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The health-related quality of life of ankylosing spondylitis patients assessed by SF-36: a systematic review and meta-analysis

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Abstract

Purpose

The main purpose of this meta-analysis was to evaluate the impact of ankylosing spondylitis on the health-related quality of life assessed by the Medical Outcomes Short-Form-36 questionnaire (SF-36).

Methods

A systematic literature search was performed on PubMed and Web of Science until January 22, 2016 to obtain eligible studies. Random effect model was performed to summarize the scores of each domain. The radar chart was used to compare the scores of AS patients with other health conditions. Spearman’s correlation analysis and meta-regression were used to explore the related factors. STATA (version 11.0) and SPSS (version 13.0) were adopted in this meta-analysis.

Results

Thirty-eight studies were included in this study, which were all reliable to summarize the scores of the SF-36. Pooled mean scores of the physical health domains ranged from 45.93 to 58.17, with the RP and PF domains being the lowest and the highest, respectively. Pooled mean scores of the mental health domains ranged from 47.49 to 62.52, with the VT and SF domains being the lowest and the highest, respectively. Besides, the physical component summary was lower than the mental component summary. BASDAI and BASFI were negatively associated with some domains of the SF-36 significantly. Patients with AS had a substantial impaired HRQoL in comparison with the general population.

Conclusions

AS could adversely affect the HRQoL of patients. Measuring HRQoL should be considered as an essential part of the overall assessment of health status of AS patients, which would provide valuable clues for improving the management of disease and making decisions regarding treatment.

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References

  1. Braun, J., & Sieper, J. (2007). Ankylosing spondylitis. Lancet, 369(9570), 1379–1390. doi:10.1016/S0140-6736(07)60635-7.

    Article  PubMed  Google Scholar 

  2. Gran, J. T., & Husby, G. (1993). The epidemiology of ankylosing spondylitis. Seminars in Arthritis and Rheumatism, 22(5), 319–334.

    Article  CAS  PubMed  Google Scholar 

  3. Exarchou, S., Lie, E., Lindstrom, U., Askling, J., Forsblad-d’Elia, H., Turesson, C., et al. (2015). Mortality in ankylosing spondylitis: results from a nationwide population-based study. Annals of the Rheumatic Diseases,. doi:10.1136/annrheumdis-2015-207688.

    PubMed  Google Scholar 

  4. Feldtkeller, E., Khan, M. A., van der Heijde, D., van der Linden, S., & Braun, J. (2003). Age at disease onset and diagnosis delay in HLA-B27 negative vs. positive patients with ankylosing spondylitis. Rheumatology International, 23(2), 61–66.

    PubMed  Google Scholar 

  5. Ward, M. M., Weisman, M. H., Davis, J. C, Jr., & Reveille, J. D. (2005). Risk factors for functional limitations in patients with long-standing ankylosing spondylitis. Arthritis and Rheumatism, 53(5), 710–717. doi:10.1002/art.21444.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Missaoui, B., & Revel, M. (2006). Fatigue in ankylosing spondylitis. Annales de réadaptation et de médecine physique, 49(6), 305–308, 389–391. doi:10.1016/j.annrmp.2006.03.007.

  7. Haywood, K. L., Packham, J. C., & Jordan, K. P. (2014). Assessing fatigue in ankylosing spondylitis: the importance of frequency and severity. Rheumatology (Oxford), 53(3), 552–556. doi:10.1093/rheumatology/ket397.

    Article  Google Scholar 

  8. Bedaiwi, M., Sari, I., Thavaneswaran, A., Ayearst, R., Haroon, N., & Inman, R. D. (2015). Fatigue in ankylosing spondylitis and nonradiographic axial spondyloarthritis: Analysis from a longitudinal observation cohort. Journal of Rheumatology, 42(12), 2354–2360. doi:10.3899/jrheum.150463.

    Article  CAS  PubMed  Google Scholar 

  9. van Tubergen, A., Coenen, J., Landewe, R., Spoorenberg, A., Chorus, A., Boonen, A., et al. (2002). Assessment of fatigue in patients with ankylosing spondylitis: A psychometric analysis. Arthritis and Rheumatism, 47(1), 8–16.

