{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:48:43Z","timestamp":1790192923286,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sj\u00f6gren's Syndrome (SS), mainly affecting women in their midlife, is characterized by persistent inflammation in glands producing tears and saliva, often leading to significant complications. This study investigates the differences in autonomic system functioning between individuals with SS and healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From April 2019 to December 2022, 329 diagnosed primary SS (pSS) patients and 30 healthy controls were enrolled at Taipei Veterans General Hospital, Taipei, Taiwan. The study assessed autonomic nervous system functioning using various HRV metrics. Participants were divided based on age and AECG criteria, including salivary gland biopsy and autoantibody status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant differences in Heart Rate Variability (HRV) were observed between pSS patients and healthy controls. The total power index was notably lower in pSS patients (4.98\u2009\u00b1\u20091.29) than in controls (5.54\u2009\u00b1\u20091.21, <jats:italic>p<\/jats:italic>\u2009=\u2009.022). Additionally, Vagal (VAG) activity was significantly reduced in the pSS group (4.95\u2009\u00b1\u20091.33) compared to the healthy control group (5.47\u2009\u00b1\u20091.19, <jats:italic>p<\/jats:italic>\u2009=\u2009.041). Age\u2010stratified analysis highlighted that the \u226450\u2009years pSS group had a higher heart rate (77.74\u2009\u00b1\u200910.42) compared to the &gt;50\u2009years group (73.86\u2009\u00b1\u200910.35, <jats:italic>p<\/jats:italic>\u2009=\u2009.005). This group also showed a higher total power index (5.78\u2009\u00b1\u20091.30) versus the &gt;50\u2009years group (4.68\u2009\u00b1\u20091.19, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), and significantly lower VAG activity (4.70\u2009\u00b1\u20091.26, <jats:italic>p<\/jats:italic>\u2009=\u2009.007) compared to healthy controls. Furthermore, the Standard Deviation of Normal\u2010to\u2010Normal Intervals (SDNN) was greater in the \u226450\u2009years SS group (44.45\u2009\u00b1\u200937.12) than in the &gt;50\u2009years group (33.51\u2009\u00b1\u200926.18, <jats:italic>p<\/jats:italic>\u2009=\u2009.007). In pSS patients, those positive for both salivary gland biopsy and autoantibodies demonstrated a lower Total Power (4.25\u2009\u00b1\u20091.32) and R\u2010wave validity (93.50\u2009\u00b1\u20094.79, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) than other groups, suggesting more severe autonomic imbalance. The R\u2010R interval variation (RRIV) was also significantly higher in this dual\u2010positive group (696.10\u2009\u00b1\u2009975.41, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). Additionally, the ESSPRI for dryness was markedly higher in the dual\u2010positive group (8.10\u2009\u00b1\u20091.45, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05), indicating more severe symptoms. These findings reveal significant variations in autonomic function in SS patients, especially in those with dual\u2010positive biopsy and autoantibody status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates significant autonomic dysfunction in pSS patients compared to healthy controls, particularly in those positive for both salivary gland biopsy and autoantibodies. The age\u2010stratified analysis further emphasizes the impact of aging on autonomic system functioning in pSS, suggesting a need for age\u2010specific management approaches in pSS patient care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.15088","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T04:39:20Z","timestamp":1709872760000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Unveiling the <scp>age\u2010related<\/scp> dynamics in Sj\u00f6gren's syndrome: Insights from heart rate variability and autonomic function"],"prefix":"10.1111","volume":"27","author":[{"given":"Hong\u2010Chun","family":"Lin","sequence":"first","affiliation":[{"name":"Center for Traditional Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Institute of Traditional Medicine National Yang Ming Chiao Tung University  Taipei 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