ArticleArthritis care & research2020
American Indians Have a Higher Risk of Sjögren's Syndrome and More Disease Activity Than European Americans and African Americans.
Article in Arthritis care & research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 17 citations in OpenAlex.
- Comparative Analysis of Clinical Trials of Biologic Drugs for Patients with Primary Sjögren's Syndrome.Journal of clinical medicine · 2026Review
- Distinct IgM and IgG autoantibody profiles characterize incomplete and classified systemic autoimmune diseases.Frontiers in immunology · 2026Article
- Prevalence and Incidence of Sjögren's Disease in Alaska Native and American Indian Peoples of Alaska.Arthritis care & research · 2025Article
- Prevalence and Clinical Characteristics of Vasculitis in the Alaska Native and American Indian Peoples of Alaska.Arthritis care & research · 2025Article
- Epidemiology of Sjogren's syndrome in a sample of the Egyptian population: a cross-sectional study.The Journal of international medical research · 2024Article
- Unique Serum Immune Phenotypes and Stratification of Oklahoma Native American Rheumatic Disease Patients.Arthritis care & research · 2023Article
- Uranium Exposure in American Indian Communities: Health, Policy, and the Way Forward.Environmental health perspectives · 2021Review
- Molecular Decolonization: An Indigenous Microcosm Perspective of Planetary Health.International journal of environmental research and public health · 2020Article
- Transcriptomic and Network Analysis of Minor Salivary Glands of Patients With Primary Sjögren's Syndrome.Frontiers in immunology · 2020Article
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Authors and funding
20 authors at 8 institutions in 2 countries.
Funding
Abstract
objectiveTo describe the clinical and serologic manifestations of Sjögren's syndrome (SS) in ethnic groups of the US.
methodsThis was a cross-sectional study of 648 patients with primary SS: 20 African American (AA), 164 American Indian (AI), 426 European American (EA), and 38 patients of other races evaluated in a multidisciplinary Sjögren's International Collaborative Clinical Alliance research clinic.
resultsAA subjects comprised 3.1% of the SS cohort, much lower than the percentage of AA in the state of Oklahoma (P = 3.01 × E - 05), the US (P = 2.24E - 13), or a systemic lupus erythematosus (SLE) cohort at the same institution (P = 4.26 × 10E - 27). In contrast, the percentage of AI in the SS cohort (25.3%) was much higher than expected (P = 3.17E - 09 versus SLE cohort, P = 6.36 - 26 versus Oklahoma, and P = 8.14E - 96 versus US population). The SS classification criteria were similar between AA and EA, but subjects of AI ancestry had lower rates of abnormal tear and salivary flow, as well as anti-Ro/SSA and anti-La/SSB antibodies. Paradoxically, AI had higher levels of disease activity (mean ± SD European League Against Rheumatism Sjögren's Syndrome Disease Activity Index score 3.77 ± 4.78) in comparison to EA (2.90 ± 4.12; P = 0.011) and more extraglandular manifestations affecting mainly the articular and glandular domains. Meanwhile, AA patients were characterized by higher rates of hypergammaglobulinemia (odds ratio [OR] 1.39 [95% confidence interval (95% CI) 1.39-8.65]; P = 0.01), elevated erythrocyte sedimentation rate (ESR) (OR 3.95 [95% CI 1.46-9.95]; P = 0.009), and parotid enlargement (OR 4.40 [95% CI 1.49-13.07]; P = 0.02).
conclusionAI are affected at high rates with SS but present with few classical features, potentially preventing timely diagnosis. In contrast to SLE, SS is infrequent and not more severe among AA, but the triad of hypergammaglobulinemia, increased ESR, and parotid enlargement warrants extra vigilance for lymphomagenesis.
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