    Article  PubMed  Google Scholar 

  10. Hakkou, J., Rostom, S., Mengat, M., Aissaoui, N., Bahiri, R., & Hajjaj-Hassouni, N. (2013). Sleep disturbance in Moroccan patients with ankylosing spondylitis: Prevalence and relationships with disease-specific variables, psychological status and quality of life. Rheumatology International, 33(2), 285–290. doi:10.1007/s00296-012-2376-6.

    Article  PubMed  Google Scholar 

  11. Boonen, A., Chorus, A., Miedema, H., van der Heijde, D., Landewe, R., Schouten, H., et al. (2001). Withdrawal from labour force due to work disability in patients with ankylosing spondylitis. Annals of the Rheumatic Diseases, 60(11), 1033–1039.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Barlow, J. H., Wright, C. C., Williams, B., & Keat, A. (2001). Work disability among people with ankylosing spondylitis. Arthritis and Rheumatism, 45(5), 424–429.

    Article  CAS  PubMed  Google Scholar 

  13. Dincer, U., Cakar, E., Kiralp, M. Z., & Dursun, H. (2007). Assessment of sexual dysfunction in male patients with ankylosing spondylitis. Rheumatology International, 27(6), 561–566. doi:10.1007/s00296-006-0248-7.

    Article  PubMed  Google Scholar 

  14. Oh, J. S., Heo, H. M., Kim, Y. G., Lee, S. G., Lee, C. K., & Yoo, B. (2009). The effect of anti-tumor necrosis factor agents on sexual dysfunction in male patients with ankylosing spondylitis: A pilot study. International Journal of Impotence Research, 21(6), 372–375. doi:10.1038/ijir.2009.44.

    Article  CAS  PubMed  Google Scholar 

  15. Cella, D., & Nowinski, C. J. (2002). Measuring quality of life in chronic illness: The functional assessment of chronic illness therapy measurement system. Archives of Physical Medicine and Rehabilitation, 83(12 Suppl 2), S10–S17. doi:10.1053/apmr.2002.36959.

    Article  PubMed  Google Scholar 

  16. Ware, J., & Sherbourne, S. D. (1992). The MOS 36-item short form health survey (SF-36). 1. Conceptual frame-work and item selection. Medical Care, 30, 473–481.

    Article  PubMed  Google Scholar 

  17. Ware, J. E, Jr. (2000). Using generic measures of functional health and well-being to increase understanding of disease burden. Spine, 25(12), 1467.

    Article  PubMed  Google Scholar 

  18. Ozgul, A., Peker, F., Taskaynatan, M. A., Tan, A. K., Dincer, K., & Kalyon, T. A. (2006). Effect of ankylosing spondylitis on health-related quality of life and different aspects of social life in young patients. Clinical Rheumatology, 25(2), 168–174. doi:10.1007/s10067-005-1150-5.

    Article  PubMed  Google Scholar 

  19. Husted, J. A., Gladman, D. D., Farewell, V. T., Long, J. A., & Cook, R. J. (1997). Validating the SF-36 health survey questionnaire in patients with psoriatic arthritis. Journal of Rheumatology, 24(3), 511–517.

    CAS  PubMed  Google Scholar 

  20. Dougados, M., & Baeten, D. (2011). Spondyloarthritis. Lancet, 377(9783), 2127–2137. doi:10.1016/S0140-6736(11)60071-8.

    Article  PubMed  Google Scholar 

  21. von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gotzsche, P. C., Vandenbroucke, J. P., et al. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Preventive Medicine, 45(4), 247–251.

    Article  Google Scholar 

  22. Vandenbroucke, J. P., von Elm, E., Altman, D. G., Gotzsche, P. C., Mulrow, C. D., Pocock, S. J., et al. (2014). Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and elaboration. International Journal of Surgery, 12(12), 1500–1524. doi:10.1016/j.ijsu.2014.07.014.

    Article  PubMed  Google Scholar 

  23. Matcham, F., Scott, I. C., Rayner, L., Hotopf, M., Kingsley, G. H., Norton, S., et al. (2014). The impact of rheumatoid arthritis on quality-of-life assessed using the SF-36: A systematic review and meta-analysis. Seminars in Arthritis and Rheumatism, 44(2), 123–130. doi:10.1016/j.semarthrit.2014.05.001.

