COMPARATIONS OF SALIVARY GLAND ULTRASONOGRAPHY FINDINGS IN PRIMARY SJOGREN'S SYNDROME VS TYPE 2 DIABETES MELLITUS

Background Primary Sjogren syndrome (pSS) is a chronic autoimmune disease that mainly affects the exocrine glands [1]. Type 2 diabetes mellitus (DM) is also autoimmune disease involving not only the pancreas but also salivary glands. In both diseases, sicca symptoms due to different mechanisms were common [1, 2]. The use of salivary gland ultrasonography (SGUS) has become widespread in the diagnosis and follow-up of pSS [3, 4]. In DM, fewer US-based studies have shown abnormalities in the major salivary glands [2]. Objectives This study aimed to compare the SGUS findings in patients with pSS and DM patients with sicca symptoms and to examine the relationship between these findings with clinical and laboratory parameters. Methods In this study, 32 patients with pSS and 28 DM patients with sicca symptoms (not meet ACR/EULAR pSS criteria) were included. Demographic data and patient characteristics were obtained from medical records. Physical examination was assessed by a rheumatologist. In all patients, bilateral parotid and submandibular gland US was performed by a blind another rheumatologist, using the Hocevar and the Outcome Measures in Rheumatology (OMERACT) scoring system. Clinic and ultrasonographic variables were compared between groups. The association between SGUS score and disease duration was analyzed by correlation analysis. Results Patients with pSS presented higher SGUS scores than patients with DM significantly (the Hocevar total score; 20.93(±9.65) vs 3.82(±3.71); p<0.05, the OMERACT total score; 5.96(±2.30) vs 2.07(±1.65); p<0.05, respectively). In patients with pSS, the submandibular gland scores higher than the parotid gland scores while in patients with DM showed higher parotid gland scores. Other demographic data is shown in Table 1. In pSS patients, the Hocevar and the OMERACT total SGUS scores were significantly correlated with disease duration (r=0.584, p<0.01 vs r=0.518, p<0.01, respectively). This correlation was not found in patients with DM (Figure 1). Table 1. Demograpfic data and salivary gland ultrasonography scores in pSS and diabetic patients pSS patients(n=32) DM patients with sicca(n=28) Age, mean(±SD) 53.90(±9,70) 52.25(±7.65) Disease duration, mean(±SD) 7.68(±4.01) 8.46(±6.31) First symptom, n(%) Sicca 5(15.62%) 4(14.28%) Non-sicca 23(71.87%) 20(71.42%) Parotitis, n(%) 7(21.87%) 2(7.14%) a Anti-Ro positivity, n(%) 22(68.75%) 0(0.0%) a Unstimulated saliva flow rate ≤0.1 ml/m, n(%) 28(87.5%) 13(46.42%) a Schirmer’s test≤5 mm/5 m in at least one eye, n(%) 30(93.75%) 8(28.57%) a The Hocevar total SGUS score, mean(±SD) 20.93(±9.65) 3.82(±3.71) a right parotid 4.62(±2.73) 1.25(±1.17) a left parotid 4.34(±2.57) 1.25(±1.08) a right submandibular 6.06(±3.07) 0.67(±0.41) a left submandibular 6.31(±2.95) 0.64(±0.43) a The OMERACT total SGUS score,(mean(±SD) 5.96(±2.30) 2.07(±1.65) a right parotid 1,28(±0.77) 0,71(±0.59) a left parotid 1,21(±0.65) 0,78(±0.62) a right submandibular 1,68(±0.82) 0,44(±0.25) a left submandibular 1,78(±0.83) 0,47(±0.32) a a p<0.05 Figure 1. Correlation between SGUS scores and disease duratin in two groups Conclusion This study demonstrated that the major salivary gland involvement was more severe, submandibular gland dominant and correlated with disease duration in pSS. Contrarily, in patients with DM, it was mild compared to pSS, parotid dominant and uncorrelated with disease duration. References [1]Mariette, X. and L.A. Criswell, Primary Sjögren’s syndrome. New England Journal of Medicine, 2018. [2]Gupta, A., et al., A Cross-Sectional Study on Ultrasonographic Measurements of Parotid Glands in Type 2 Diabetes Mellitus. Int J Dent, 2021. [3]Finzel, S., et al., Patient-based reliability of the Outcome Measures in Rheumatology (OMERACT) ultrasound scoring system for salivary gland assessment in patients with Sjögren’s syndrome. Rheumatology (Oxford), 2021. [4]Hocevar, A., et al., Ultrasonographic changes of major salivary glands in primary Sjogren’s syndrome. Diagnostic value of a novel scoring system. Rheumatology (Oxford), 2005. Disclosure of Interests None declared