Abstract
Background/Aims: To determine the prevalence of autonomic dysfunction among Korean patients with primary Sjogren’s syndrome (pSS) and its associations with the clinical features of pSS. Methods: We analyzed 154 participants from the Korean Initiative of primary Sjogren’s Syndrome (KISS) as a prospective pSS cohort and 154 age- and sex matched healthy controls. A standardized 5-minute, supine, resting heart rate variability (HRV) test was performed, and autonomic dysfunction was defined as standard deviation of normal-to-normal RR intervals (SDNN) < 30 ms in patients < 50 years old and SDNN < 20 ms in patients ≥ 50 years old. The associations between autonomic dysfunction and various clinical features of pSS were analyzed. Results: The overall autonomic activity in patients with pSS was significantly lower than that in controls. Autonomic dysfunction with the HRV test was observed in 35.7% of the KISS participants and was associated with a higher European League Against Rheumatism Sjogren’s Syndrome Patient Reported Index fatigue score (p = 0.024). Raynaud’s phenomenon was a more frequent clinical presentation in pSS patients with autonomic dysfunction than in those without autonomic dysfunction (29.4% and 14.4%, respectively; p = 0.048). Decreased parasympathetic activity was observed in 41.6% of pSS patients. No differences were found in the oral and ocular signs of pSS according to the decreased parasympathetic activity. Conclusions: In Korean patients with pSS, decreased and imbalanced autonomic activity is prevalent and is associated with fatigue. However, an association between autonomic dysfunction and glandular manifestations was not detected.
Original language | English |
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Article number | PMC5214725 |
Pages (from-to) | 165-173 |
Number of pages | 9 |
Journal | Korean Journal of Internal Medicine |
Volume | 32 |
Issue number | 1 |
DOIs | |
State | Published - Jan 2017 |
Bibliographical note
Funding Information:This study was supported by a grant from the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (HI13C0016). We thank So Young Kim, the research nurse for the KISS cohort, for collecting the clinical data and Sun Jun Kim, the technician who performed the heart rate variability test.
Publisher Copyright:
© 2017 The Korean Association of Internal Medicine.
Keywords
- Autonomic nervous system
- Fatigue
- Heart rate variability
- Sjogren’s syndrome