    Article  PubMed  Google Scholar 

  24. Zhang, S.-K., Guo, L.-W., Chen, Q., Zhang, M., Liu, S.-Z., Quan, P.-L., et al. (2015). Prevalence of human papillomavirus 16 in esophageal cancer among the Chinese population: A systematic review and meta-analysis. Asian Pacific Journal of Cancer Prevention, 15(23), 10143–10149. doi:10.7314/apjcp.2014.15.23.10143.

    Article  Google Scholar 

  25. Yang, B., Fan, S., Zhi, X., Wang, Y., Wang, Y., Zheng, Q., et al. (2015). Prevalence of hyperhomocysteinemia in China: A systematic review and meta-analysis. Nutrients, 7(1), 74–90. doi:10.3390/nu7010074.

    Article  Google Scholar 

  26. Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. BMJ, 327(7414), 557–560. doi:10.1136/bmj.327.7414.557.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Harris, R., Bradburn, M., Deeks, J., Harbord, R., Altman, D., & Steichen, T. (2010). Stata module for fixed and random effects meta-analysis. Statistical software components. Department of Economics, Boston College, USA.

  28. Ribu, L., Hanestad, B. R., Moum, T., Birkeland, K., & Rustoen, T. (2007). A comparison of the health-related quality of life in patients with diabetic foot ulcers, with a diabetes group and a nondiabetes group from the general population. Quality of Life Research, 16(2), 179–189. doi:10.1007/s11136-006-0031-y.

    Article  PubMed  Google Scholar 

  29. Jenkinson, C., Coulter, A., & Wright, L. (1993). Short-form 36 (SF-36) health survey questionnaire: Normative data for adults of working age. British Medical Journal, 29, 1437–1440.

    Article  Google Scholar 

  30. Clarke, P. M., Simon, J., Cull, C. A., & Holman, R. R. (2006). Assessing the impact of visual acuity on quality of life in individuals with type 2 diabetes using the short form-36. Diabetes Care, 29(7), 1506–1511. doi:10.2337/dc05-2150.

    Article  PubMed  Google Scholar 

  31. Ward, M. M. (1999). Health-related quality of life in ankylosing spondylitis: A survey of 175 patients. Arthritis Care & Research, 12(4), 247–255.

    Article  CAS  Google Scholar 

  32. Tubergen, A. V., Coenen, J., Landewe, R., Spoorenberg, A., Chorus, A., Boonen, A., et al. (2002). Assessment of fatigue in patients with ankylosing spondylitis: A psychometric analysis. Arthritis and Rheumatism, 47(1), 8–16.

    Article  PubMed  Google Scholar 

  33. Ariza-Ariza, R., Hernandez-Cruz, B., & Navarro-Sarabia, F. (2003). Physical function and health-related quality of life of Spanish patients with ankylosing spondylitis. Arthritis and Rheumatism, 49(4), 483–487. doi:10.1002/art.11197.

    Article  PubMed  Google Scholar 

  34. Chorus, A. M., Miedema, H. S., Boonen, A., & Van Der Linden, S. (2003). Quality of life and work in patients with rheumatoid arthritis and ankylosing spondylitis of working age. Annals of the Rheumatic Diseases, 62(12), 1178–1184.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. van Tubergen, A., Landewe, R., Heuft-Dorenbosch, L., Spoorenberg, A., van der Heijde, D., van der Tempel, H., et al. (2003). Assessment of disability with the World Health Organisation Disability Assessment Schedule II in patients with ankylosing spondylitis. Annals of the Rheumatic Diseases, 62(2), 140–145.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Dagfinrud, H., Mengshoel, A. M., Hagen, K. B., Loge, J. H., & Kvien, T. K. (2004). Health status of patients with ankylosing spondylitis: A comparison with the general population. Annals of the Rheumatic Diseases, 63(12), 1605–1610. doi:10.1136/ard.2003.019224.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Barkham, N., Kong, K. O., Tennant, A., Fraser, A., Hensor, E., Keenan, A. M., et al. (2005). The unmet need for anti-tumour necrosis factor (anti-TNF) therapy in ankylosing spondylitis. Rheumatology (Oxford), 44(10), 1277–1281. doi:10.1093/rheumatology/keh713.

