Abstract：
OBJECTIVE: To identify primary Sjögren\'s syndrome (pSS) patients with arthralgia at risk for osteoarthritis (OA) or arthritis.
METHODS: This study included 368 pSS patients admitted to a mono-centric from March 2010 to December 2020. Patients were divided into groups according to whether complicated with OA or arthritis. Data were analyzed to determine the differences in demographical characteristics, symptoms, and laboratory examination.
RESULTS: The involvement of the OA joints was predominately knee and spine sites (including cervical and lumbar spine degeneration). When diagnosing arthritis, it was mainly peripheral symmetric polyarthritis, the most affected sites were the interphalangeal and metacarpophalangeal joints. There were significant differences in age, disease duration, uric acid (UA), and total cholesterol (TC) between pSS-OA and pSS-nOA patients (P < 0.050). Logistic regression analysis showed that age (OR = 1.965; P = 0.009) and joint pain (OR = 3.382; P < 0.001) were dangerous factors associated with OA. Interestingly, although the level of UA, TC, and triglycerides (TG) was shown to be positive with OA, there was no statistical significance after the OR was computed in the four-cell table. In pSS-arthritis, EULAR Sjögren\'s syndrome disease activity index (ESSDAI) (P = 0.011), the frequency of joint pain (P < 0.001), and muscular involvement (P = 0.037) were higher than non-arthritis group. In pSS patients only presenting with joint pain, arthritis patients had higher ESSDAI and system involvements, but lower UA and TG levels compared with OA group (P < 0.050).
CONCLUSIONS: In pSS patients with arthralgia, OA accounted for the majority. pSS patients with advanced age and more pronounced metabolic characteristics, such as elevated blood lipids and uric acid, was a key factor in groups at risk for OA. However, arthritis patients had higher rates of dry mouth and eye, higher disease activity, antibodies positive, and more organs damage. In the future, it may be necessary to be more cautious in the diagnosis of joint manifestations in pSS patients in order to make the appropriate treatments.
METHODS: This study included 368 pSS patients admitted to a mono-centric from March 2010 to December 2020. Patients were divided into groups according to whether complicated with OA or arthritis. Data were analyzed to determine the differences in demographical characteristics, symptoms, and laboratory examination.
RESULTS: The involvement of the OA joints was predominately knee and spine sites (including cervical and lumbar spine degeneration). When diagnosing arthritis, it was mainly peripheral symmetric polyarthritis, the most affected sites were the interphalangeal and metacarpophalangeal joints. There were significant differences in age, disease duration, uric acid (UA), and total cholesterol (TC) between pSS-OA and pSS-nOA patients (P < 0.050). Logistic regression analysis showed that age (OR = 1.965; P = 0.009) and joint pain (OR = 3.382; P < 0.001) were dangerous factors associated with OA. Interestingly, although the level of UA, TC, and triglycerides (TG) was shown to be positive with OA, there was no statistical significance after the OR was computed in the four-cell table. In pSS-arthritis, EULAR Sjögren\'s syndrome disease activity index (ESSDAI) (P = 0.011), the frequency of joint pain (P < 0.001), and muscular involvement (P = 0.037) were higher than non-arthritis group. In pSS patients only presenting with joint pain, arthritis patients had higher ESSDAI and system involvements, but lower UA and TG levels compared with OA group (P < 0.050).
CONCLUSIONS: In pSS patients with arthralgia, OA accounted for the majority. pSS patients with advanced age and more pronounced metabolic characteristics, such as elevated blood lipids and uric acid, was a key factor in groups at risk for OA. However, arthritis patients had higher rates of dry mouth and eye, higher disease activity, antibodies positive, and more organs damage. In the future, it may be necessary to be more cautious in the diagnosis of joint manifestations in pSS patients in order to make the appropriate treatments.
摘要：
目的：确定患有关节痛的原发性干燥综合征（pSS）患者有患骨关节炎（OA）或关节炎的风险。
方法：本研究包括2010年3月至2020年12月接受单中心治疗的368例pSS患者。根据是否并发OA或关节炎将患者分为两组。对数据进行了分析，以确定人口统计学特征的差异，症状,和实验室检查。
结果：OA关节受累主要是膝关节和脊柱部位（包括颈椎和腰椎退变）。诊断关节炎时，主要是外周对称性多关节炎,受影响最大的部位是指间关节和掌指关节。年龄差异显著,疾病持续时间,尿酸（UA），pSS-OA和pSS-nOA患者的总胆固醇（TC）（P<0.050）。Logistic回归分析显示,年龄(OR=1.965;P=0.009)和关节痛(OR=3.382;P<0.001)是OA发病的危险因素。有趣的是,虽然UA的水平，TC,甘油三酯（TG）显示为OA阳性，在四细胞表中计算OR后,无统计学意义.在pSS-关节炎中，EULARSjögren综合征疾病活动指数（ESSDAI）（P=0.011），关节疼痛的频率（P<0.001），和肌肉受累（P=0.037）高于非关节炎组。在仅出现关节痛的pSS患者中，关节炎患者有较高的ESSDAI和系统受累，但UA和TG水平低于OA组(P<0.050)。
结论：在有关节痛的pSS患者中，OA占大多数。具有高龄和更明显的代谢特征的pSS患者，如血脂和尿酸升高，是OA风险人群的关键因素。然而,关节炎患者口干眼的发生率较高，更高的疾病活动，抗体阳性,更多的器官损伤。在未来,在诊断pSS患者的关节表现时，可能需要更加谨慎，以便做出适当的治疗。
方法：本研究包括2010年3月至2020年12月接受单中心治疗的368例pSS患者。根据是否并发OA或关节炎将患者分为两组。对数据进行了分析，以确定人口统计学特征的差异，症状,和实验室检查。
结果：OA关节受累主要是膝关节和脊柱部位（包括颈椎和腰椎退变）。诊断关节炎时，主要是外周对称性多关节炎,受影响最大的部位是指间关节和掌指关节。年龄差异显著,疾病持续时间,尿酸（UA），pSS-OA和pSS-nOA患者的总胆固醇（TC）（P<0.050）。Logistic回归分析显示,年龄(OR=1.965;P=0.009)和关节痛(OR=3.382;P<0.001)是OA发病的危险因素。有趣的是,虽然UA的水平，TC,甘油三酯（TG）显示为OA阳性，在四细胞表中计算OR后,无统计学意义.在pSS-关节炎中，EULARSjögren综合征疾病活动指数（ESSDAI）（P=0.011），关节疼痛的频率（P<0.001），和肌肉受累（P=0.037）高于非关节炎组。在仅出现关节痛的pSS患者中，关节炎患者有较高的ESSDAI和系统受累，但UA和TG水平低于OA组(P<0.050)。
结论：在有关节痛的pSS患者中，OA占大多数。具有高龄和更明显的代谢特征的pSS患者，如血脂和尿酸升高，是OA风险人群的关键因素。然而,关节炎患者口干眼的发生率较高，更高的疾病活动，抗体阳性,更多的器官损伤。在未来,在诊断pSS患者的关节表现时，可能需要更加谨慎，以便做出适当的治疗。
