背景：
已有報道顯示在一些風濕性疾病中男性較女性有更嚴重的表現。然而，並沒有研究建立原發性幹燥綜合症病人和性別相關的臨床特點。因此，在這項研究中，我們調查原發性幹燥綜合症在男性和女性診斷時的臨床表現。
方法：
特定區域的199個未經治療的患者被納入一項5年的前瞻性研究，期間對他們進行原發性幹燥綜合症診斷標準相關的檢查，以及對他們腺體外表現進行檢查。在診斷時取血清做樣本並用ELISA的方法檢測Ro52/SSA抗體。研究的重要結果在一項377例原發性幹燥綜合症的患者獨立隊列研究中被重複證實，並做了meta分析。
結果：
我們發現並證實男性中腺體外累及包括肺部病變、血管炎及淋巴結病變的幾率更高，並且在研究隊列中發現男性診斷年齡更小。此外，SSA抗體陽性的男性患者比女性的Ro-52檢測水平更高。
結論：
我們對兩組獨立隊列研究證實，在診斷原發性幹燥綜合症時，男性患者的腺體外累及明顯多於女性患者。約一半的男性患者在診斷原發性幹燥綜合症時存在腺體外累及，說明幹燥綜合症在男性患者中有更嚴重的表現形式，盡管男性發病率較低。
附原文：
Background：
A more severe disease phenotype has been reported in men compared to women in several rheumatic diseases. However, studies have not conclusively established sex-related clinical features in primary Sjögren’s syndrome (pSS). In this study, we therefore investigated the clinical presentation of pSS in women and men at diagnosis.
Methods:
Incident, treatment naïve patients (n = 199) during a 5-year period in a specified area were prospectively included and examined for items of classification criteria for pSS as well as extraglandular manifestations (EGM). Serum was sampled at the time of diagnosis and anti-Ro52/SSA levels were measured by ELISA. Replication of significant findings was confirmed in an independent cohort of pSS patients (n = 377), and meta-analysis was performed.
Results:
An increased frequency of extraglandular manifestations in men was observed and replicated (p = 0.05, p = 0.0003, and p meta = 0.002). This related to pulmonary involvement, vasculitis, and lymphadenopathy being more common in men, for whom a lower age at diagnosis was observed in the exploratory cohort. Additionally, SSA-positive male patients had significantly higher levels of anti-Ro52 levels than their female counterparts in sera available for analysis (p = 0.02).
Conclusions:
Our analysis of two independent cohorts of incident pSS demonstrates that the presence and number of EGM are significantly more frequent among men with pSS than women at diagnosis. Importantly, around half of the male patients presented with more than one EGM at diagnosis, supporting the conclusion that pSS in men represents a more severe form of disease, regardless of the lower risk for men to develop pSS.
引自：
Ramírez Sepúlveda JI, Kvarnström M, Brauner S, Baldini C, Wahren-Herlenius M.Difference in clinical presentation between women and men in incident primary Sjögren's syndrome.BIOLOGY OF SEX DIFFERENCES，2017.5(12)
