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Open Access Highly Accessed Research article

Meta-analysis of the association of HLA-DRB1 with rheumatoid arthritis in Chinese populations

Meng Yang1, Xiaocong Kuang2, Jianmin Li3*, Yanbin Pan3, Meile Tan3, Binzhu Lu3, Qiumei Cheng3, Lingyan Wu3 and Guodong Pang3

Author Affiliations

1 Postgraduate School of Guangxi Medical University, 22 Shuangyong Road, Nanning 530021, Guangxi, People’s Republic of China

2 Department of pathophysiology of Guangxi Medical University, 22 Shuangyong Road, Nanning 530021, Guangxi, People’s Republic of China

3 Department of Dermatology, the third affiliated hospital of Guangxi Medical University, 13 Dancun Road, Nanning 530031, Guangxi, People’s Republic of China

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BMC Musculoskeletal Disorders 2013, 14:307  doi:10.1186/1471-2474-14-307

Published: 27 October 2013

Abstract

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-DRB1and 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-DRB1*04, *0401, *0404, *0405 and *0410 than controls (ORDRB1*04 =4.19, 95% CI =3.44–5.11, p<0.00001; ORDRB1*0401 =2.53, 95% CI =1.54–4.16, p=0.0003; ORDRB1*0404 =2.28, 95% CI =1.28–4.06, p=0.005; ORDRB1*0405=3.71, 95% CI =2.52–5.45, p<0.00001; ORDRB1*0410 =2.99, 95% CI =1.25–7.14, p=0.01respectively). 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.

Keywords:
Rheumatoid arthritis; HLA-DRB1; Laboratory parameters; Meta-analysis