Abstract
OBJECTIVE: To identify the association between sex hormones and Sjogren's disease. METHODS: A case-control study investigating the relationship between sex hormones and Sjogren's disease was conducted at Nanjing Drum Tower Hospital from January 2018 to January 2024. Two-sample Mendelian randomization was then performed to identify the causal association by using the public genome-wide association study data from the UK Biobank and the FinnGen consortium. RESULTS: In the case-control study, a total of 93 cases diagnosed with Sjogren's disease were compared to 90 Sjogren's disease-like non-Sjogren's disease controls from a population of naturally postmenopausal women. An association was observed between E2 (aOR = 0.984; 95% CI: 0.971-0.997; p = 0.018), hypo-estradiol (aOR = 2.195; 95% CI: 1.156-4.165; p = 0.016), and Sjogren's disease. Mendelian randomization analysis indicated that higher odds of Sjogren's disease were associated with decreased E2 in females, as estimated by the inverse-variance weighted (OR = 0.954; 95% CI: 0.917-0.992; p = 0.019). CONCLUSION: Our study demonstrates that Sjogren's disease leads to reduced E2. This indicates that low E2 is a consequence of the disease rather than a causative factor.