Subclinical atherosclerosis in primary Sjögren's syndrome: comparable risk with diabetes mellitus.

OBJECTIVES: It has been found that the risk of subclinical atherosclerosis in some connective tissue diseases (CTDs) was equivalent to type 2 diabetes mellitus (T2 DM). There is no clinical study focusing on the differences of subclinical atherosclerosis between primary Sjögren's syndrome (pSS) and T2 DM. Our aim is to investigate the prevalence of subclinical atherosclerosis in pSS patients, compare the differences in subclinical atherosclerosis between pSS and T2 DM patients, and determine the risk factors of subclinical atherosclerosis.

METHOD: A retrospective case-control study of 96 patients with pSS, 96 age- and sex-matched T2 DM patients and healthy individuals underwent evaluation, including clinical data and carotid ultrasound examination. Univariate and multivariate models were used to explore the related factors of carotid intima-media thickness (IMT) and carotid plaque.

RESULTS: Increased IMT scores were detected in patients with pSS and T2 DM compared to controls. The percentages of carotid IMT were detected in 91.7% of pSS and 93.8% of T2 DM patients versus 81.3% in the controls. Carotid plaques were detected in 82.3%, 82.3% and 66.7% of pSS, T2 DM, and controls, respectively. Age and the presence of pSS and T2 DM emerged as risk factors for IMT (adjusted OR = 1.25, 4.40, and 9.92, respectively). In addition, age, total cholesterol, and the presence of pSS and T2 DM emerged as risk factors for carotid plaque (adjusted OR = 1.14, 1.50, 4.18, and 3.79, respectively).

CONCLUSIONS: The prevalence of subclinical atherosclerosis in pSS patients was increased, which was comparable to that in T2 DM patients. The presence of pSS is associated with subclinical atherosclerosis. Key Points • The prevalence of subclinical atherosclerosis is higher in primary Sjögren' s syndrome. • The risk of subclinical atherosclerosis is similar in primary Sjögren's syndrome and diabetes mellitus patients. • Advanced age was an independent predictor of carotid IMT and plaque formation in primary Sjögren's syndrome. • Primary Sjögren's syndrome and diabetes mellitus are associated with atherosclerosis.