Yuying Zhang1, Mengtao Li1, Liyun Zhang2, Qin Li3, Pinting Yang4, Xiaodan Kong5, Xinwang Duan6, Miaojia Zhang7, Xiaomei Li8, Yongfu Wang9, Jian Xu10, Yanhong Wang11, Evelyn Hsieh12, Jiuliang Zhao1, Dong Xu13, Yan Zhao14, Xiaofeng Zeng1. 1. Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Immunologic Diseases, Ministry of Science & Technology, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No. 1 Shuaifuyuan, Beijing, 100730, China. 2. Department of Rheumatology, Shanxi Bethune Hospital, Taiyuan, China. 3. Department of Rheumatology, The First People's Hospital of Yunnan Province, Kunming, China. 4. Department of Rheumatology and Immunology, The First Affiliated Hospital, China Medical University, Shenyang, China. 5. Department of Rheumatology and Immunology, The Second Hospital of Dalian Medical University, Dalian, China. 6. Department of Rheumatology, The Second Affiliated Hospital of Nanchang University, Nanchang, China. 7. Department of Rheumatology, Jiangsu Provincial People's Hospital, Nanjing, China. 8. Department of Rheumatology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Hefei, China. 9. Department of Rheumatology, The First Affiliated Hospital of Baotou Medical College, Baotou, China. 10. Department of Rheumatology, The First Affiliated Hospital of Kunming Medical University, Kunming, China. 11. Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China. 12. Section of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA. 13. Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Immunologic Diseases, Ministry of Science & Technology, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No. 1 Shuaifuyuan, Beijing, 100730, China. xudong74@hotmail.com. 14. Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Immunologic Diseases, Ministry of Science & Technology, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No. 1 Shuaifuyuan, Beijing, 100730, China. zhaoyan_pumch2002@aliyun.com.
Abstract
INTRODUCTION: Primary Sjögren's syndrome (pSS) has been related to a higher risk of comorbidities, but studies examining comorbidities among patients with and without extraglandular manifestations are limited. The objectives of this study were to assess the prevalence of comorbidities in Chinese pSS patients and to determine the relationship between comorbidities and extraglandular manifestations. METHOD: This cross-sectional study was based on the multicenter pSS registry established by the Chinese Rheumatism Data Center. Patients fulfilling the 2002 American-European criteria or the 2016 classification criteria for pSS were enrolled from May 2016 to December 2018. Demographic data, disease characteristics, comorbidities (cardiovascular disease, thyroid disorder, malignancy, and fragility fracture), and extraglandular manifestations were collected. Multivariate analyses were used to assess the relationships between comorbidities and extraglandular manifestations. RESULTS: A total of 4087 pSS patients were included (95.7% female and mean age of 51.2 ± 13.1 years). The baseline prevalence of comorbidities was 3.8% for cardiovascular diseases, 12.1% for thyroid disorders, 1.8% for malignancies, and 1.7% for fragility fractures. The presence of extraglandular manifestations was associated with more comorbidities. Patients with more than one extraglandular manifestation had a higher prevalence of cardiovascular disease (adjusted odds ratio [aOR] 2.004, 95% confidence interval [CI] 1.221-3.288), thyroid disorder (aOR 1.380, 95% CI 1.022-1.863), and fragility fracture (aOR 2.684, 95% CI 1.505-4.786) after adjustment for age, sex, disease duration, and the significant variables in the univariate analysis. CONCLUSIONS: The presence of extraglandular manifestations in pSS was associated with an increased comorbidity burden, especially cardiovascular disease, thyroid disorder, and fragility fracture. Key Points • This is the first study assessing the association between extraglandular manifestations and comorbidity burden based on the largest pSS registry in China. • Patients with multiple extraglandular manifestations tend to have increased comorbid cardiovascular disease, thyroid disorder, and fragility fracture.
INTRODUCTION: Primary Sjögren's syndrome (pSS) has been related to a higher risk of comorbidities, but studies examining comorbidities among patients with and without extraglandular manifestations are limited. The objectives of this study were to assess the prevalence of comorbidities in Chinese pSSpatients and to determine the relationship between comorbidities and extraglandular manifestations. METHOD: This cross-sectional study was based on the multicenter pSS registry established by the Chinese Rheumatism Data Center. Patients fulfilling the 2002 American-European criteria or the 2016 classification criteria for pSS were enrolled from May 2016 to December 2018. Demographic data, disease characteristics, comorbidities (cardiovascular disease, thyroid disorder, malignancy, and fragility fracture), and extraglandular manifestations were collected. Multivariate analyses were used to assess the relationships between comorbidities and extraglandular manifestations. RESULTS: A total of 4087 pSSpatients were included (95.7% female and mean age of 51.2 ± 13.1 years). The baseline prevalence of comorbidities was 3.8% for cardiovascular diseases, 12.1% for thyroid disorders, 1.8% for malignancies, and 1.7% for fragility fractures. The presence of extraglandular manifestations was associated with more comorbidities. Patients with more than one extraglandular manifestation had a higher prevalence of cardiovascular disease (adjusted odds ratio [aOR] 2.004, 95% confidence interval [CI] 1.221-3.288), thyroid disorder (aOR 1.380, 95% CI 1.022-1.863), and fragility fracture (aOR 2.684, 95% CI 1.505-4.786) after adjustment for age, sex, disease duration, and the significant variables in the univariate analysis. CONCLUSIONS: The presence of extraglandular manifestations in pSS was associated with an increased comorbidity burden, especially cardiovascular disease, thyroid disorder, and fragility fracture. Key Points • This is the first study assessing the association between extraglandular manifestations and comorbidity burden based on the largest pSS registry in China. • Patients with multiple extraglandular manifestations tend to have increased comorbid cardiovascular disease, thyroid disorder, and fragility fracture.
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