High prevalence of serum metabolic alterations in primary Sjögren's syndrome : Influence on clinical and immunological expression

• Published in: Journal of rheumatology 2007-04, Vol.34 (4), p.754-761
• Main Authors: RAMOS-CASALS, Manuel, BRITO-ZERON, Pilar, SISO, Antoni, VARGAS, Alfonso, ROS, Emili, BOVE, Albert, BELENGUER, Rafael, PLAZA, Joan, BENAVENT, Jaume, FONT, Josep
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - adverse effects; Adult; Aged; Antibodies, Antinuclear - blood; Biological and medical sciences; Case-Control Studies; Diabetes Complications - etiology; Diabetes Complications - immunology; Diabetes. Impaired glucose tolerance; Disorders of blood lipids. Hyperlipoproteinemia; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Hypercholesterolemia - immunology; Hypertriglyceridemia - immunology; Hyperuricemia - immunology; Male; Medical sciences; Metabolic diseases; Middle Aged; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Sjogren's Syndrome - blood; Sjogren's Syndrome - complications; Sjogren's Syndrome - drug therapy; Sjogren's Syndrome - immunology
• ISSN: 0315-162X; 1499-2752

To analyze the prevalence and clinical significance of associated metabolic alterations [dyslipidemia, diabetes mellitus (DM), and hyperuricemia] in a large series of unselected patients with primary Sjögren's syndrome (SS). We analyzed 254 consecutive patients with primary SS who had a complete analytical followup study for at least 5 consecutive years. The control group consisted of 254 age and sex-matched patients without systemic autoimmune diseases consecutively followed during the same period in a primary care center. In comparison with controls, patients with primary SS showed a higher frequency of dyslipidemia (47% vs 33%; p = 0.002), DM (28% vs 18%; p = 0.006), and hyperuricemia (9% vs 4%; p = 0.007). The mean age at SS diagnosis was 10 years greater in patients with DM (p < 0.001) and hyperuricemia (p = 0.009). Hypercholesterolemia was associated with a lower frequency of immunological markers such as anti-Ro/SSA antibodies (p = 0.001), anti-La/SSB antibodies (p = 0.005), low C3 (p = 0.047), and low C4 levels (p = 0.030), while hypertriglyceridemia and DM were associated with a higher prevalence of extraglandular features, especially renal, liver, and vasculitic involvement. A higher prevalence of DM was found in patients treated with corticosteroids (40% vs 19%; p = 0.001). Patients with primary SS showed a higher prevalence of associated dyslipidemia, DM, and hyperuricemia in comparison with an age and sex-matched control group. Metabolic alterations were associated with a differentiated pattern of clinical and immunological SS expression, but not with SS-related therapies (except for the higher frequency of DM observed in patients treated with corticosteroids).