Salivary Flow Rates and Oral Health Related Quality of Life Are Associated with Ultrasonographic Scoring of the Major Salivary Glands in Sjogren Syndrome

Yasemin Yalçınkaya¹, Gonca Mumcu², Filiz Ture Ozdemir³, Zeynep Erturk¹, Ali Ugur Unal¹, Pamir Atagunduz⁴, Haner Direskeneli⁵ and Nevsun Inanc^6,7, ¹Department of Internal Medicine, Division of Rheumatology, Marmara University, Istanbul, Turkey, ²Department of Health Management, Marmara University, Faculty of Health Sciences, Istanbul, Turkey, ³Marmara University, School of Medicine, Department of Immunology, Istanbul, Turkey, ⁴Department Internal Medicine, Division of Rheumatology, Marmara University,, Istanbul, Turkey, ⁵Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey, ⁶Marmara University, Istanbul, Turkey, ⁷Departement of İnternal Medicine, Division of Rheumatology, Marmara University, Istanbul, Turkey

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: salivary gland and ultrasonography, Sjogren's syndrome

Session Information

Date: Monday, October 22, 2018

Session Title: Sjögren's Syndrome – Basic and Clinical Science Poster

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Ultrasonography (USG) of major salivary glands (SG-USG) as a non-invasive method is widely used to evaluate salivary gland involvement in Sjogren’s syndrome (SjS). Since decreases in salivary flow rates (SFRs) due to chronic inflammation and destruction of the salivary glands limit the functional and protective capacities of saliva in the oral environment, poor oral health related quality of life (OHRQoL) is commonly seen in patients with SjS. The aim of the study was to assess the relationships between SFRs, OHRQoL and USG changes of major salivary glands in patients with primary SjS.

Methods: Sixty-seven SjS patients (F/M:66/1) with the mean age of 51.1±11.8 years. The duration of follow-up period of 60±49 months fulfilling ACR-EULAR classification criteria (2002) were included. Major salivary glands (bilateral parotis and submandibular glands) were scored according to two different scoring systems which are Hocevar A.(0-48) and Milic VD. (0-12). Unstimulated saliva were collected in patients between 9 a.m. and 10 a.m in the morning. Then, salivary flow rate (SFR) were calculated as millilitres per minute (ml/min) in laboratory conditions (FTO). Oral health related quality of life (OHRQoL) as a patient reported outcome measure (PROM) was evaluated by using Oral health impact profile (OHIP-14). High scores indicated poor OHRQoL status. Oral health (GM) and USG images (NI) were evaluated by two authors as double-blind in the same visit.

Results: Unstimulated SFR was 0.9±0.8 ml/min and xerostomia (SFR ≤0,1 ml/minute) was seen 31,3% (n=21) of the group. Scores of Hocevar, Milic and OHIP-14 were found to be poor in patients with dry mouth compared to those of others (p<0.05). Scores of homogeneity and hypoechogenic areas in Parotid glands were also higher in patients with xerostomia than the others (p<0.05)(Table 1).

Conclusion: Unstimulated SFRs were associated with the structural changes of Parotid glands. Poor OHRQoL as a PROM was shown in patients due to reduced salivary outputs. In clinical practice, USG images of salivary glands could give insight to physicians about SFR and OHRQoL in patients with SjS.

Tablo-1: Salivary Flow Rates, OHIP-14 and Parotid Glans-USG Scores of SjS Patients

Salivary Flow Rates (SFR)

≤0,1 ml/minute

(n=21)

>0,1 ml/minute

(n=46)

Parotid R-homogeneity

1,7±0,7

1,02±0,7

0.001

Parotid R-hypoechogenic areas

1,3±1,1

0,4±0,7

0.001

Parotid L-homogeneity

1,6±0,9

1,1±0,7

0.007

Parotid L-hypoechogenic areas

1,2±0,9

0,5±0,8

0.001

Hocevar-total score

24,6±9,1

15,4±8,7

0.001

Milic-total score

7,4±2,2

4,8±2,4

0.000

OHIP-14 score

27,4±20,4

8,04±13,9

0.000

Disclosure: Y. Yalçınkaya, None; G. Mumcu, None; F. Ture Ozdemir, None; Z. Erturk, None; A. U. Unal, None; P. Atagunduz, None; H. Direskeneli, None; N. Inanc, None.

To cite this abstract in AMA style:

Yalçınkaya Y, Mumcu G, Ture Ozdemir F, Erturk Z, Unal AU, Atagunduz P, Direskeneli H, Inanc N. Salivary Flow Rates and Oral Health Related Quality of Life Are Associated with Ultrasonographic Scoring of the Major Salivary Glands in Sjogren Syndrome [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/salivary-flow-rates-and-oral-health-related-quality-of-life-are-associated-with-ultrasonographic-scoring-of-the-major-salivary-glands-in-sjogren-syndrome/. Accessed September 16, 2021.

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