Is HLA-DR6 a protective factor against posttransplantation diabetes mellitus?

BACKGROUND: Posttransplant diabetes mellitus (PTDM) has several pre- and posttransplant risk factors. METHODS: The incidence and risk factors of PTDM were retrospectively evaluated in 2117 kidney allograft recipients from June 1984 to March 2004. Type and dosage of immunosuppressive agents, pretransplant weight and human leukocyte antigen (HLA) phenotypes in PTDM patients were compared with 61 matched controls. RESULTS: Sixty-one cases (2.8%) developed PTDM requiring insulin or oral hypoglycemic therapy, out of which 47.5% were men and 52.5% were women, although only 35% of our overall recipients are women. Onset occurred at a mean of 489 days following transplantation. Patients receiving more than 15 mg/d prednisolone developed PTDM more often than those on less than 15 mg/d (P = .000). Similarly PTDM was more frequent among patients who received more than 300 mg/d cyclosporine compared with those on less than 300 mg/d (P = .015). Mean weight in PTDM cases and controls was 65 +/- 13.4 kg and 57 +/- 13.6 kg, respectively (P = .005). HLA-DR6 was observed in 12.2% of nonaffected subjects but in none of the PTDM group (P = .002). Conversely, HLA-DR8 was seen only in PTDM patients (P = .012). In addition HLA-A26 was more common among PTDM patients (P = .02) and HLA-DR52 more frequent in nonaffected subjects (P = .025). CONCLUSION: Our findings suggest that female sex, dosages of prednisolone and cyclosporine, pretransplant weight, and genetic factors are associated with an increased risk of PTDM. The rate of PTDM appeared to be independent of weight gain in the first year posttransplant. Protection against PTDM may be afforded by HLA-DR6 and possibly HLA-DR52. Conversely and higher incidence of diabetes has been associated with HLA-DR8 and HLA-A26.

[The significance of HLA DR6 and DR8 among patients with rheumatoid arthritis].

Among 380 patients with rheumatoid arthritis (RA), there were 63 cases who had HLA DR4 without any other counterpart DR type (Group DR4.*), 30 with DR6 but without DR4 (Group DR6.DR4-), 37 with both DR6 and DR4 (Group DR6.DR4+), 34 with DR8 but without DR4 (Group DR8.DR4-), and 15 with both DR8 and DR4 (Group DR8.DR4+). 53, 29, 32, 32, or 13 female RA patients respectively from Groups DR4.*, DR6.DR4-, DR6.DR4+, DR8.DR4-, or DR8.DR4+ were investigated for the severity of their disease. 40 joints in 18 patients, 2 in 1, 19 in 8, 13 in 6, or 10 in 4 respectively from Groups DR4.*, DR6.DR4-, DR6.DR4+, DR8.DR4-, or DR8.DR4+ had had the previous history of total joint replacement operations for the diseased hips (THR) or knees (TKR). The number of cases (p < 0.01) or that of joints (p < 0.001) was significantly less among Group DR6.DR4- patients than the corresponding figure among Group DR4.* patients. Significantly smaller (p < 0.02) number of cases with DR6 (Groups DR6.DR4- and DR6.DR4+ combined) had experienced THR's and/or TKR's than those in Group DR4.*. Group DR8.DR4- patients had undergone THR/TKR operations in smaller number of the joints (p < 0.05) in comparison to Group DR4.* patients, though the difference was not significant when the numbers of operated cases were compared between the Groups. The age at RA onset among Groups DR4.*, DR6.DR4-, DR6.DR4+, DR8.DR4-, or DR8.DR4+ was 38.5 +/- 14.2 (mean +/- SD) years, 46.6 +/- 12.2, 41.7 +/- 11.7, 44.9 +/- 13.1, or 40.8 +/- 10.2 respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Histocompatibility antigens and geographic tongue.

The HLA-A, B and HLA-DR antigens were investigated in 50 unrelated Greek persons with geographic tongue and in 380 healthy control persons. An increased incidence of DR5 and DRW6 antigens was observed in the blood of persons with geographic tongue. Ten (20%) of them had the DRW6 antigen, and it was significantly increased compared with 29 (7.6%) of the controls (p < 0.01, RR = 3.32). Twenty-seven (54%) of the experimental group showed DR5 antigen compared with 136 (35.7%) of the controls (p < 0.025, RR = 2.18). On the contrary, only 12% (5) of the experimental group had the B51 antigen in comparison with the controls (26.3%) (p < 0.05, RR = 0.37). A decrease of the DR2 antigen was also found in the persons with geographic tongue (24%) in comparison with the controls (39.2%) (p < 0.05, RR = 0.58).

Partial deficiency of thyroxine-binding globulin: an HLA study.

Partial thyroxine-binding globulin (TBG) deficiency, with a median TBG of 2.3 mg/l, was found in 25 mature babies with hypothyroxinaemia (3 girls and 22 boys) from our screening programme for congenital hypothyroidism during 1988-1990. Analysis of the HLA system revealed the possibility that antigen DR6 may be considered as a risk factor for TBG deficiency (44.0 vs. 19.2%) and DR2 as a protective factor (16.0 vs. 37.5%). Similar laboratory findings were also present in 16 mothers and 1 father.