Rheumatology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Clin Exp Rheumatol. 2023 May;41(5):1179-1182. doi: 10.55563/clinexprheumatol/anuuqb. Epub 2023 Jan 23.
To evaluate the association between liver fibrosis and the HLACw6 allele in psoriatic arthritis (PsA) patients.
A retrospective longitudinal study involving PsA patients with determination of the HLA-Cw6 allele was performed. Liver fibrosis was estimated by using the FIB-4 (fibrosis-4) score. A multivariate logistic model was undertaken to assess the odds ratio (OR), with its 95% confidence interval, of liver fibrosis after adjustment for potential confounding factors.
A total of 209 PsA patients were included: 25.3% HLA-Cw6 were positive, 59.8% were receiving biological disease-modifying anti-rheumatic drugs (bDMARDs), 29.6% had arterial hypertension (AHT), 24% dyslipidaemia, and 4.2% acute myocardial infarction (AMI). The HLA-Cw6 allele was more frequent in PsA patients with normal FIB-4 values (p=0.024), as opposed to AHT (p=0.002), AMI (p=0.023) and dyslipidaemia (p=0.030), which were found more frequently in subjects with altered FIB-4 values. The presence HLA-Cw6 and the use of bDMARDs were confirmed as protective factors against liver fibrosis (OR 0.210, 0.062-0.707, p=0.012 and OR 0.397, 0.166-0.949, p=0.038, respectively). Conversely, AHT emerged as a risk factor (OR 2.973, 1.125-7.858, p=0.028).
In PsA, the HLA-Cw6 allele and bDMARDs behave as protective factors for liver fibrosis, while AHT is an independent risk factor.
评估银屑病关节炎（PsA）患者肝纤维化与 HLACw6 等位基因之间的关联。
对存在 HLACw6 等位基因的 PsA 患者进行回顾性纵向研究。采用 FIB-4（纤维化 4）评分评估肝纤维化。采用多变量逻辑模型评估潜在混杂因素调整后的比值比（OR）及其 95%置信区间，以评估肝纤维化的可能性。
共纳入 209 例 PsA 患者：25.3% HLA-Cw6 阳性，59.8%接受生物疾病修饰抗风湿药物（bDMARDs）治疗，29.6%患有动脉高血压（AHT），24%血脂异常，4.2%急性心肌梗死（AMI）。与 AHT（p=0.002）、AMI（p=0.023）和血脂异常（p=0.030）相比，FIB-4 值正常的 PsA 患者 HLA-Cw6 等位基因更为常见（p=0.024），而 FIB-4 值改变的患者中更常见 AHT（p=0.002）、AMI（p=0.023）和血脂异常（p=0.030）。存在 HLA-Cw6 和使用 bDMARDs 被确认为肝纤维化的保护因素（OR 0.210，0.062-0.707，p=0.012 和 OR 0.397，0.166-0.949，p=0.038）。相反，AHT 则是一个危险因素（OR 2.973，1.125-7.858，p=0.028）。
在 PsA 中，HLACw6 等位基因和 bDMARDs 是肝纤维化的保护因素，而 AHT 是独立的危险因素。
