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Patients with Sjögren’s syndrome likely to have higher CVD risk, lower BMD
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Patients with primary Sjögren’s syndrome were as likely to have comorbidities such as subclinical atherosclerosis and lower bone mineral density as patients with rheumatoid arthritis and more likely to be at risk than healthy individuals, according to recently published study data.
Researchers studied 64 consecutive patients with primary Sjögren’s syndrome (SS), 77 patients with rheumatoid arthritis (RA) and 60 healthy individuals at the General Hospital of Athens, Greece. Participants were examined and demographic data, clinical features, treatment methods and risk factors for atherosclerosis and osteoporosis were gathered. Patients with SS were assessed for symptoms including presence of oral and ocular dryness, dry cough, arthritis, Raynaud’s phenomenon, pulmonary involvement pleuritic, pericarditis, renal or hepatic involvement and other potential manifestations of the disease, and the Sjögren’s syndrome Disease Activity Index was calculated. Demographics between the three groups were similar.
Risk factors for atherosclerosis and osteoporosis included family history of coronary disease or low energy fractures and past medical history including cardiac risk factors, smoking history, alcohol consumption, malabsorption, thyroid function and other factors. Laboratory tests included full blood counts, erythrocyte sedimentation rate (ESR), C-reactive protein levels, lipid profiles, homocysteine, parathyroid, vitamin D and fibrinogen levels and markers of liver, kidney and thyroid function were measured. Calcium and phosphorus were measured in both serum and urine. The extractable nuclear antibody panel of blood tests was conducted, along with complement levels. Hypergammaglobulinemia and cryoglobulins were measured, and the anti-cyclic citrullinated peptide antibody was measured in patients with RA. Additionally, the presence of plaque or arterial wall thickening of carotid and femoral walls was assessed with ultrasound measurements of intima-media thickness (IMT).
Compared with healthy individuals, patients with SS had lower cholesterol levels and were less likely to have family history of CVD. Patients with SS also had shorter disease duration, lower triglycerides, higher vitamin D levels, lower incidence of diabetes and a lower intake of daily steroids than patients with RA, according to the researchers.
Higher IMT scores and rates of arterial wall-thickening were seen in both patients with SS and RA compared with healthy participants. Increased prevalence of arterial wall-thickening in patients with SS was 59.4% compared with 40.4% in healthy participants. Age was the only predictor of arterial wall thickening or plaque in patients with SS, the researchers reported.
Higher rates of osteoporosis or osteopenia were seen in patients with SS who also exhibited urinary pH of 5.5 or higher. The presence of osteoporosis or osteopenia was associated with plaque found on ultrasound. Approximately 80% of patients with plaque had impaired bone health compared with 20% of patients without plaque in adjusted and unadjusted models, according to the researchers. - by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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