Subjects who participated in the Lifelines Cohort study who have Raynaud’s phenomenon have a higher prevalence of self-reported cases of systemic sclerosis (SSc) compared with participants without Raynaud’s phenomenon.

These were the findings of a study published in the Diagnosis and Management of Systemic Sclerosis in 2023. 

Scientists remain partially in the dark about many pathophysiology features of SSc. Studies suggest that patients with Raynaud’s phenomenon and positive antinuclear antibodies are at greater risk of developing this disorder. 

Patients with SSc tend to develop pulmonary disease involving pulmonary arterial hypertension and interstitial lung disease. Pulmonary disease is the primary cause of death among these patients. To shed further light on the prevalence of SSc in the general population and in individuals with Raynaud’s phenomenon, the authors analyzed data from the Lifelines Cohort Study, a prospective population-based cohort study assessing the health-related behaviors of 167,729 individuals living in the northern area of the Netherlands. 

Read more about SSc etiology 

The authors also sought to understand the extent of pulmonary involvement among individuals in the study with Raynaud’s phenomenon and symptoms typically observed in SSc. The research team excluded individuals with a known history of connective tissue disease to eliminate the risk of recruiting patients who may already be suffering from or developing SSc. 

The researchers visited the Lifelines outpatient clinic and conducted extensive physical examinations on all participants. They also assessed the role of skin autofluorescence as a potential early biomarker for pulmonary disease in patients with Raynaud’s phenomenon.

Of 73,948 subjects that were included, 3911 (5.3%) had definite Raynaud’s phenomenon. Around 23.5% patients with Raynaud’s phenomenon had symptoms related to SSc compared with 7.1% in the group of individuals without Raynaud’s phenomenon. Patients with both Raynaud’s phenomenon and symptoms associated with SSc demonstrated greater skin autofluorescence compared with other groups. In addition, they more frequently reported dyspnea at rest and upon exertion, as well signs associated with pulmonary fibrosis. 

“The current study demonstrated an increased prevalence of SSc-related symptoms in subjects with Raynaud’s phenomenon compared to those without Raynaud’s phenomenon, and an increased prevalence of pulmonary symptoms in those with both Raynaud’s phenomenon and SSc-related symptoms,” the authors concluded. 


van de Zande, Abdulle AE, Al-Adwi Y, et al. Self-reported systemic sclerosis-related symptoms are more prevalent in subjects with Raynaud’s phenomenon in the Lifelines population: focus on pulmonary complications. Diagnostics. Published online June 25, 2023. doi:10.3390/diagnostics13132160