High prevalence of serum metabolic alterations in primary Sjögren's syndrome: influence on clinical and immunological expression.
OBJECTIVE
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).


METHODS
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.


RESULTS
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).


CONCLUSIONS
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).
Ramos-Casals
Manuel
M
Department of Autoimmune Diseases and the Lipid Unit, School of Medicine, University of Barcelona, Institut d'Investigacions BiomEdiques August Pi i Sunyer, Hospital Clínic, Spain. mramos@clinic.ub.es
Brito-Zerón
Pilar
P
Sisó
Antoni
A
Vargas
Alfonso
A
Ros
Emili
E
Bove
Albert
A
Belenguer
Rafael
R
Plaza
Joan
J
Benavent
Jaume
J
Font
Josep
J
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood; D016022:Case-Control Studies; D048909:Diabetes Complications / Q000209:etiology / Q000276:immunology*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000276:immunology*; D015228:Hypertriglyceridemia / Q000276:immunology*; D033461:Hyperuricemia / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012859:Sjogren's Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000276:immunology
D000305:Adrenal Cortex Hormones; D000974:Antibodies, Antinuclear