Gender Differences In Clinical Course Of Rheumatoid Arthritis
Keywords:
rheumatoid arthritis, gender differences, osteoporosis, systemic manifestations, bone metabolism, autoimmune disease.Abstract
Background: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disorder characterized by progressive joint destruction and systemic manifestations. Gender plays a significant role in disease prevalence, severity, and clinical presentation; however, sex-specific differences in RA progression remain insufficiently explored.
Objective: To investigate gender-related differences in the clinical course, articular involvement, systemic manifestations, and bone metabolism parameters among patients with rheumatoid arthritis.
Methods: A total of 293 patients diagnosed with RA aged 17–79 years were examined, including 20% men and 80% women. Clinical assessments included disease activity, radiographic staging, joint damage scoring, bone mineral density evaluation, and laboratory analysis of osteoassociated hormones and trace elements. Statistical analyses were performed using ANOVA, MANOVA, and correlation methods.
Results: Women demonstrated a more severe clinical course, with higher disease activity and more advanced radiographic stages compared to men. Female patients more frequently exhibited involvement of proximal interphalangeal, maxillary, and knee joints, while men showed a greater prevalence of sacroiliac joint lesions, tendovaginitis, and intra-articular Hoffa bodies. Extra-articular manifestations also displayed sexual dimorphism: pulmonary and peripheral nervous system complications were more common in men, whereas Sjögren’s syndrome and central nervous system involvement were predominantly observed in women. Bone metabolism disturbances were identified in both sexes, with distinct hormonal and mineral profile variations depending on gender.
Conclusion: Rheumatoid arthritis demonstrates substantial gender-specific differences in disease severity, joint distribution, systemic manifestations, and metabolic alterations. Recognition of these distinctions may improve personalized diagnostic strategies, therapeutic planning, and long-term disease monitoring.
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