Queiro Rubén, González Del Pozo Pablo, Alvarez Paula, Calleja Norma, Braña Ignacio, Loredo Marta, Pardo Estefanía, Burger Stefanie, Alonso Sara, Alperi Mercedes
Rheumatology Division, Central University Hospital of Asturias, 33011 Oviedo, Spain.
Department of Medicine, Oviedo University School of Medicine, 33006 Oviedo, Spain.
Biomedicines. 2024 Sep 25;12(10):2174. doi: 10.3390/biomedicines12102174.
BACKGROUND/OBJECTIVES: In recent years, a possible connection between HLA-Cw6 and a distinctive cardiometabolic (CM) profile in patients with psoriatic disease (PsD) has been proposed, although there is still little support for this. Our aim was to further investigate this possible association by studying a large population of PsD patients.
For this study, three different cohorts of patients with PsD were analyzed: two with a majority of cutaneous psoriasis, pooled n: 600, and a third with only psoriatic arthritis-PsA-cases, n: 340. Potential relationships between HLA-Cw6 and the different CM risk factors (hypertension, diabetes, obesity, dyslipidemia) were analyzed using univariate and multivariate regression models, while the final net effect was assessed using fixed- or random-effects meta-analyses, as appropriate.
In the PsA cohort, no association was detected between HLA-Cw6 carriership and any of the CM comorbidity factors. In psoriasis cohorts, after correcting for age, sex, disease duration, and arthritis, HLA-Cw6 carriers had a reduced diabetes risk (OR 0.49, 95%CI: 0.26-0.91, = 0.026). This latter effect was confirmed by a fixed-effects meta-analysis of the included cohorts (pooled OR: 0.50, 95%CI: 0.27-0.90).
This work demonstrates a potential protective effect of the HLA-Cw6 allele on the risk of diabetes in PsD. Our findings together with those of others seem to confirm the existence of a novel HLA-Cw6-linked cardiometabolic endotype in this disease.
背景/目的：近年来，有人提出银屑病（PsD）患者中HLA - Cw6与独特的心脏代谢（CM）特征之间可能存在联系，尽管对此的支持仍然很少。我们的目的是通过研究大量PsD患者进一步调查这种可能的关联。
在本研究中，分析了三组不同的PsD患者队列：两组以皮肤银屑病为主，合并样本量n = 600，第三组仅为银屑病关节炎（PsA）病例，n = 340。使用单变量和多变量回归模型分析HLA - Cw6与不同CM风险因素（高血压、糖尿病、肥胖、血脂异常）之间的潜在关系，同时根据情况使用固定效应或随机效应荟萃分析评估最终的净效应。
在PsA队列中，未检测到HLA - Cw6携带与任何CM合并症因素之间存在关联。在银屑病队列中，校正年龄、性别、病程和关节炎后，HLA - Cw6携带者患糖尿病的风险降低（OR = 0.49，95%CI：0.26 - 0.91，P = 0.026）。纳入队列的固定效应荟萃分析证实了这一效应（合并OR：0.50，95%CI：0.27 - 0.90）。
这项研究表明HLA - Cw6等位基因对PsD患者患糖尿病的风险具有潜在保护作用。我们的研究结果与其他研究结果似乎证实了这种疾病中存在一种新的与HLA - Cw6相关的心脏代谢内型。
