Full Papers
Biopsychosocial determinants and gender disparities in health-related quality of life among rheumatoid arthritis patients: a nationwide multicentre study in China
Y. Zhu1, H. Xu2, L. Zhang3, Y. Huo4, R. Wu5, L. Wu6, L. Lei7, L. Geng8, C. Tan9, X. Li10, R. Li11, Y. Su12
- Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China.
- Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China.
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, Shanxi, China.
- Department of Rheumatology and Immunology, The Fifth People’s Hospital of Datong, Datong, Shanxi, China.
- Department of Rheumatology and Immunology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
- Department of Rheumatology and Immunology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China.
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
- Department of Rheumatology and Immunology, The Drum Tower Clinical Medical School of Nanjing Medical University, Nanjing, Jiangsu, China.
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
- Department of Rheumatology and Immunology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
- Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China. doctorliru123@163.com
- Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing; and Department of Rheumatology and Immunology, Peking University People’s Hospital, Qingdao, Shandong, China. suyin@pkuph.edu.cn
Women’s Rheumatoid Arthritis Research Collaborative Group
CER19364
Full Papers
PMID: 41758546 [PubMed]
Received: 27/09/2025
Accepted : 19/01/2026
In Press: 20/02/2026
Abstract
OBJECTIVES:
This study aimed to investigate the gender-specific factors influencing health-related quality of life (HRQoL) among rheumatoid arthritis (RA) patients within biopsychosocial framework and the interacting effects of these factors.
METHODS:
A prospective multi-centre cross-sectional study was conducted. Binary logistic regression and subsequent stratified analyses were used to analyse the determinants of HRQoL among RA patients and how they interacted.
RESULTS:
Female patients (83.85%) exhibited earlier onset (45.68 vs. 50.85 years), longer disease duration (60.00 vs. 36.00 months), lower Clinical Disease Activity Index (CDAI) (19.00 vs. 22.00), and less glucocorticoid use (39.55% vs. 47.75%). Multivariable analysis suggested that better HRQoL was linked to urban residence and higher education. Worse HRQoL was related to older age at onset, higher financial burden, glucocorticoid use, elevated CDAI, irregular follow up, longer follow-up intervals, comorbidities, anxiety/depressive symptoms, poor sleep satisfaction, and fatigue. Stratified analysis revealed significant interactions among CDAI and financial burden, anxiety/depressive symptoms and sleep satisfaction.
CONCLUSIONS:
These findings highlight the biopsychosocial factors affecting HRQoL, emphasising the need for gender-specific strategies and targeted interventions focusing on financial burden, anxiety/depressive symptoms and sleep satisfaction in RA patients with moderate-to-high disease activity.
