Clinical Rheumatology

, Volume 38, Issue 2, pp 447–455 | Cite as

Association between primary Sjogren’s syndrome, arterial stiffness, and subclinical atherosclerosis: a systematic review and meta-analysis

  • Wai Chung YongEmail author
  • Anawin Sanguankeo
  • Sikarin Upala
Original Article


In rheumatoid arthritis and systemic lupus erythematosus, cardiovascular disease is frequently one of the leading causes of mortality or morbidity. Studies have shown that acute systemic inflammation and chronic systemic vasculitis are associated with endothelial dysfunction and atherosclerotic plaque formation, subsequently leading to cardiovascular disease. This meta-analysis aimed to explore the association of subclinical atherosclerosis and arterial stiffness in primary Sjogren’s syndrome. A comprehensive search of the MEDLINE and Embase databases was performed from date of inception through August 2017. The inclusion criterion was observational studies evaluating the association between primary Sjogren’s syndrome, subclinical atherosclerosis, and arterial stiffness by measuring pulse wave velocity (PWV) and intima–media thickness (IMT). Definitions of PSS and methods to assess PWV and IMT were recorded for each study. Different locations of IMT were evaluated including common carotid, internal carotid, and femoral arteries. The pooled mean difference (MD) of PWV and IMT and 95% confidence interval (CI) were calculated using a random-effect meta-analysis. The between-study heterogeneity of effect size was quantified using the Q statistic and I2. Data were extracted from eight observational studies involving 767 subjects. Pooled result demonstrated a significant increase in PWV in patients who have PSS compared with controls (MD = 1.30 m/s; 95% CI 0.48–2.12; p value = 0.002; I2 = 85%). Patients with PSS also have higher IMT (MD = 0.08 mm; 95% CI 0.04–0.11; p value < 0.01; I2 = 72%). Our study suggests that PSS is associated with arterial stiffness and subclinical atherosclerosis. Further studies need to be conducted to find the correlation of subclinical atherosclerosis in PSS with the cardiovascular event, the pathophysiological changes of arterial stiffness in PSS, and the benefit of statins, because controlling cardiovascular risk factors or disease activity could potentially help avoid progression of atherosclerosis to overt cardiovascular disease.


Arterial stiffness Atherosclerosis Cardiovascular disease Sjogren’s syndrome 


Compliance with ethical standards



Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

10067_2018_4265_MOESM1_ESM.docx (12 kb)
ESM 1 (DOCX 11 kb)


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Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  1. 1.Department of Internal Medicine, Greenfield Family MedicineBaystate Franklin Medical CenterGreenfieldUSA
  2. 2.Division of NephrologyJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Department of Preventive and Social Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
  4. 4.Section of Endocrinology, Diabetes, and Metabolism, Department of MedicineUniversity of ChicagoChicagoUSA

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