{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:22:14Z","timestamp":1788434534291,"version":"build-2803163510"},"reference-count":47,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"unspecified","delay-in-days":62,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018952","name":"Birmingham Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018952","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["ACF-2023-09-012"],"award-info":[{"award-number":["ACF-2023-09-012"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2026,2,3]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We aimed to assess the impact of socioeconomic status (SES) on risk of Sj\u00f6gren\u2019s disease (SjD) compared with non-Sj\u00f6gren\u2019s Sicca and population controls, and on the clinical features of SjD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single-centre UK cohort provided participants with SjD (European Alliance of Associations for Rheumatology\/American College of Rheumatology (EULAR\/ACR) 2016, n=256) and non-Sj\u00f6gren\u2019s Sicca (anti-Sj\u00f6gren\u2019s syndrome type A (SSA)\/Ro negative, n=175). Health Survey for England 2019 provided local population controls (n=972). English Indices of Multiple Deprivation (IMD) 2019 quintiles at recruitment and highest educational attainment defined SES.<\/jats:p>\n                    <jats:p>Adjusted logistic regression models evaluated associations between SES and diagnosis. Linear models assessed the impact of IMD on disease variables. Population controls were matched with age, sex and ethnicity to compare SES distributions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across IMD and educational attainment, participants with SjD had lower SES status compared to Sicca (p=0.008 and p=0.018). Odds of SjD (vs Sicca) were highest in most deprived IMD quintile 1 and reduced by 74% in quintile 2 (OR 0.26 (0.12, 0.58), p&lt;0.001).<\/jats:p>\n                    <jats:p>Immunoglobulin G and A levels were inversely associated with IMD. In SjD, each unit increase in IMD reduced IgG by 6.03% (\u22129.84%, \u22122.05%; p=0.003) and IgA by 6.46% (\u221210.87%, \u22121.60%; p=0.010).<\/jats:p>\n                    <jats:p>When compared with population controls, IMD was not a risk factor for SjD (p=0.257) whereas Sicca was associated with lower deprivation (p=0.003). Those with a degree level qualification had the highest odds of diagnosis (SjD or Sicca).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Low SES is associated with increased risk of SjD compared to Sicca and with higher immunoglobulin levels. The Sicca cohort may be less deprived than the general population. The role of environmental factors in modulating salivary gland pathology requires further exploration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-006348","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T14:05:14Z","timestamp":1772633114000},"page":"e006348","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of socioeconomic deprivation on risk and disease activity of Sj\u00f6gren\u2019s disease"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0863-2635","authenticated-orcid":false,"given":"Aliaksandra","family":"Baranskaya","sequence":"first","affiliation":[{"name":"Rheumatology Research Group, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK"},{"name":"NIHR Birmingham Biomedical Research Centre, University Hospitals, Birmingham, UK"},{"name":"Department of Rheumatology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8312-4532","authenticated-orcid":false,"given":"Matilde","family":"Bandeira","sequence":"additional","affiliation":[{"name":"Rheumatology Research Group, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK"},{"name":"Department of Rheumatology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"},{"name":"Rheumatology Department, Unidade Local de Sa\u00fade Santa Maria, Centro Acad\u00e9mico de Medicina de Lisboa (CAML), Lisboa, Lisboa, Portugal"},{"name":"Faculdade de Medicina, Universidade de Lisboa, CAML, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Nadeem","sequence":"additional","affiliation":[{"name":"University of Leicester Medical School, University of Leicester, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon J","family":"Bowman","sequence":"additional","affiliation":[{"name":"Rheumatology Research Group, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK"},{"name":"NIHR Birmingham Biomedical Research Centre, University Hospitals, Birmingham, UK"},{"name":"Department of Rheumatology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Pucino","sequence":"additional","affiliation":[{"name":"Rheumatology Research Group, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK"},{"name":"Immunoallergology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 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