Evaluation of Xerostomia in Sjögren’s Syndrome and Its Impact on Quality of Life and Nutritional Status: A Cross-Sectional Study

Abstract

Background and aims: Patients with primary Sjögren’s Syndrome (PSS) suffer from xerostomia, or dry mouth, which has been associated with oral/teeth disease and can compromise food intake, nutritional status, and quality of life (QoL). Materials and methods: Cross-sectional study by mail of questionnaires with European League Against Rheumatism (EULAR) Sjögren’s Syndrome Patient Reported Index (ESSPRI), Xerostomia Quality of Life Scale (XeQoLS), Primary Sjögren’s Syndrome Quality of Life (PSS-QoL), food restrictions, and nutritional status questions, to the authors’ patients with PSS, sicca, and systemic lupus erythematosus (SLE). Results: A total of 46 patients responded: 19 patients with PSS, 13 with Sicca, and 14 with SLE. Patients with sicca were older. Patients with PSS and sicca had a higher ESSPRI dryness score. XeQoLs was higher in patients with PSS and sicca, but was similar in PSS-QoL. There was non-significant food restriction, higher in patients with PSS for sugary foods (58.0% versus 47.0% versus 36.0%; p=0.4), sticky foods (58.0% versus 54.0% versus 29.0%; p=0.2), meat/fish (26.0% versus 15.0% versus 0.0%; p=0.1), acidic beverages (63.0% versus 62.0% versus 29.0%; p=0.1) and dairy (47.0% versus 23.0% versus 29.0%; p=0.3). Average weight and BMI were similar, with higher prevalence in patients with sicca and SLE who are underweight (0.0% versus 7.7% versus 7.7%; p=0.5), and lower prevalence in patients with sicca and obesity (33.0% versus 7.7% versus 36.0%; p=0.1). Malnutrition Universal Screening Tool (MUST) score showed non-significant higher at-risk status for patients with PSS (42.0% versus 23.0% versus 21.0%; p=0.6). Conclusion: Patients with PSS had lower xerostomia-related QoL, but similar overall QoL between groups. Reduction in food intake was higher in patients with PSS, and may be related to symptom management, but might lead to nutritional mistakes. A greater proportion of patients with PSS were overweight, but nutritional risk is still high. The authors’ main issue is the small sample size.