Table 4.
Multivariate analysis of possible determinants of sexual ill health
| Characteristics | Sexual dysfunction during last month∗∗ |
Bad/very bad sex life during last year |
Sex life not at all/to a low extent meaningful during last year |
Sexual needs not at all/to a low extent accommodated during last year |
Sex life to a high/some extent more complicated because of RA |
Ever experienced sexual problems due to RA treatment |
RA induced negative body image |
|---|---|---|---|---|---|---|---|
| OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |
| Sociodemographic data | |||||||
| Gender | |||||||
| Male | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Female | 2.5 (1.3–4.8) | 0.9 (0.4–2.8) | 1.1 (0.4–2.6) | 1.1 (0.5–2.4) | 1.3 (0.6–2.7) | 0.9 (0.5–1.8) | 1.5 (0.7–3.3) |
| Age group | |||||||
| Age < 45 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Age 45–65 | 3.5 (1.3–9.4) | 1.1 (0.3–4.7) | 3.8 (0.9–15.4) | 3.6 (0.8–17.0) | 0.7 (0.3–1.9) | 1.0.(0.4–2.7) | 0.4 (0.2–0.9) |
| Age 65+ | 10.6 (3.5–32.5) | 0.6 (0.1–3.6) | 5.7 (1.2–28.2) | 3.4 (0.6–18.4) | 0.7 (0.2–2.0) | 1.1 (0.4–3.1) | 0.1 (0.0–0.3) |
| Cohabitating status | |||||||
| Living alone | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Cohabitating | 0.8 (0.3–2.7) | 1.37 (0.2–10.5) | 0.9 (0.1–5.7) | 0.7 (0.1–3.2) | 1.3 (0.4–4.6) | 0.5 (0.1–2.1) | 0.4 (0.1–1.6) |
| Partner status | |||||||
| Single | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| In a relationship | 0.6 (0.2–1.8) | 1.7 (0.3–11.0) | 1.9 (0.3–11.9) | 1.2 (0.3–6.0) | 0.7 (0.2–2.2) | 7.4 (1.7–33.0) | 4.3 (1.2–16.4) |
| Characteristics related to RA | |||||||
| Paraclinical variables | |||||||
| Anti-CCP negative∗ | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Anti-CCP positive∗ | 2.1 (0.9–4.8) | 0.6 (0.2–2.13) | 0.8 (0.3–2.3) | 2.0 (0.6–6.7) | 0.7 (0.3–1.7) | 1.1 (0.5–2.7) | 0.9 (0.4–2.7) |
| IgM-RF negative† | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| IgM-RF positive† | 0.5 (0.2–1.3) | 1.01 (0.3–4.0) | 1.5 (0.4–5.2) | 0.6 (0.2–1.8) | 0.9 (0.4–2.5) | 0.6 (0.2–1.5) | 2.7 (0.9–8.1) |
| Comorbidity | |||||||
| CCI 0–1 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| CCI 2+ | 0.7 (0.2–2.7) | 1.3 (0.3–6.8) | 2.3 (0.4–13.2) | 4.4 (1.2–16.2) | 4.0 (1.1–15.5) | 2.7 (0.7–9.6) | 0.9 (0.2–3.8) |
| Medical treatment related to RA | |||||||
| Methotrexate | |||||||
| Previous | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Current | 0.8 (0.4–1.6) | 0.8 (0.3–2.3) | 0.9 (0.4–2.12) | 0.9 (0.4–2.2) | 3.3 (1.4–7.7) | 1.1 (0.6–2.1) | 1.3 (0.6–2.7) |
