Background Cigarette smoking has been found to play a pathogenic role in several autoimmune diseases. However, data about its influence on Sjögren's syndrome (SS) is scarce [1,2].
Objectives To assess the impact of cigarette smoking on patients with SS.
Methods This was a cross-sectional study in which consecutive patients with SS (2002 AECG) followed at a single center were included. Smoking status (ever) together with additional environmental factors and clinical and laboratory characteristics were assessed. Bivariate analysis and the mixed-cluster methodology based on multivariate descriptive methods were employed to analyze data.
Results Out of a total of 277 patients, 94% were women. The mean age of patients was 51.2 ± 12.5 years, and the mean duration of the disease was 7.1 ± 7.1 years. By Chisholm and Mason classification, 93% of patients were positive for a minor salivary gland biopsy. Anti-Ro and anti-La antibodies were present in 65% and 40% respectively (by ELISA). Polyautoimmunity was registered in 43% of patients. Smokers showed a longer duration of the disease and were mostly men. Cigarette smoking was associated with parotidomegaly (OR: 1.9; 95%CI 1.05–4.3; p=0.03), polyautoimmunity (OR: 1.9; 95%CI 1.2–3.3; p=0.009), acid peptic disease (OR: 2.3; 95%CI 1.4–4.0; p=0,0008), and coffee consumption (OR: 1.7; 95%CI 0.98–3.6; p=0.04). In order to clarify whether the observed associations were influenced by gender or coffee consumption, 4 clusters were built: 1) men with a high frequency of smoking and coffee consumption (5.6%), 2) women who exclusively reported coffee consumption (42%), 3) women who all drank coffee and smoked cigarettes (30%) and 4) women with no coffee consumption but a third had been exposed to tobacco (22.4%). Cluster 2 patients were statistically less prone to present factors found in the bivariate analysis suggesting that coffee consumption may counteract the harmful effects of smoking.
Conclusions Our results indicate that cigarette smoking has significant effects on SS expression, which could be modified by coffee consumption.
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Karabulut G, et al. Mod Rheumatol 2011;21(6):602–7.
Disclosure of Interest None declared