    Article  CAS  Google Scholar 

  38. Braun, J., Brandt, J., Listing, J., Zink, A., Alten, R., Burmester, G., et al. (2005). Two year maintenance of efficacy and safety of infliximab in the treatment of ankylosing spondylitis. Annals of the Rheumatic Diseases, 64(2), 229–234. doi:10.1136/ard.2004.025130.

    Article  CAS  PubMed  Google Scholar 

  39. Heiberg, M. S., Nordvag, B. Y., Mikkelsen, K., Rodevand, E., Kaufmann, C., Mowinckel, P., et al. (2005). The comparative effectiveness of tumor necrosis factor-blocking agents in patients with rheumatoid arthritis and patients with ankylosing spondylitis: A six-month, longitudinal, observational, multicenter study. Arthritis and Rheumatism, 52(8), 2506–2512. doi:10.1002/art.21209.

    Article  CAS  PubMed  Google Scholar 

  40. Ozgul, A., Peker, F., Taskaynatan, M. A., Tan, A. K., Dincer, K., & Kalyon, T. A. (2006). Effect of ankylosing spondylitis on health-related quality of life and different aspects of social life in young patients. Clinical Rheumatology, 25(2), 168–174. doi:10.1007/s10067-005-1150-5.

    Article  PubMed  Google Scholar 

  41. Cakar, E., Dincer, U., Kiralp, M., Taskaynatan, M., Yasar, E., Bayman, E., et al. (2007). Sexual problems in male ankylosing spondylitis patients: relationship with functionality, disease activity, quality of life, and emotional status. Clinical Rheumatology, 26(10), 1607–1613.

    Article  PubMed  Google Scholar 

  42. Boonen, A., Patel, V., Traina, S., Chiou, C. F., Maetzel, A., & Tsuji, W. (2008). Rapid and sustained improvement in health-related quality of life and utility for 72 weeks in patients with ankylosing spondylitis receiving etanercept. Journal of Rheumatology, 35(4), 662–667.

    CAS  PubMed  Google Scholar 

  43. Choi, C. B., Kim, T. J., Park, H. J., Uhm, W. S., Jun, J. B., Bae, S. C., et al. (2008). Safety and clinical responses in ankylosing spondylitis after three months of etanercept therapy. Journal of Korean Medical Science, 23(5), 852–856. doi:10.3346/jkms.2008.23.5.852.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Maksymowych, W., Mallon, C., Morrow, S., Shojania, K., Olszynski, W., Wong, R., et al. (2009). Development and validation of the spondyloarthritis research consortium of Canada (SPARCC) enthesitis index. Annals of the Rheumatic Diseases, 68(6), 948–953.

    Article  CAS  PubMed  Google Scholar 

  45. Mustur, D., Vesovic-Potic, V., Stanisavljevic, D., Ille, T., & Ille, M. (2009). Assessment of functional disability and quality of life in patients with ankylosing spondylitis. Srpski Arhiv za Celokupno Lekarstvo, 137(9–10), 524–528.

    Article  PubMed  Google Scholar 

  46. Salaffi, F., Carotti, M., Gasparini, S., Intorcia, M., & Grassi, W. (2009). The health-related quality of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: A comparison with a selected sample of healthy people. Health and Quality Life Outcomes, 7, 25. doi:10.1186/1477-7525-7-25.

    Article  Google Scholar 

  47. Deodhar, A., Braun, J., Inman, R. D., Mack, M., Parasuraman, S., Buchanan, J., et al. (2010). Golimumab reduces sleep disturbance in patients with active ankylosing spondylitis: Results from a randomized, placebo-controlled trial. Arthritis Care & Research, 62(9), 1266–1271. doi:10.1002/acr.20233.

    Article  Google Scholar 

  48. Torres, T. M., Ferraz, M. B., & Ciconelli, R. M. (2010). Resource utilisation and cost of ankylosing spondylitis in Brazil. Clinical and Experimental Rheumatology, 28(4), 490–497.

    CAS  PubMed  Google Scholar 

  49. Bodur, H., Ataman, S., Rezvani, A., Bugdayci, D. S., Cevik, R., Birtane, M., et al. (2011). Quality of life and related variables in patients with ankylosing spondylitis. Quality of Life Research, 20(4), 543–549. doi:10.1007/s11136-010-9771-9.

