中国人群 HLA-DRB1 与类风湿关节炎关联性的荟萃分析。
Meta-analysis of the association of HLA-DRB1 with rheumatoid arthritis in Chinese populations.
机构信息
Department of Dermatology, the third affiliated hospital of Guangxi Medical University, 13 Dancun Road, Nanning 530031, Guangxi, People's Republic of China.
出版信息
BMC Musculoskelet Disord. 2013 Oct 27;14:307. doi: 10.1186/1471-2474-14-307.
BACKGROUND
Individual studies have reported different results regarding the association of HLA alleles with RA in Chinese populations. This study was performed to systematically summarize results on the association of HLA-DRB1 with rheumatoid arthritis (RA) in China.
METHODS
We examined the case-control studies concerned about the relationship between HLA-DRB1 and RA and differences of clinical and laboratory parameters between the HLA-DR4 (DR4)+ and DR4- in RA patients in Chinese populations. Odds ratios (ORs) and weighted mean difference (WMD) with corresponding 95% confidence intervals (CI) was used to describe the relationship.
RESULTS
22 studies with 1690 cases and 1793 controls were included. Chinese populations with RA had significantly higher frequencies of HLA-DRB104, 0401, 0404, 0405 and 0410 than controls (ORDRB104 =4.19, 95% CI =3.44-5.11, p<0.00001; ORDRB10401 =2.53, 95% CI =1.54-4.16, p=0.0003; ORDRB10404 =2.28, 95% CI =1.28-4.06, p=0.005; ORDRB10405=3.71, 95% CI =2.52-5.45, p<0.00001; ORDRB10410 =2.99, 95% CI =1.25-7.14, p=0.01 respectively). As to laboratory parameters, Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Rheumatoid factor (RF), Anti-cyclic citrullinated peptide antibodies (Anti-CCP ) in patients with DR4+ were higher than patients with DR4- (WMD=0.26, 95% CI =0.15-0.37, p<0.00001; WMD = 0.26, 95% CI =0.12-0.41, p=0.0005; WMD = 0.44, 95% CI =0.23-0.65, p<0.00001; WMD = 0.58, 95% CI =0.24-0.91, p=0.0007 respectively). As to clinical features, there was no difference in duration of morning stiffness, number of swollen joints, number of joint tenderness, X-ray phases and joint function between the DR4+ and DR4- in RA patients.
CONCLUSIONS
It was found that HLA-DRB1*04, *0401, *0404, *0405 and *0410 are risk factors for RA in Chinese populations. ESR, CRP, RF, Anti-CCP are different between the DR4+ and DR4- in RA patients in Chinese populations, while there's no difference for indexes of clinical features.
背景
已有个别研究报告了中国人群中 HLA 等位基因与类风湿关节炎（RA）之间关联的不同结果。本研究旨在系统总结中国人群中 HLA-DRB1 与类风湿关节炎之间关联的病例对照研究结果，以及 RA 患者中 HLA-DR4（DR4+）和 DR4-之间临床和实验室参数的差异。比值比（OR）和加权均数差（WMD）及其相应的 95%置信区间（CI）用于描述相关性。
方法
我们检索了关于 HLA-DRB1 与 RA 之间关系以及中国人群中 RA 患者 HLA-DR4（DR4+）和 DR4-之间临床和实验室参数差异的病例对照研究。使用比值比（OR）和加权均数差（WMD）及其相应的 95%置信区间（CI）来描述相关性。
结果
共纳入 22 项研究，包括 1690 例病例和 1793 例对照。与对照组相比，中国人群中 RA 患者 HLA-DRB104、0401、0404、0405 和0410 的频率显著升高（ORDRB104=4.19，95%CI=3.44-5.11，p<0.00001；ORDRB10401=2.53，95%CI=1.54-4.16，p=0.0003；ORDRB10404=2.28，95%CI=1.28-4.06，p=0.005；ORDRB10405=3.71，95%CI=2.52-5.45，p<0.00001；ORDRB10410=2.99，95%CI=1.25-7.14，p=0.01）。在实验室参数方面，DR4+患者的红细胞沉降率（ESR）、C 反应蛋白（CRP）、类风湿因子（RF）、抗环瓜氨酸肽抗体（Anti-CCP）高于 DR4-患者（WMD=0.26，95%CI=0.15-0.37，p<0.00001；WMD=0.26，95%CI=0.12-0.41，p=0.0005；WMD=0.44，95%CI=0.23-0.65，p<0.00001；WMD=0.58，95%CI=0.24-0.91，p=0.0007）。在临床特征方面，DR4+和 DR4-患者的晨僵持续时间、肿胀关节数、关节压痛数、X 线分期和关节功能无差异。
结论
在中国人群中，HLA-DRB1*04、*0401、*0404、0405 和0410 是 RA 的危险因素。在中国人群中，DR4+和 DR4-的 RA 患者的 ESR、CRP、RF、Anti-CCP 不同，但临床特征指标无差异。
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