@article{3348266,
    title = "Liver Fibrosis in Primary Sjögren’s Syndrome",
    author = "Androutsakos, T. and Voulgaris, T.A. and Bakasis, A.-D. and Koutsompina, M.-L. and Chatzis, L. and Argyropoulou, O.D. and Pezoulas, V. and Fotiadis, D.I. and Papatheodoridis, G. and Tzioufas, A.G. and Goules, A.V.",
    journal = "Frontiers in Immunology",
    year = "2022",
    volume = "13",
    publisher = "Frontiers Media S.A",
    doi = "10.3389/fimmu.2022.889021",
    keywords = "alanine aminotransferase;  alkaline phosphatase;  aspartate aminotransferase;  hydroxychloroquine;  methotrexate;  prednisone, adult;  antidiabetic activity;  Article;  body mass;  chronic liver disease;  cohort analysis;  comparative study;  controlled study;  diabetes mellitus;  disease duration;  disease status;  echography;  elastography;  fatty liver;  female;  histology;  human;  hyperlipidemia;  hypertransaminasemia;  immunological monitoring;  liver fibrosis;  liver stiffness;  lymphadenopathy;  lymphoma;  major clinical study;  male;  middle aged;  non insulin dependent diabetes mellitus;  nonalcoholic fatty liver;  outpatient department;  pathophysiology;  prevalence;  Rheumatism Sjogrens Syndrome Disease Activity Index;  risk factor;  Sjoegren syndrome;  transient elastography;  adverse event;  complication;  elastography;  liver cirrhosis;  non insulin dependent diabetes mellitus;  Sjoegren syndrome, Diabetes Mellitus, Type 2;  Elasticity Imaging Techniques;  Humans;  Liver Cirrhosis;  Middle Aged;  Non-alcoholic Fatty Liver Disease;  Sjogren's Syndrome",
    abstract = "Background: Primary Sjögren syndrome (pSS) is a systemic autoimmune epithelitis, potentially affecting salivary epithelium, biliary epithelium, and hepatocytes. Common immunological mechanisms might cause clinically silent liver inflammation, and combined with non-alcoholic fatty liver disease (NAFLD), liver fibrosis (LF) may occur. No studies have explored the occurrence of LF in the context of NAFLD among pSS patients. Methods: Consecutive pSS patients from the rheumatology outpatient clinic of the Department of Pathophysiology and individuals evaluated in the hepatology outpatient clinic for possible NAFLD serving as comparators underwent transient elastography (TE) to assess LF and liver steatosis (LS). All participants had no overt chronic liver disease. Clinical, demographic, and laboratory data were collected from all participants at the time of TE. Results: Fifty-two pSS patients and 198 comparators were included in the study. The median age (range) of pSS and comparators was 62.5 (30–81) and 55 (19–86) years, respectively. Both groups had similar prevalence regarding type 2 diabetes mellitus, hyperlipidemia, and similar body mass index (BMI). Patients with pSS had less frequently high LS (S2, S3) (27% vs. 62%, p < 0.001) and significant LF (F2–4) [2 (3.8%) vs. 34 (17.2%), p = 0.014] than comparators. Univariable analysis showed that advanced LF was significantly associated with older age, higher LS, greater BMI, and disease status (comparators than pSS); of these, only age was identified as an independent LF risk factor in the multivariable logistic regression analysis. Conclusion: Liver fibrosis among pSS patients is most likely not attributed to the disease per se. Copyright © 2022 Androutsakos, Voulgaris, Bakasis, Koutsompina, Chatzis, Argyropoulou, Pezoulas, Fotiadis, Papatheodoridis, Tzioufas and Goules."
}