    Article  PubMed  Google Scholar 

  50. Hakkou, J., Rostom, S., Aissaoui, N., Berrada, K., Abouqal, R., Bahiri, R., et al. (2011). Psychological status in Moroccan patients with ankylosing spondylitis and its relationships with disease parameters and quality of life. Journal of Clinical Rheumatology, 17(8), 424–428.

    Article  PubMed  Google Scholar 

  51. Ovayolu, N., Ovayolu, O., & Karadag, G. (2011). Health-related quality of life in ankylosing spondylitis, fibromyalgia syndrome, and rheumatoid arthritis: a comparison with a selected sample of healthy individuals. Clinical Rheumatology, 30(5), 655–664.

    Article  PubMed  Google Scholar 

  52. Ozdemir, O. (2011). Quality of life in patients with ankylosing spondylitis: Relationships with spinal mobility, disease activity and functional status. Rheumatology International, 31(5), 605–610. doi:10.1007/s00296-009-1328-2.

    Article  PubMed  Google Scholar 

  53. Revicki, D. A., Rentz, A. M., Luo, M. P., & Wong, R. L. (2011). Psychometric characteristics of the short form 36 health survey and functional assessment of chronic illness Therapy-Fatigue subscale for patients with ankylosing spondylitis. Health and Quality Life Outcomes, 9, 36. doi:10.1186/1477-7525-9-36.

    Article  Google Scholar 

  54. Ibn Yacoub, Y., Amine, B., Laatiris, A., & Hajjaj-Hassouni, N. (2012). Gender and disease features in Moroccan patients with ankylosing spondylitis. Clinical Rheumatology, 31(2), 293–297. doi:10.1007/s10067-011-1819-x.

    Article  PubMed  Google Scholar 

  55. Packham, J. C., Jordan, K. P., Haywood, K. L., Garratt, A. M., & Healey, E. L. (2012). Evaluation of Ankylosing Spondylitis Quality of Life questionnaire: Responsiveness of a new patient-reported outcome measure. Rheumatology, 51(4), 707–714. doi:10.1093/rheumatology/ker377.

    Article  PubMed  Google Scholar 

  56. Pimentel-Santos, F., Pinto, T., Santos, H., Barcelos, A., Cunha, I., Branco, J., et al. (2012). Portuguese version of the bath indexes for ankylosing spondylitis patients: A cross-cultural adaptation and validation. Clinical Rheumatology, 31(2), 341–346.

    Article  CAS  PubMed  Google Scholar 

  57. Akad, K., Solmaz, D., Sari, I., Onen, F., Akkoc, N., & Akar, S. (2013). Performance of response scales of activity and functional measures of ankylosing spondylitis: Numerical rating scale versus visual analog scale. Rheumatology International, 33(10), 2617–2623. doi:10.1007/s00296-013-2789-x.

    Article  PubMed  Google Scholar 

  58. Alkan, B., Fidan, F., Erten, Ş., Aksekili, H., Alemdar, A., Eroğlu, E., et al. (2013). Fatigue and correlation with disease-specific variables, spinal mobility measures, and health-related quality of life in ankylosing spondylitis. Modern Rheumatology, 23(6), 1101–1107.

    Article  PubMed  Google Scholar 

  59. Cho, H., Kim, T., Kim, T. H., Lee, S., & Lee, K. H. (2013). Spinal mobility, vertebral squaring, pulmonary function, pain, fatigue, and quality of life in patients with ankylosing spondylitis. Annals of Rehabilitation Medicine, 37(5), 675–682. doi:10.5535/arm.2013.37.5.675.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Yigit, S., Sahin, Z., Demir, S., & Aytac, D. (2013). Home-based exercise therapy in ankylosing spondylitis: short-term prospective study in patients receiving tumor necrosis factor alpha inhibitors. Rheumatology International, 33(1), 71–77.

    Article  CAS  PubMed  Google Scholar 

  61. Yılmaz, O., Tutoğlu, A., Garip, Y., Ozcan, E., & Bodur, H. (2013). Health-related quality of life in Turkish patients with ankylosing spondylitis: impact of peripheral involvement on quality of life in terms of disease activity, functional status, severity of pain, and social and emotional functioning. Rheumatology International, 33(5), 1159–1163.

