Rheumatology Clinic, Kastamonu Training and Research Hospital, Kastamonu, Turkey.
Division of Rheumatology, Department of Physical Medicine and Rehabilitation, School of Medicine, Ankara University, Ankara, Turkey.
BMC Endocr Disord. 2024 Sep 27;24(1):199. doi: 10.1186/s12902-024-01740-z.
This study aimed to compare the salivary gland ultrasonography(SGUS) findings in patients with primary Sjögren's Syndrome (pSS) and diabetes mellitus(DM) patients with sicca symptoms and to examine the relationship between salivary gland ultrasonography (SGUS) findings with clinical and laboratory parameters.
In this study, 34 patients with pSS and 34 DM patients with sicca symptoms were included. In all patients, bilateral parotid, and submandibular gland ultrasonography (totally 272 glands) was performed by blinded 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.
Patients with pSS presented significantly higher SGUS scores than patients with DM (the Hocevar score; 20.93(± 9.65) vs. 3.82(± 3.71); p < 0.05, the OMERACT score; 5.96(± 2.30) vs. 2.07(± 1.65); p < 0.05, respectively). In patients with pSS, the submandibular gland scores were significantly higher than the parotid gland scores (right; p < 0.05 vs. left; p < 0.01) while DM patients showed significantly higher parotid gland scores (right; p < 0.05 vs. left; p < 0.05). In pSS patients, the SGUS scores were associated with disease duration (r = 0.57; r = 0.50; p < 0.05), symptom duration (r = 50; r = 0.47; p < 0.05), and the European League Against Rheumatism Sjögren's Syndrome Patient Reported Index (ESSPRI)-dryness score (r = 0.35, r = 0.36; p < 0.05). However, in DM patients, the SGUS scores are highly correlated with the ESSPRI-dryness (r = 0.74, r = 0.72; p < 0.05) and HbA1C level (r = 0.91, r = 0.86; p < 0.05).
This study demonstrated that major salivary gland involvement was more severe and correlated with disease duration, and submandibular gland was dominantly affected in pSS. Contrarily, in DM patients, salivary gland involvement was milder, parotid dominant and related to level of dryness and HbA1C, rather than disease duration when compared to pSS.
本研究旨在比较原发性干燥综合征（pSS）患者与伴有干燥症状的糖尿病（DM）患者的唾液腺超声（SGUS）结果，并探讨唾液腺超声（SGUS）结果与临床和实验室参数之间的关系。
本研究纳入了 34 例 pSS 患者和 34 例 DM 伴有干燥症状的患者。所有患者均由盲法风湿病学家进行双侧腮腺和颌下腺超声（共 272 个腺体）检查，采用 Hočevar 和风湿病疗效评估（OMERACT）评分系统进行评分。比较两组患者的临床和超声变量。采用相关分析比较 SGUS 评分与疾病病程的相关性。
与 DM 患者相比，pSS 患者的 SGUS 评分显著更高（Hočevar 评分：20.93(±9.65) vs. 3.82(±3.71)；p<0.05，OMERACT 评分：5.96(±2.30) vs. 2.07(±1.65)；p<0.05）。在 pSS 患者中，颌下腺评分显著高于腮腺评分（右侧；p<0.05 对比左侧；p<0.01），而 DM 患者的腮腺评分显著更高（右侧；p<0.05 对比左侧；p<0.05）。在 pSS 患者中，SGUS 评分与疾病病程（r=0.57；r=0.50；p<0.05）、症状持续时间（r=0.50；r=0.47；p<0.05）和欧洲抗风湿病联盟干燥综合征患者报告指数（ESSPRI）-干燥评分（r=0.35，r=0.36；p<0.05）相关。然而，在 DM 患者中，SGUS 评分与 ESSPRI-干燥（r=0.74，r=0.72；p<0.05）和 HbA1C 水平（r=0.91，r=0.86；p<0.05）高度相关。
本研究表明，主要唾液腺受累更严重，与疾病病程相关，且 pSS 以颌下腺为主。相反，DM 患者的唾液腺受累较轻，以腮腺为主，与干燥程度和 HbA1C 相关，而与疾病病程无关。