| Never | 0.4 (0.0–6.6) | 2.5 (0.1–72.9) | 1.4 (0.1–36.6) | 1.00 (.-.)†† | 0.9 (0.1–12.5) | 0.2 (0.0–3.0) | 0.2 (0.1–3.7) |
| Biologics‡ | |||||||
| Previous | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Biologics: present | 1.4 (0.5–4.2) | 2.1 (0.4–11.8) | 1.3 (0.3–5.5) | 0.6 (0.2–2.0) | 0.4 (0.1–1.4) | 0.9 (0.3–2.9) | 0.7 (0.2–2.1) |
| Biologics: never | 2.1 (0.8–6.0) | 2.6 (0.5–12.7) | 1.5 (0.4–5.7) | 0.4 (0.1–1.1) | 0.9 (0.3–2.8) | 0.8 (0.3–2.3) | 0.5 (0.2–1.5) |
| Lifestyle factors | |||||||
| BMI categories§ | |||||||
| <18.5 | 0.8 (0.2–3.7) | 0.9 (0.1–16.3) | 4.3 (0.4–45.6) | 0.8 (0.1–10.9) | 2.2 (0.3–14.9) | 1.5 (0.2–9.7) | 3.5 (0.5–27.1) |
| 18.5–24 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| 25–29 | 1.1 (0.6–2.2) | 1.1 (0.4–3.1) | 0.9 (0.4–2.4) | 1.9 (0.8–4.4) | 1.1 (0.5–2.3) | 0.6 (0.3–1.2) | 1.0 (0.5–2.1) |
| 30–39 | 0.9 (0.5–2.1) | 1.1 (0.4–3.2) | 2.0 (0.8–5.1) | 1.8 (0.7–4.7) | 1.0 (0.5–2.4) | 0.7 (0.3–1.5) | 1.7 (0.8–3.7) |
| 40+ | 1.9 (0.3–14.3) | 2.0 (0.2–22.2) | 4.4 (0.3–55.9) | 5.7 (0.8–38.0) | 0.5 (0.0–6.0) | 0.3 (0.0–2.3) | 0.5 (0.0–4.0) |
| Smoking categories | |||||||
| No daily smoking | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Daily smoking | 0.6 (0.3–1.3) | 0.7 (0.2–2.4) | 1.4 (0.5–3.9) | 1.3 (0.5–3.3) | 1.4 (0.6–3.1) | 0.7 (0.3–1.5) | 1.6 (0.7–3.6) |
| Alcohol categories | |||||||
| No weekly alcohol | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| <7/<14 units/week | 1.1 (0.6–2.1) | 1.4 (0.5–3.9) | 1.1 (0.5–2.7) | 1.5 (0.7–3.4) | 2.2 (1.1–4.5) | 1.3 (0.6–2.5) | 2.0 (0.9–4.1) |
| >7/>14 units/week | 0.9 (0.3–2.7) | 0.9 (0.2–4.2) | 0.3 (0.1–1.4) | 0.6 (0.1–2.8) | 2.2 (0.7–6.7) | 1.1 (0.4–3.1) | 3.4 (1.2–9.9) |
| Patient-reported outcomes | |||||||
| Physical function categories‖ | |||||||
| HAQ 0–1 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| HAQ 1–2 | 1.6 (0.8–3.3) | 0.9 (0.3–2.7) | 1.1 (0.4–2.9) | 0.8 (0.4–1.9) | 0.4 (0.2–0.9) | 1.3 (0.6–2.7) | 1.3 (0.6–2.7) |
| HAQ 2–3 | 2.0 (0.4–8.8) | 3.1 (0.5–19.6) | 2.9 (0.5–15.9) | 2.8 (0.7–11.8) | 0.8 (0.2–3.8) | 2.0 (0.5–7.6) | 0.8 (0.2–3.5) |
| Depression categories¶ | |||||||
| BDI ≤ 13 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| BDI 14–19 | 2.4 (0.9–6.1) | 4.4 (1.5–13.3) | 2.9 (0.9–8.7) | 2.8 (1.1–7.3) | 1.7 (0.6–4.9) | 1.0 (0.4–2.5) | 2.1 (0.9–5.3) |
| BDI 20–28 | 2.4 (0.6–9.7) | 3.3 (0.8–13.4) | 2.1 (0.5–10.0) | 1.0 (0.3–4.1) | 1.5 (0.3–6.7) | 1.7 (0.5–5.7) | 4.5 (1.3–15.3) |
| BDI ≥ 29 | 1.8 (0.1–26.1) | 31.9 (1.9–546.9) | 5.6 (0.3–101.8) | 2.5 (0.2–29.6) | 1.00 (.-.)†† | 1.9 (0.2–17.2) | 38.3 (2.3–636.4) |
| Loneliness categories# | |||||||
