Abstract
ObjectiveTo address the association between a history of tuberculosis (TB) or nontuberculous mycobacterial (NTM) infection and the risk of newly diagnosed Sjögren’s syndrome (SS).MethodsUsing a nationwide, population-based, claims dataset, and after excluding those who had rheumatoid arthritis or systemic lupus erythematosus, we identified 5,751 newly diagnosed SS cases during 2007–2012, and compared them to 86,265 non-SS controls matched (1:15) for age, sex, and the year of first SS diagnosis date. The association between the risk of incident SS and a history of mycobacterial infection, including TB and NTM, was quantified by calculating odds ratios (ORs) with 95% confidence intervals (CIs) using conditional logistic regression analysis after adjustment for Charlson comorbidity index (CCI) and bronchiectasis.ResultsThe mean age was 55±14 years, and the proportion of female gender was 87.8% in both newly diagnosed SS cases andnon-SS controls. An association was observed between NTM infection (OR, 11.24; 95% CI, 2.37–53.24) and incident SS, but not between TB infection and incident SS (OR, 1.29; 95% CI, 0.97–1.71) after adjustment for CCI and bronchiectasis. The association between NTM and SS risk was remarkably strong among those aged between 45 and 65 years (OR, 39.24; 95% CI, 3.97–387.75) and those without bronchiectasis (OR, 39.98; 95% CI, 3.83–376.92).ConclusionThe study reveals a significant association of newly diagnosed SS with a history NTM infection, especially among individuals aged 40–65 years or those without bronchiectasis.
Highlights
Sjogren’s syndrome (SS) is estimated to affect approximately 1% of the general population and characterized to occur predominantlyin middle-aged women, with a female-to-male ratio of approximately 9:1 [1]
An association was observed between nontuberculous mycobacterial (NTM) infection (OR, 11.24; 95% confidence intervals (CI), 2.37–53.24) and incident SS, but not between TB infection and incident SS (OR, 1.29; 95% CI, 0.97–1.71) after adjustment for Charlson comorbidity index (CCI) and bronchiectasis
The study reveals a significant association of newly diagnosed SS with a history NTM infection, especially among individuals aged 40–65 years or those without bronchiectasis
Summary
Sjogren’s syndrome (SS) is estimated to affect approximately 1% of the general population and characterized to occur predominantlyin middle-aged women, with a female-to-male ratio of approximately 9:1 [1]. Mycobacterial infections,including tuberculosis (TB) and nontuberculous mycobacterial (NTM) infection, are characterized by a subacute clinical course with a dysregulated granulomatous inflammation [5] and have been implicated in the development of autoimmunity [6, 7]. Both SS and NTM infection predominantly affect middle-aged women, indicating potential shared mechanisms in these two diseases [8,9,10]. The aim of this study is to investigate the association between mycobacterial infection and the risk of newly diagnosed SS using a population-based, longitudinal dataset
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