Mediterranean journal of rheumatology · 2025
Age, Gender, and Disease Duration as Key Determinants of Comorbidity Burden in Spondyloarthritis: A Multicentre Cross-Sectional Study.
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S Chandrashekara, Shenoy Padmanabha, Kumar Uma, Pandya Sapan, Ghosh Alakendu, Khare Apurva, Dudam Rajkiran, Goswami Rudra Prosad
Аннотация
OBJECTIVE: The burden of comorbidities associated with spondylarthritis (SpA) in India remains relatively unexplored, with most existing research limited to specific regions. This study aimed to evaluate the prevalence and patterns of comorbidities among SpA patients across India.
METHODS: This multicentre, observational study was conducted at seven centres across India using data from the Indian Rheumatology Association database. Comorbidities were classified according to the ICD-10 Charlson Comorbidity Index. Patients were stratified into two age groups (>50 vs. ≤50 years). Statistical analyses included descriptive statistics, Fisher's exact test, chi-square test, two-tailed t-test, and logistic regression to identify predictors of comorbidity.
RESULTS: Of 1,250 SpA patients (mean age 39.8 ± 13.3 years), 25% had comorbidities. The most common were hypertension (11.8%) and diabetes (8.5%), including 1.1% with complications. Comorbidities were significantly more frequent in patients >50 years (55.3%) vs ≤50 years (16.6%, P < 0.001). Older age was associated with higher rates of diabetes (24.5% vs. 4.0%), hypertension (32.6% vs. 6.0%), and thyroid disorders (9.5% vs. 2.8%) (P < 0.001 for all). Logistic regression revealed age as the strongest predictor for hypertension (P < 0.001, Wald = 101.3), diabetes (P < 0.001), hyperlipidaemia (P = 0.022), and thyroid disorders (P = 0.003). Female gender was associated with thyroid disorders (P < 0.001), and longer disease duration with diabetes (P = 0.022).
CONCLUSION: This study underscores a substantial comorbidity burden among Indian SpA patients, highlighting the need for comprehensive screening and management strategies, particularly in older patients and those with longer disease duration.
METHODS: This multicentre, observational study was conducted at seven centres across India using data from the Indian Rheumatology Association database. Comorbidities were classified according to the ICD-10 Charlson Comorbidity Index. Patients were stratified into two age groups (>50 vs. ≤50 years). Statistical analyses included descriptive statistics, Fisher's exact test, chi-square test, two-tailed t-test, and logistic regression to identify predictors of comorbidity.
RESULTS: Of 1,250 SpA patients (mean age 39.8 ± 13.3 years), 25% had comorbidities. The most common were hypertension (11.8%) and diabetes (8.5%), including 1.1% with complications. Comorbidities were significantly more frequent in patients >50 years (55.3%) vs ≤50 years (16.6%, P < 0.001). Older age was associated with higher rates of diabetes (24.5% vs. 4.0%), hypertension (32.6% vs. 6.0%), and thyroid disorders (9.5% vs. 2.8%) (P < 0.001 for all). Logistic regression revealed age as the strongest predictor for hypertension (P < 0.001, Wald = 101.3), diabetes (P < 0.001), hyperlipidaemia (P = 0.022), and thyroid disorders (P = 0.003). Female gender was associated with thyroid disorders (P < 0.001), and longer disease duration with diabetes (P = 0.022).
CONCLUSION: This study underscores a substantial comorbidity burden among Indian SpA patients, highlighting the need for comprehensive screening and management strategies, particularly in older patients and those with longer disease duration.