Salivary Metabolomic Alterations in Primary Sjögren Disease: A Systematic Review and Meta‐Analysis

Objectives This systematic review assesses the diagnostic potential of salivary metabolomics in discriminating between primary Sjögren disease (pSjD) and healthy controls, aiming to identify potential biomarkers for clinical application. Materials and Methods A systematic search was conducted across PubMed, Web of Science and Scopus following the Centre for Reviews and Dissemination and PRISMA 2020 guidelines. Methodological quality was primarily assessed using the Quality Assessment of Diagnostic Accuracy in OMICS (QUADOMICS) tool. Meta‐analysis utilised random‐effects models, with effect sizes presented via forest plots. Results Nine studies met criteria, displaying heterogeneous metabolite profiles. Meta‐analysis of two studies with complete quantitative data revealed no significant differences in glycine, pyruvic acid or succinic acid levels between pSjD and controls. Glycine demonstrated substantial heterogeneity ( I 2 = 81.2%), whereas pyruvic and succinic acids showed consistent pooled effects with no heterogeneity ( I 2 = 0%). Conclusions Evidence for succinic acid, pyruvic acid and glycine as salivary biomarkers remains insufficient. Although pSjD is associated with alterations in the salivary metabolome, the evidence remains limited and heterogeneous. Further high‐quality studies are required to clarify their diagnostic potential. Clinical Relevance pSjD saliva exhibits a metabolic ‘shift’, suggesting that salivary metabolomics may reflect disease‐related alterations despite variability in individual metabolites.