{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T06:02:12Z","timestamp":1789970532195,"version":"4.0.1"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Sj\u00f6gren\u2019s disease is characterized by autoimmune destruction of exocrine glands. Obesity generally worsens the course of many diseases; however, earlier observations in our cohort suggested a paradoxically lower disease activity (ESSDAI) in overweight\/obese patients. This cross-sectional study aimed to investigate potential mechanisms underlying these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Chemerin and oxidized low-density lipoprotein (oxLDL) levels were measured in a subset of regularly followed patients (n=75). Patients were stratified by body mass index (BMI): BMI &amp;lt;25 kg\/m\u00b2 (\u201cnon-obese\u201d, n=27) and BMI \u226525 kg\/m\u00b2 (\u201coverweight\/obese\u201d, n=48). Demographic, laboratory, and immunological parameters, disease activity (ESSDAI), extraglandular manifestations, and treatments were compared using biostatistical analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Chemerin and oxLDL levels did not differ significantly between groups. ESSDAI was significantly lower in overweight\/obese patients (5.04 vs. 2.76; p=0.04), while complement c3 levels were higher (1.20 vs. 1.46 g\/L; p&amp;lt;0.001). Across all patients, chemerin positively correlated with BMI, age at diagnosis, c3, c4, CRP, platelet count, and leukocyte count. Hemoglobin and hematocrit were higher in overweight\/obese patients, whereas neutrophil ratio was lower and lymphocyte ratio slightly higher. Statin therapy was also more frequent in the overweight\/obese group (p=0.04). In this group, BMI and platelet count independently predicted chemerin levels, while platelet count predicted chemerin in normal-weight patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite its positive correlation with BMI, chemerin levels were not significantly higher in overweight\/obese patients, suggesting relatively lower levels. This may partly explain their more favorable immunological profile. Increased statin use may also contribute through anti-inflammatory effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1890786","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:35:59Z","timestamp":1789968959000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The obesity paradox in primary Sj\u00f6gren\u2019s disease: immunometabolic associations of chemerin, platelet count, and statin use"],"prefix":"10.3389","volume":"17","author":[{"given":"Kincs\u0151","family":"Mezei","sequence":"first","affiliation":[{"name":"Division of Clinical Immunology, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen","place":["Debrecen, Hungary"]},{"name":"Gyula Petr\u00e1nyi Clinical Immunology and Allergology Doctoral School, University of Debrecen","place":["Debrecen, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikt\u00f3ria","family":"Orosz","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen","place":["Debrecen, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ildik\u00f3 Fanny","family":"Horv\u00e1th","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen","place":["Debrecen, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zs\u00f3fia","family":"Aradi","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen","place":["Debrecen, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajnalka","family":"L\u0151rincz","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Debrecen","place":["Debrecen, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariann","family":"Harangi","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Debrecen","place":["Debrecen, Hungary"]},{"name":"Institute of Health Studies, Faculty of Health Sciences, University of Debrecen","place":["Debrecen, Hungary"]},{"name":"E\u00f6tv\u00f6s Lor\u00e1nd Research Network-University of Debrecen (ELKH-UD) Vascular Pathophysiology Research Group, University of Debrecen","place":["Debrecen, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ant\u00f3nia","family":"Sz\u00e1nt\u00f3","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen","place":["Debrecen, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-024-01135-3","article-title":"Update on the pathophysiology and treatment of primary Sj\u00f6gren syndrome","volume":"20","author":"Baldini","year":"2024","journal-title":"Nat Rev Rheumatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/s10238-021-00728-6","article-title":"Sj\u00f6gren's syndrome: a systemic autoimmune disease","volume":"22","author":"Negrini","year":"2022","journal-title":"Clin Exp 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