    Article  PubMed  Google Scholar 

  62. Bao, C., Huang, F., Khan, M. A., Fei, K., Wu, Z., Han, C., et al. (2014). Safety and efficacy of golimumab in Chinese patients with active ankylosing spondylitis: 1-year results of a multicentre, randomized, double-blind, placebo-controlled phase III trial. Rheumatology (Oxford), 53(9), 1654–1663. doi:10.1093/rheumatology/keu132.

    Article  Google Scholar 

  63. Dundar, U., Solak, O., Toktas, H., Demirdal, U. S., Subasi, V., Kavuncu, V., et al. (2014). Effect of aquatic exercise on ankylosing spondylitis: A randomized controlled trial. Rheumatology International, 34(11), 1505–1511. doi:10.1007/s00296-014-2980-8.

    Article  CAS  PubMed  Google Scholar 

  64. Osterhaus, J. T., & Purcaru, O. (2014). Discriminant validity, responsiveness and reliability of the arthritis-specific Work Productivity Survey assessing workplace and household productivity within and outside the home in patients with axial spondyloarthritis, including nonradiographic axial spondyloarthritis and ankylosing spondylitis. Arthritis Research & Therapy, 16(4), R164. doi:10.1186/Ar4680.

    Article  Google Scholar 

  65. Webers, C., Essers, I., Ramiro, S., Stolwijk, C., Landewe, R., van der Heijde, D., et al. (2014). Gender-attributable differences in outcome of ankylosing spondylitis: Long-Term Results from the Outcome in Ankylosing Spondylitis International Study. Arthritis & Rheumatology, 66, S1137.

    Google Scholar 

  66. Erkol, İ. E., Demirci, K., Doğru, A., & Şahin, M. (2015). Ankylosing spondylitis patients with Type D personality have worse clinical status. Modern Rheumatology, 29, 1–8.

    Google Scholar 

  67. Jennings, F., Oliveira, H. A., de Souza, M. C., Cruz Vda, G., & Natour, J. (2015). Effects of aerobic training in patients with ankylosing spondylitis. Journal of Rheumatology, 42(12), 2347–2353. doi:10.3899/jrheum.150518.

    Article  PubMed  Google Scholar 

  68. Pelaez-Ballestas, I., Boonen, A., Vazquez-Mellado, J., Reyes-Lagunes, I., Hernandez-Garduno, A., Goycochea, M. V., et al. (2015). Coping strategies for health and daily-life stressors in patients with rheumatoid arthritis, ankylosing spondylitis, and gout: STROBE-compliant article. Medicine (Baltimore), 94(10), e600. doi:10.1097/MD.0000000000000600.

    Article  Google Scholar 

  69. Smith, B. H., Elliott, A. M., Chambers, W. A., Smith, W. C., Hannaford, P. C., & Penny, K. (2001). The impact of chronic pain in the community. Family Practice, 18(3), 292–299.

    Article  CAS  PubMed  Google Scholar 

  70. Carmona, L., Ballina, J., Gabriel, R., Laffon, A., & EPISER Study Group. (2001). The burden of musculoskeletal diseases in the general population of Spain: Results from a national survey. Annals of the Rheumatic Diseases, 60(11), 1040–1045.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Ware, J. E, Jr. (2000). SF-36 health survey update. Spine, 25(24), 3130–3139.

    Article  PubMed  Google Scholar 

  72. Barlow, J. H., Macey, S. J., & Struthers, G. R. (1993). Gender, depression, and ankylosing spondylitis. Arthritis Care & Research, 6(1), 45–51.

    Article  CAS  Google Scholar 

  73. Matcham, F., Rayner, L., Steer, S., & Hotopf, M. (2013). The prevalence of depression in rheumatoid arthritis: A systematic review and meta-analysis. Rheumatology (Oxford), 52(12), 2136–2148. doi:10.1093/rheumatology/ket169.

    Article  Google Scholar 

  74. Petitti, D. B. (2001). Approaches to heterogeneity in meta-analysis. Statistics in Medicine, 20(23), 3625–3633.

    Article  CAS  PubMed  Google Scholar 

  75. Robert, S., Cherepanov, D., Palta, M., Dunham, N., Feeny, D., & Fryback, D. (2009). Socioeconomic status and age variations in health-related quality of life: results from the National Health Measurement Study. Journal of Gerontology, 64B, 378–389.

