Department of Rheumatology, National Hospital Organization Tokyo National Hospital, 3-1-1 Takeoka, Kiyose 204-8585, Japan.
Department of Nephrology, Ushiku Aiwa General Hospital, 896 Shishiko-cho, Ushiku 300-1296, Japan.
Genes (Basel). 2023 Jul 19;14(7):1470. doi: 10.3390/genes14071470.
The prevalence of chronic kidney disease (CKD) was reported to be higher in rheumatoid arthritis (RA) patients than in normal healthy individuals. Human leukocyte antigen () was associated with RA or CKD. Few studies on the association of with CKD in RA have been reported. Here, we investigated the association of polymorphisms with CKD in Japanese RA patients.
genotyping was conducted in 351 Japanese RA patients with CKD (estimated glomerular filtration rate [eGFR] lower than 60 [mL/min/1.73 m]) and 959 without CKD (eGFR equal to or higher than 60 [mL/min/1.73 m]). Associations of allele carrier frequencies of with CKD were examined in the RA patients.
There was an association of with CKD in RA, but this did not achieve statistical significance ( = 0.0265, odds ratio [OR] 1.70, c = 0.7412, 95% confidence interval [CI] 1.09-2.64). The DR6 serological group was associated with CKD in RA ( = 0.0008, OR 1.65, 95% CI 1.24-2.20). A gene-dosage effect of DR6 was not detected. Logistic regression analysis showed that the association of DR6 with CKD in RA was independent of clinical characteristics.
The present study first revealed the independent predisposing association of DR6 with CKD in Japanese RA patients, although DR6 is known to be protective against RA. Our data suggest direct or indirect roles of for the development of CKD in RA, but the mechanisms are not clear.
据报道，类风湿关节炎（RA）患者的慢性肾脏病（CKD）患病率高于正常健康人群。人类白细胞抗原（HLA）与 RA 或 CKD 相关。关于 RA 与 CKD 相关的 HLA 研究较少。本研究旨在探讨日本 RA 患者 HLA 多态性与 CKD 的相关性。
对 351 例合并 CKD（估算肾小球滤过率[eGFR]＜60[mL/min/1.73 m]）的日本 RA 患者和 959 例无 CKD（eGFR≥60[mL/min/1.73 m]）患者进行基因分型。在 RA 患者中，检查等位基因携带频率与 CKD 的相关性。
HLA 与 RA 合并 CKD 相关，但无统计学意义（=0.0265，比值比[OR]1.70，c=0.7412，95%置信区间[CI]1.09-2.64）。DR6 血清学组与 RA 合并 CKD 相关（=0.0008，OR 1.65，95%CI 1.24-2.20）。未检测到 DR6 的基因剂量效应。Logistic 回归分析显示，DR6 与 RA 合并 CKD 的相关性独立于临床特征。
本研究首次揭示了 DR6 与日本 RA 患者 CKD 独立相关，尽管 DR6 已知对 RA 有保护作用。我们的数据表明，DR6 可能直接或间接导致 RA 患者发生 CKD，但具体机制尚不清楚。
