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 (T 2 DM). There is no clinical study focusing on the differences of subclinical atherosclerosis between primary Sjögren’s syndrome (pSS) and T 2 DM. Our aim is to investigate the prevalence of subclinical atherosclerosis in pSS patients, compare the differences in subclinical atherosclerosis between pSS and T 2 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 T 2 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 T 2 DM compared to controls. The percentages of carotid IMT were detected in 91.7% of pSS and 93.8% of T 2 DM patients versus 81.3% in the controls. Carotid plaques were detected in 82.3%, 82.3% and 66.7% of pSS, T 2 DM, and controls, respectively. Age and the presence of pSS and T 2 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 T 2 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 T 2 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.