    Article  Google Scholar 

  76. De Vogli, R., Gimeno, D., & Kivimaki, M. (2008). Socioeconomic inequalities in health in 22 European countries. New England Journal of Medicine, 359(12), 1290. doi:10.1056/NEJMc081414. author reply 1290–1291.

    Article  PubMed  Google Scholar 

  77. Kidd, B., Mullee, M., Frank, A., & Cawley, M. (1988). Disease expression of ankylosing spondylitis in males and females. The Journal of Rheumatology, 15(9), 1407–1409.

    CAS  PubMed  Google Scholar 

  78. Gran, J. T., & Husby, G. (1990). Ankylosing spondylitis in women. Seminars in Arthritis and Rheumatism, 19(5), 303–312.

    Article  CAS  PubMed  Google Scholar 

  79. Jimenez-Balderas, F. J., & Mintz, G. (1993). Ankylosing spondylitis: Clinical course in women and men. The Journal of Rheumatology, 20(12), 2069–2072.

    CAS  PubMed  Google Scholar 

  80. Blazer, D., Burchett, B., Service, C., & George, L. K. (1991). The association of age and depression among the elderly: An epidemiologic exploration. Journal of Gerontology, 46(6), M210–M215.

    Article  CAS  PubMed  Google Scholar 

  81. Stordal, E., Mykletun, A., & Dahl, A. A. (2003). The association between age and depression in the general population: A multivariate examination. Acta Psychiatrica Scandinavica, 107(2), 132–141.

    Article  CAS  PubMed  Google Scholar 

  82. Kim, S. M., Jung, J. W., Park, I. W., Ahn, C. M., Kim, Y. I., Yoo, K. H., et al. (2016). Gender differences in relations of smoking status, depression, and suicidality in Korea: Findings from the Korea National Health and Nutrition Examination Survey 2008–2012. Psychiatry Investigation, 13(2), 239–246. doi:10.4306/pi.2016.13.2.239.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Calin, A., Garrett, S., Whitelock, H., Kennedy, L. G., O’Hea, J., Mallorie, P., et al. (1994). A new approach to defining functional ability in AS: The development of the Bath ankylosing spondylitis functional index. Journal of Rheumatology, 21, 2281–2285.

    CAS  PubMed  Google Scholar 

  84. Garrett, S., Jenkinson, T., Kennedy, L., Whitelock, H., Gaisford, P., & Calin, A. (1994). A new approach to defining disease status in AS: The Bath ankylosing spondylitis disease activity index. Journal of Rheumatology, 21, 2286–2291.

    CAS  PubMed  Google Scholar 

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Acknowledgments

The study was supported by grants from the National Natural Science Foundation of China (30771849, 30972530, 81273169, 81573218, and 81571572).

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    Authors and Affiliations

    1. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China

      Xiao Yang, Dazhi Fan, Qing Xia, Mengmeng Wang, Xu Zhang, Xiaona Li, Guoqi Cai, Li Wang, Lihong Xin & Faming Pan

    2. Department of Obstetrics, South Medical University Affiliated Maternal & Child Health Hospital of Foshan, 11 Renmin Road, Foshan, 528000, Guangdong, China

      Dazhi Fan

    3. Department of Rheumatism and Immunity, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China

      Shengqian Xu

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    1. Xiao Yang
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    3. Qing Xia
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    Correspondence to Faming Pan.

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    Xiao Yang and Dazhi Fan contributed equally to this work and should be considered co-first authors.

    Electronic supplementary material

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    Online Resource 1

    Quality assessment instrument (PDF 16 kb)

    Online Resource 2

    Comparison of HRQoL in AS patients to patients with RA and type 2 diabetes (PDF 72 kb)

    Online Resource 3

    Subgroup analysis of the HRQoL of ankylosing spondylitis patients (PDF 200 kb)

    Online Resource 4

    Assessment of publication bias (PDF 127 kb)

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    Yang, X., Fan, D., Xia, Q. et al. The health-related quality of life of ankylosing spondylitis patients assessed by SF-36: a systematic review and meta-analysis. Qual Life Res 25, 2711–2723 (2016). https://doi.org/10.1007/s11136-016-1345-z

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