2.104, P=0.001), current treatment with biologic agents (OR=2.257, P=0.0003), origin from endemic countries (OR=2.661, P=0.0009), and disease duration (OR=1.002, P=0.024).
CONCLUSION: BD displays a more severe course among males. This subgroup develops more irreversible damage and presents more frequently ocular and vascular involvement during disease course. On the other hand, female patients are prone to experience articular involvement, headache, CNS and gastrointestinal involvement. These data suggest the existence of a gender-driven disease expression.