Shi Zhenghao, Chen Jiaxu, Xue Luan
Department of Rheumatology and Immunology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, People's Republic of China.
Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
Int J Gen Med. 2025 Sep 4;18:5137-5153. doi: 10.2147/IJGM.S543209. eCollection 2025.
Sjögren's syndrome (SS) is a systemic autoimmune disorder predominantly affecting middle-aged and elderly women, characterized by lymphocytic infiltration of exocrine glands-particularly the salivary and lacrimal glands-resulting in xerophthalmia and xerostomia. Osteoporosis (OP), sharing similar age of onset and gender predilection, is a skeletal disorder defined by reduced bone mineral density and heightened fracture risk. The comorbidity of SS and OP represents a prevalent clinical phenomenon, with studies reporting an incidence rate of 33.1% to 51.6% among SS patients, significantly higher than that observed in healthy elderly populations. Vitamin D metabolism, widespread abnormal immune responses, hormonal imbalances, metabolic acidosis, and the RANKL/RANK/OPG axis exert significant contributory roles in the pathogenesis of both conditions. Treatment regimens for SS and OP may present certain overlaps yet potential contradictions. In this narrative review, we summarize the bidirectional relationship between these two diseases, thoroughly discuss the existing challenges in their management, and emphasize that recommending a comprehensive management strategy for SS patients with concurrent OP is crucial for enhancing patients' quality of life.
干燥综合征（SS）是一种主要影响中老年女性的全身性自身免疫性疾病，其特征是外分泌腺——尤其是唾液腺和泪腺——出现淋巴细胞浸润，导致干眼症和口干症。骨质疏松症（OP）与SS发病年龄和性别偏好相似，是一种以骨矿物质密度降低和骨折风险增加为特征的骨骼疾病。SS和OP的合并症是一种常见的临床现象，研究报告显示SS患者中的发病率为33.1%至51.6%，显著高于健康老年人群。维生素D代谢、广泛的异常免疫反应、激素失衡、代谢性酸中毒以及RANKL/RANK/OPG轴在这两种疾病的发病机制中都发挥着重要作用。SS和OP的治疗方案可能存在一定重叠但也有潜在矛盾。在这篇叙述性综述中，我们总结了这两种疾病之间的双向关系，深入讨论了它们管理中存在的挑战，并强调为并发OP的SS患者推荐全面的管理策略对于提高患者生活质量至关重要。
