Prevalence, severity, and predictors of dry eye and dry mouth in Chinese patients with primary Sjögren syndrome

Clin Rheumatol. 2018 Nov;37(11):2971-2979. doi: 10.1007/s10067-018-4233-9. Epub 2018 Aug 9.

Abstract

Dry eye and dry mouth are typical clinical symptoms of primary Sjögren's syndrome (pSS), yet not considered in the assessment of severity and predictors in China. This study aimed to investigate the prevalence, severity, and potential predictors of dry eye/dry mouth among Chinese pSS patients. A cross-sectional study was conducted from the Affiliated Hospital of Nantong University. A series of questionnaires were applied: Ocular Surface Disease Index (OSDI), EULAR Sjogren's Syndrome Patient Reported Index (ESSPRI)-dry mouth items, fatigue severity scale (FSS), the 10 cm visual analog scale (VAS). Laboratory examinations were taken to obtain some biochemical indicators (i.e., C-reactive protein, erythrocyte sedimentation rate, anti-SSA/SSB antibody). Stepwise logistic/linear regression model was used to investigate the potential predictors of dry eye/dry mouth, respectively. Statistical analysis was performed using SPSS version 20.0. Two hundred twenty-four pSS patients were included in this study. Among them, 215 (95.98%) patients reported ESSPRI-dry mouth items score > 0, and the mean score was 4.92 ± 2.43. In addition, according to the score of OSDI, 84 (37.5%) subjects reported non-dry eye, whereas 140 (62.5%) subjects reported dry eye (44 mild, 31 moderate, 65 severe), and the mean of the total OSDI score was 25.01 ± 23.58. Then, using logistic regression and linear regression respectively, we found that age and fatigue were the potential predictors of dry eye, whereas dry mouth was predicted by age, fatigue, total pain, and ESR. The results of this study suggested that rheumatologists should pay attention to pSS patients' dry eye and dry mouth, especially those with older age, higher level of ESR, more severe fatigue, and pain.

Keywords: China; Dry eye; Dry mouth; Predictors; Primary Sjögren syndrome.

MeSH terms

  • Adult
  • China / epidemiology
  • Cross-Sectional Studies
  • Dry Eye Syndromes / epidemiology*
  • Dry Eye Syndromes / etiology
  • Fatigue / etiology
  • Female
  • Humans
  • Linear Models
  • Logistic Models
  • Male
  • Middle Aged
  • Prevalence
  • Severity of Illness Index
  • Sjogren's Syndrome / complications*
  • Sjogren's Syndrome / physiopathology*
  • Surveys and Questionnaires
  • Xerostomia / epidemiology*
  • Xerostomia / etiology