Bazancir-Apaydin Zilan, Apaydin Hakan, Armagan Berkan, Orhan Kevser, Erten Sukran
Department of Physiotherapy and Rehabilitation, Ankara Medipol University, Ankara, Türkiye.
Department of Rheumatology, Ankara Etlik City Hospital, Ankara, Türkiye.
Int J Rheum Dis. 2025 Jan;28(1):e70069. doi: 10.1111/1756-185X.70069.
To investigate the central sensitization (CS) in patients with autoimmune connective tissue diseases (ACTDs) and its relationship with disease activity, laboratory findings, medical treatments, organ involvements, and comorbidity.
One hundred and eleven patients with ACTDs and 40 healthy individuals were included. All patients were divided into three groups in terms of their diseases: Sjögren's syndrome (SS), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE). The CS was assessed using the central sensitization inventory (CSI-A and CSI-B scores). The disease activity, laboratory findings, medical treatments, organ involvements, and comorbidity of all patients were evaluated.
Overall, 41.4% patients with ACTDs had CS. SS group had the highest CS positivity (n = 21, 58.3%) compared to the RA (n = 14, 36.8%) and SLE (n = 11, 29.7%) groups. The SS group had a significantly higher CSI-A score (p < 0.016) than the RA and SLE group, which had similar scores. CSI-A (p = 0.008, r = -0.63) and CSI-B (p = 0.001, r = -0.76) scores were moderately to high correlated with vitamin D3 levels in SLE group. CSI-B score was moderately correlated with folic acid levels (p = 0.03, r = 0.50) and TSH (p = 0.005, r = 0.55) in SS group. The CSI-A score ≥ 40 subgroup had more female gender, frequency of COPD or asthma, more coexisting fibromyalgia, higher VAS score, more common exocrine gland involvement, and higher corticosteroid dose compared to the CSI score < 40 subgroup.
CS is commonly seen in patients with ACTDs, especially in SS. CS is associated with vitamin D3, folic acid, and TSH levels in ACTD subgroups and the patients with clinical CS have a specific profile.
探讨自身免疫性结缔组织病（ACTDs）患者的中枢致敏（CS）及其与疾病活动度、实验室检查结果、治疗、器官受累情况和合并症的关系。
纳入111例ACTDs患者和40例健康个体。所有患者根据疾病分为三组：干燥综合征（SS）、类风湿关节炎（RA）和系统性红斑狼疮（SLE）。使用中枢致敏量表（CSI-A和CSI-B评分）评估CS。评估所有患者的疾病活动度、实验室检查结果、治疗、器官受累情况和合并症。
总体而言，41.4%的ACTDs患者存在CS。与RA组（n = 14，36.8%）和SLE组（n = 11，29.7%）相比，SS组的CS阳性率最高（n = 21，58.3%）。SS组的CSI-A评分显著高于RA组和SLE组（p < 0.016），而后两组评分相似。在SLE组中，CSI-A（p = 0.008，r = -0.63）和CSI-B（p = 0.001，r = -0.76）评分与维生素D3水平呈中度至高度相关。在SS组中，CSI-B评分与叶酸水平（p = 0.03，r = 0.50）和促甲状腺激素（p = 0.005，r = 0.55）呈中度相关。与CSI评分<40的亚组相比，CSI-A评分≥40的亚组女性更多、慢性阻塞性肺疾病或哮喘的发生率更高、合并纤维肌痛更常见、视觉模拟评分（VAS）更高、外分泌腺受累更常见且皮质类固醇剂量更高。
CS在ACTDs患者中常见，尤其是在SS患者中。在ACTDs亚组中，CS与维生素D3、叶酸和促甲状腺激素水平相关，且临床存在CS的患者具有特定特征。