| UCLA 20–34 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| UCLA 35–49 | 1.8 (0.9–3.3) | 2.6 (0.9–7.5) | 3.7 (1.5–8.9) | 1.4 (0.7–3.1) | 0.5 (0.3–1.0) | 2.9 (1.5–5.6) | 1.8 (0.9–3.6) |
| UCLA 50–64 | 1.8 (0.7–5.0) | 6.0 (1.6–23.3) | 6.1 (1.5–25.1) | 1.7 (0.6–5.3) | 0.5 (0.1–1.5) | 1.5 (0.5–4.3) | 0.9 (0.3–2.7) |
| UCLA 65–80 | 1.00 (.-.)†† | 1.00 (.-.)†† | 1.00 (.-.)†† | 1.00 (.-.)†† | 1.00 (.-.)†† | 11.0 (0.4–299.5) | 0.3 (0.1–8.7) |
| Pain categories | |||||||
| VAS Pain 0–34 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| VAS Pain 35–74 | 0.7 (0.3–1.4) | 0.8 (0.3–2.4) | 0.3 (0.1–0.8) | 0.6 (0.3–1.5) | 0.7 (0.3–1.4) | 1.4 (0.7–2.9) | 0.9 (0.4–2.1) |
| VAS Pain 75+ | 1.2 (0.2–7.9) | 0.6 (0.1–5.3) | 0.4 (0.0–4.3) | 0.9 (0.1–5.3) | 0.7 (0.1–6.0) | 2.2 (0.4–11.8) | 1.3 (0.3–6.9) |
| Fatigue categories | |||||||
| VAS Fatigue 0–34 | 1.00 | 1.00 | 1.00 (.-.) | 1.00 | 1.00 | 1.00 | 1.00 |
| VAS Fatigue 35–74 | 1.9 (0.9–4.1) | 2.4 (0.7–8.4 | 4.7 (1.7–12.9) | 1.7 (0.7–4.4) | 0.4 (0.2–0.9) | 0.9 (0.4–2.0) | 1.3 (0.6–3.0) |
| VAS Fatigue 75+ | 4.1 (1.4–12.3) | 1.3 (0.3–6.3) | 2.1 (0.4–10.2) | 2.7 (0.7–9.7) | 0.6 (0.2–2.1) | 1.1 (0.4–3.2) | 1.6 (0.5–4.9) |
Abbreviations: BDI = Beck Depression Inventory; BMI = body mass index; CCI = Charlson's Comorbidity Index; CCP = cyclic citrullinated peptide; CI = confidence interval; HAQ = Health Assessment Questionnaire; IgM-RF = immunoglobulin M rheumatoid factor; MTX = methotrexate; OR = odds ratio; RA = rheumatoid arthritis; UCLA = University of California Los Angeles; VAS = Visual Analog Scale.
All ORs are mutually adjusted for all characteristics included in the table. Bold values indicating OR to be significantly different from 1 at a 0.05 significance level.
Anti-CCP positive/negative, cutoff as defined by local laboratory.
IgM-RF positive/negative, cutoff as defined by local laboratory.
Biologics include anakinra, tocilizumab, abatacept, etanercept, certolizumab, adalimumab, infliximab, golimumab.
BMI categories: <18.5 underweight; 18.5–24.9 normal weight; 25–29.9 overweight; >30–39.9 severe overweight; BMI >40 extreme overweight.
HAQ categories: 0–1 mild to moderate difficulty; 1–2 moderate to severe disability; 2–3 severe to very severe disability.
BDI categories: ≤13 minimal or no depression; 14–19 light depression; 20–28 moderate depression; ≥29 severe depression.
UCLA Loneliness categories: 20–34, low; 35–49, moderate; 50–64, moderately high; 65–80, high.
Sexual dysfunction measured with CSFQ score, cutoff 47≤ for men and ≤41 for women.
Numbers too small to calculate OR and CI.