Zhi-Ming Ouyang, Yao-Wei Zou, Ye Lu, Jie Pan, Tao Wu, Pei-Wen Jia, Hu-Wei Zheng, Yun Su, Le-Feng Chen, Jian-Zi Lin, Kui-Min Yang, Pei-Yu Lin, Jin-Yuan Han, Jian-Da Ma, Lie Dai
{"title":"在绝经后发作的类风湿关节炎中，早期绝经与独立于炎症的较高疾病活动性相关。","authors":"Zhi-Ming Ouyang, Yao-Wei Zou, Ye Lu, Jie Pan, Tao Wu, Pei-Wen Jia, Hu-Wei Zheng, Yun Su, Le-Feng Chen, Jian-Zi Lin, Kui-Min Yang, Pei-Yu Lin, Jin-Yuan Han, Jian-Da Ma, Lie Dai","doi":"10.1186/s12905-025-03670-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Early menopause (EM, age ≤ 45 years) is associated with an increased risk of developing rheumatoid arthritis (RA). We aimed to investigate its impact on disease characteristics in RA patients.</p><p><strong>Methods: </strong>This cross-sectional study included natural post-menopausal RA patients from an observational RA cohort recruited between January 2015 and October 2023. Demographic characteristics and clinical data were collected. Patients were divided into EM and usual menopause (UM, menopause age > 45 years) groups. Patients-reported outcomes (PROs, included patient global assessment of disease activity [PtGA], pain visual analogue scale [VAS] and Stanford health assessment questionnaire disability index [HAQ-DI]), and PROs-associated indicators (included 28-joint tender joint count [TJC28] and provider global assessment of disease activity [PrGA]) were assessed.</p><p><strong>Results: </strong>Among 1427 female RA patients, 557 natural post-menopausal RA patients were enrolled. The peak menopause age was between 46 and 50 years, with RA incidence peaking 5 years post-menopause. Compared with UM patients, RA patients with natural EM (n = 98,17.6%) exhibited more serious disease, including worse PROs and PROs-associated indicators, as well as higher C-reactive protein (CRP, all P < 0.05). Among 344 (61.8%) patients with RA onset after menopause, EM patients (n = 62, 18.0%) were characterized with worse PROs and PROs-associated indicators than those with UM patients (all P < 0.05), but no difference in inflammatory makers. Multivariate linear regression showed that menopause age was independently and negatively associated with PROs, including PtGA (β = -0.872, 95% CI -1.619, -0.125), HAQ-DI (β = -0.646, 95% CI -1.059, -0.233) in RA patients especially in those onset after menopause (PtGA [β = -1.028, 95% CI -2.022, -0.034]; HAQ-DI [β = -0.916, 95% CI -1.461, -0.370]).</p><p><strong>Conclusion: </strong>Early menopause impacts on PROs independent of inflammation in patients with RA especially in those with postmenopausal-onset RA, which imply the importance of differentiation of non-inflammatory disease activity.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"138"},"PeriodicalIF":2.4000,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931845/pdf/","citationCount":"0","resultStr":"{\"title\":\"Early menopause is associated with higher disease activity independent of inflammation in postmenopausal-onset rheumatoid arthritis.\",\"authors\":\"Zhi-Ming Ouyang, Yao-Wei Zou, Ye Lu, Jie Pan, Tao Wu, Pei-Wen Jia, Hu-Wei Zheng, Yun Su, Le-Feng Chen, Jian-Zi Lin, Kui-Min Yang, Pei-Yu Lin, Jin-Yuan Han, Jian-Da Ma, Lie Dai\",\"doi\":\"10.1186/s12905-025-03670-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Early menopause (EM, age ≤ 45 years) is associated with an increased risk of developing rheumatoid arthritis (RA). We aimed to investigate its impact on disease characteristics in RA patients.</p><p><strong>Methods: </strong>This cross-sectional study included natural post-menopausal RA patients from an observational RA cohort recruited between January 2015 and October 2023. Demographic characteristics and clinical data were collected. Patients were divided into EM and usual menopause (UM, menopause age > 45 years) groups. Patients-reported outcomes (PROs, included patient global assessment of disease activity [PtGA], pain visual analogue scale [VAS] and Stanford health assessment questionnaire disability index [HAQ-DI]), and PROs-associated indicators (included 28-joint tender joint count [TJC28] and provider global assessment of disease activity [PrGA]) were assessed.