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Searching for a Novel HLA-Cw6-Linked Cardiometabolic Endotype in Psoriatic Disease
Rubén Queiro1,2,3,4, Pablo González Del Pozo1, Paula Alvarez1
1Rheumatology Division, Central University Hospital of Asturias, 33011 Oviedo, Spain.
Insights
The HLA-Cw6 allele may protect against diabetes in psoriatic disease (PsD) patients. This finding suggests a potential HLA-Cw6-linked cardiometabolic endotype in PsD, warranting further investigation into this association.
Area of Science:
- Immunogenetics
- Dermatology
- Cardiology
Background:
- Psoriatic disease (PsD) is linked to cardiometabolic (CM) risks.
- A potential association between HLA-Cw6 and CM profiles in PsD patients has been suggested but requires more evidence.
Purpose of the Study:
- To investigate the association between HLA-Cw6 and cardiometabolic risk factors in a large cohort of psoriatic disease patients.
Main Methods:
- Analysis of three PsD cohorts (n=940 total): two cutaneous psoriasis cohorts and one psoriatic arthritis (PsA) cohort.
- Univariate, multivariate regression, and meta-analyses were used to assess relationships between HLA-Cw6 and CM risk factors (hypertension, diabetes, obesity, dyslipidemia).
Main Results:
- No association between HLA-Cw6 and CM comorbidities was found in the PsA cohort.
- In psoriasis cohorts, HLA-Cw6 carriers showed a reduced risk of diabetes (OR 0.49, p=0.026), confirmed by meta-analysis (pooled OR 0.50).
Conclusions:
- The HLA-Cw6 allele may have a protective effect against diabetes in psoriatic disease patients.
- Findings suggest a novel HLA-Cw6-linked cardiometabolic endotype in PsD.
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.
Methods:
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.
Results:
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, p = 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).
Conclusions:
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.
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