Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.

Marital Status in Systemic Sclerosis: Association with Pulmonary Function and Skin Involvement.

Harper1,  Brock E., Assassi2,  Shervin, Geslani3,  Giovanni, Leung3,  Joanna, Bentz1,  Holly, Gonzalez1,  Emilio B., Draeger4,  Hilda T.

University of Texas Medical Branch, Galveston, TX
University of Texas Health Science Center at Houston, Houston, TX
Galveston, TX
Univ of TX Health Sci Ctr, San Antonio, TX


Systemic sclerosis (SSc) is a chronic autoimmune disease associated with fatigue, depression, and work disability. Previous studies have shown that non-married SSc patients report more unmet psychosocial needs and feelings of disability compared to their married counterparts. Being married has been associated with less frequent work disability in other rheumatic diseases, including systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). No study to date has investigated the relationship between SSc and marital status. The goal of this study is to assess possible determinants of marital status in SSc.


Demographic data including age, gender, ethnicity, marital status (married, not married but living in a marriage-like relationship, divorced, separated, widowed and never married) and clinical data including extent of skin involvement as measured by modified Rodnan Skin Score (mRSS), forced vital capacity (FVC), disease type, and presence of anti-centromere and anti-topoisomerase I antibodies were collected at enrollment in the Genetics versus ENvironment In Scleroderma Outcome Study (GENISOS). Widowed patients were subsequently excluded from the analysis. Multivariate logistic regression analysis controlling for age, gender and ethnicity was performed comparing patients in a union (married or in a marriage-like relationship) to patients who were not in a union (separated, divorced, or never married.)


Data from 303 patients with SSc were analyzed. Among women with scleroderma, 128 (50.6%) were married, 11 (4.4%) were living in a marriage-like relationship, 10 (4.0%) were separated, 59 (23.3%) were divorced, 14 (5.5%) were widowed and 31 (12.3%) were never married. Among men with scleroderma, 32 (65.3%) were married, 8 (16.3%) were separated, 1 (2.0%) was widowed and 8 (16.3%) were divorced. Multivariable logistic regression analysis revealed significant associations of FVC <50% and higher mRSS with lower likelihood of being in a union with patients with FVC <50% being 1/3 as likely of being in a union as patients with normal FVC.(Table 1) No other significant associations were identified.

Table 1. Correlation of Being In a Union with Clinical and Serologic Features of SSc

 Multivariable Logistic Regression
 OR (95% CI)p
Limited Skin Involvement1.1781 (0.7159, 1.9388)0.519
Topo +/-0.9792 (0.5003, 1.916)0.951
Centromere +/-0.9140 (0.4323, 1.9323)0.814
mRSS0.9787 (0.9582, 0.9995)0.045
Disease duration0.9935 (0.8485, 1.1634)0.936
FVC < 50 % pred0.3355 (0.1200, 0.9378)0.037


At baseline, more severe skin involvement and interstitial lung disease were associated with lower likelihood of being married or in a marriage-like relationship. Further identification of factors contributing to loss of marital support may provide strategies for preserving these relationships and better overall quality of life and coping for patients with SSc.

To cite this abstract, please use the following information:
Harper, Brock E., Assassi, Shervin, Geslani, Giovanni, Leung, Joanna, Bentz, Holly, Gonzalez, Emilio B., et al; Marital Status in Systemic Sclerosis: Association with Pulmonary Function and Skin Involvement. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :666

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