</p><p><strong>Results: </strong>Among 1427 female RA patients, 557 natural post-menopausal RA patients were enrolled. The peak menopause age was between 46 and 50 years, with RA incidence peaking 5 years post-menopause. Compared with UM patients, RA patients with natural EM (n = 98,17.6%) exhibited more serious disease, including worse PROs and PROs-associated indicators, as well as higher C-reactive protein (CRP, all P < 0.05). Among 344 (61.8%) patients with RA onset after menopause, EM patients (n = 62, 18.0%) were characterized with worse PROs and PROs-associated indicators than those with UM patients (all P < 0.05), but no difference in inflammatory makers. Multivariate linear regression showed that menopause age was independently and negatively associated with PROs, including PtGA (β = -0.872, 95% CI -1.619, -0.125), HAQ-DI (β = -0.646, 95% CI -1.059, -0.233) in RA patients especially in those onset after menopause (PtGA [β = -1.028, 95% CI -2.022, -0.034]; HAQ-DI [β = -0.916, 95% CI -1.461, -0.370]).</p><p><strong>Conclusion: </strong>Early menopause impacts on PROs independent of inflammation in patients with RA especially in those with postmenopausal-onset RA, which imply the importance of differentiation of non-inflammatory disease activity.</p>\",\"PeriodicalId\":9204,\"journal\":{\"name\":\"BMC Women's Health\",\"volume\":\"25 1\",\"pages\":\"138\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-03-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931845/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Women's Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12905-025-03670-x\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Women's Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12905-025-03670-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Early menopause is associated with higher disease activity independent of inflammation in postmenopausal-onset rheumatoid arthritis.
Objective: Early menopause (EM, age ≤ 45 years) is associated with an increased risk of developing rheumatoid arthritis (RA). We aimed to investigate its impact on disease characteristics in RA patients.
Methods: This cross-sectional study included natural post-menopausal RA patients from an observational RA cohort recruited between January 2015 and October 2023. Demographic characteristics and clinical data were collected. Patients were divided into EM and usual menopause (UM, menopause age > 45 years) groups. Patients-reported outcomes (PROs, included patient global assessment of disease activity [PtGA], pain visual analogue scale [VAS] and Stanford health assessment questionnaire disability index [HAQ-DI]), and PROs-associated indicators (included 28-joint tender joint count [TJC28] and provider global assessment of disease activity [PrGA]) were assessed.
Results: Among 1427 female RA patients, 557 natural post-menopausal RA patients were enrolled. The peak menopause age was between 46 and 50 years, with RA incidence peaking 5 years post-menopause. Compared with UM patients, RA patients with natural EM (n = 98,17.6%) exhibited more serious disease, including worse PROs and PROs-associated indicators, as well as higher C-reactive protein (CRP, all P < 0.05). Among 344 (61.8%) patients with RA onset after menopause, EM patients (n = 62, 18.0%) were characterized with worse PROs and PROs-associated indicators than those with UM patients (all P < 0.05), but no difference in inflammatory makers. Multivariate linear regression showed that menopause age was independently and negatively associated with PROs, including PtGA (β = -0.872, 95% CI -1.619, -0.125), HAQ-DI (β = -0.646, 95% CI -1.059, -0.233) in RA patients especially in those onset after menopause (PtGA [β = -1.028, 95% CI -2.022, -0.034]; HAQ-DI [β = -0.916, 95% CI -1.461, -0.370]).
Conclusion: Early menopause impacts on PROs independent of inflammation in patients with RA especially in those with postmenopausal-onset RA, which imply the importance of differentiation of non-inflammatory disease activity.
期刊介绍：
BMC Women''s Health is an open access, peer-reviewed journal that considers articles on all aspects of the health and wellbeing of adolescent girls and women, with a particular focus on the physical, mental, and emotional health of women in developed and developing nations. The journal welcomes submissions on women''s public health issues, health behaviours, breast cancer, gynecological diseases, mental health and health promotion.
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