Association between primary biliary cholangitis and risk of Sjögren's syndrome: a systematic review and meta-analysis

Background: Primary biliary cholangitis (PBC) is associated with certain autoimmune diseases. Objectives: This study aims to investigate the association between PBC and the risk of Sjögren's syndrome by applying a systematic review and meta-analysis.Method: Databases such as ProQuest, PubMed, Web of Science, Cochrane, and Google Scholar were searched up to July ۱۷, ۲۰۲۴, using keywords like "Sjögren's Syndrome," "Sicca Syndrome," "Liver Cirrhosis, Biliary," "Primary Biliary Cirrhosis," "Primary Biliary Cholangitis," "Obstructive Liver Cirrhosis," and their MeSH equivalents. No time or language restrictions were applied to the search. Studies directly addressing the association between PBC and the risk of Sjögren's syndrome were included. For low heterogeneity, a fixed-effects model was used. For moderate and severe heterogeneity, a random-effects model was used. Also, I²=۸۵.۶% for cohort studies, I²=۰% for Mendelian randomization studies, and I²=۰% for case-control studies. STATA ۱۴ software was used for data analysis, and P<۰.۰۵ was considered significant.Results: In the ۸ studies reviewed (two case-control studies, four Mendelian randomization studies, and two cohort studies), primary biliary cholangitis increased the risk of Sjögren's syndrome (OR: ۱.۱۷, (۹۵%CI: ۱.۱۱, ۱.۲۵)), systemic lupus erythematosus (OR: ۱.۴۲, (۹۵%CI: ۱.۳۵, ۱.۴۹)), and rheumatoid arthritis (OR: ۱.۱۴, (۹۵%CI: ۱.۰۳, ۱.۲۷)). However, there was no statistically significant correlation between PBC and the risk of psoriasis (OR: ۱.۴۵, ۹۵% CI: ۰.۷۱, ۲.۹۵) or systemic sclerosis (OR: ۱.۲۳, ۹۵% CI: ۰.۹۶, ۱.۵۸). Sjögren's syndrome increased the risk of PBC (OR: ۱.۷۳, ۹۵% CI: ۱.۱۲, ۲.۷۰). In Mendelian randomization studies (OR: ۱.۱۷, ۹۵% CI: ۱.۱۳, ۱.۲۱) and case-control studies (OR: ۸.۴۷, ۹۵% CI: ۱, ۷۱.۵۸), PBC was shown to increase the risk of Sjögren's syndrome; however, cohort studies did not find a significant association between PBC and the risk of Sjögren's syndrome (OR: ۱.۴۳, ۹۵% CI: ۰.۱۹, ۱۰.۶۹).Conclusions: PBC is recognized as a risk factor for rheumatoid arthritis, Sjögren's syndrome, and systemic lupus erythematosus; moreover, there is a significant risk that Sjögren's syndrome will lead to PBC.

کلیدواژه ها:

Sjogren's Syndrome ، Sicca Syndrome ، Liver Cirrhosis ، Biliary ، Primary Biliary Cholangitis ، Obstructive Liver Cirrhosis