International Journal of Rheumatic Diseases最新文献

Background: In Chinese intervention studies, the lack of specific self-care scales based on the functional characteristics of Rheumatoid arthritis (RA) patients has caused patients and researchers to spend a great deal of time completing multiple related scales during the research work. Therefore, the arthritis Self-Care Behaviors Scale (SCBS) was developed to evaluate the self-care behavior of patients with arthritis.

Objective: The objectives of this study were to translate the SCBS into Chinese and test its psychometric properties in Chinese patients with RA.

Methods: The SCBS (English version) was translated to Chinese using Brislin's forward and backward translation method. A total of 414 adults with RA completed the Chinese version of the SCBS. Item analysis, content validity, construct validity, internal consistency reliability, and test-retest reliability were used to test its psychometric properties.

Results: Item analysis showed that the SCBS (Chinese version) has good discrimination and consistency. The Cronbach's alpha coefficient was 0.873 of the content validity index (CVI). Exploratory factor analysis demonstrated a five-factor solution, which is different from the traditional one. The results of the five common factor models indicated that the revised Chinese version of SCBS had good construct validity. The test-retest coefficient was 0.82, supporting adequate reliability.

Conclusion: The Chinese version of the SCBS is a reliable and valid instrument to evaluate RA patients' self-care behavior in China. However, further research into different economic levels, education levels, and age groups would broaden the scope of the Chinese version of the SCBS.

Objective: To investigate the central sensitization (CS) in patients with autoimmune connective tissue diseases (ACTDs) and its relationship with disease activity, laboratory findings, medical treatments, organ involvements, and comorbidity.

Methods: One hundred and eleven patients with ACTDs and 40 healthy individuals were included. All patients were divided into three groups in terms of their diseases: Sjögren's syndrome (SS), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE). The CS was assessed using the central sensitization inventory (CSI-A and CSI-B scores). The disease activity, laboratory findings, medical treatments, organ involvements, and comorbidity of all patients were evaluated.

Results: Overall, 41.4% patients with ACTDs had CS. SS group had the highest CS positivity (n = 21, 58.3%) compared to the RA (n = 14, 36.8%) and SLE (n = 11, 29.7%) groups. The SS group had a significantly higher CSI-A score (p < 0.016) than the RA and SLE group, which had similar scores. CSI-A (p = 0.008, r = -0.63) and CSI-B (p = 0.001, r = -0.76) scores were moderately to high correlated with vitamin D3 levels in SLE group. CSI-B score was moderately correlated with folic acid levels (p = 0.03, r = 0.50) and TSH (p = 0.005, r = 0.55) in SS group. The CSI-A score ≥ 40 subgroup had more female gender, frequency of COPD or asthma, more coexisting fibromyalgia, higher VAS score, more common exocrine gland involvement, and higher corticosteroid dose compared to the CSI score < 40 subgroup.

Conclusions: CS is commonly seen in patients with ACTDs, especially in SS. CS is associated with vitamin D3, folic acid, and TSH levels in ACTD subgroups and the patients with clinical CS have a specific profile.

Chronic inflammation is a major characteristic of ankylosing spondylitis (AS) and is closely related to the mechanisms of cancer development. Persistent inflammatory responses can lead to DNA damage, gene mutations, and abnormal cell proliferation, all of which may increase the risk of cancer. We also explore the use of biologic therapy of AS and their potential cancer risks.

Objective: The association of long-term hyperuricemia with liver function remains less well understood. This prospective cohort study aimed to investigate the relationship between hyperuricemia and liver function as well as other metabolic and cardiovascular parameters.

Methods: We enrolled 375 participants with hyperuricemia and 599 normouricemic controls. Participants were followed up for 3 years, and data on liver indicators, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and liver ultrasonography were collected. Additionally, we assessed other parameters, such as renal function, lipid profile, blood pressure, fasting blood-glucose (FBG), and body mass index (BMI).

Results: The highest prevalence of hyperuricemia was observed in the 20-29 age groups for the participants. Among the comorbidities of patients with hyperuricemia, the proportion of dyslipidemia is the highest (58.13%), followed by fatty liver (50.13%) and liver function impairment (33.07%). During the three-year follow-up period, compared to the baseline, patients with persistent hyperuricemia showed significant increases in BMI, triglycerides, total cholesterol, AST, and ALT levels (p < 0.05). Meanwhile, patients with improved hyperuricemia for 2 years exhibited significant decreases in FBG, total cholesterol, serum creatinine (p < 0.05), along with a significant increase in eGFR (p < 0.05). Correlation analysis revealed that levels of uric acid were positively correlated with ALT, FBG, and triglycerides in persistent hyperuricemia (p < 0.05).

Conclusion: Hyperuricemia shows a notable trend of younger age onset. Persistent hyperuricemia, correlated with elevated ALT levels, indicates an increasing risk of liver damage that should be concerned about. Effective management of hyperuricemia could improve metabolic disorders and renal dysfunction.

Objective: This study aimed to investigate the mortality, survival rates, and prognostic indicators of cancer occurrence after Sjögren's syndrome (SS-CA).

Methods: The medical records of patients with SS-CA at the Peking Union Medical College Hospital (PUMCH) between January 2010 and August 2022 were retrieved. Clinical data and survival outcomes were compared to controls. The standard mortality ratio (SMR) versus the general population was calculated, and the survival and predictive markers of prognosis were analyzed using Kaplan-Meier curves and Cox regression.

Results: In total, 114 SS-CA patients were included, with a median follow-up time of 105.1 (57.3-168.0) months. Non-Hodgkin lymphoma (32, 28.1%) was the most common cancer in patients with SS-CA. The SMR of SS-CA patients was 2.61 (95% confidence interval [CI] 1.73-3.77). Patients with SS-CA exhibited significantly inferior outcomes compared to controls (p = 0.010), with 5- and 10-year overall survival rates of 91.2% and 83.2%, respectively. SS patients with a diagnostic interval between SS and cancer (SS-CA diagnostic interval) ≤ 3 years or with hematological malignancies had poorer survival compared to those with a diagnostic interval > 3 years (p < 0.001) or with solid tumors (p = 0.019). Multivariate Cox regression analysis identified the prognosis-associated factors of SS-CA as age at SS diagnosis > 50 years (HR 3.129, 95% CI 1.224-7.998; p = 0.017), SS-CA diagnostic interval ≤ 3 years (HR 7.754, 95% CI 1.953-30.781; p = 0.004), and hematological malignancies (HR 2.648, 95% CI 1.201-5.838; p = 0.016).

Conclusion: Malignant comorbidities constituted a poor prognosis in patients with SS, wherein the SS-CA diagnostic interval and the types of cancer were associated with survival.