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HLA-B51/B5 and the risk of Behçets disease: A systematic review and meta-analysis of case-control genetic association studies
Arthritis Care and Research , 10/02/09

de Menthon M et al. – The strength of the association between BD and HLA-B51/B5, and its consistency across populations of various ethnicities, lends further support to this allele being a primary and causal risk determinant for BD. Variations according to sex support an interaction of this allele with BD characteristics.

Methods

Relevant studies identified using PubMed Medline database and manual searches of the literature
Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using the random-effects model
Subgroup meta-analyses and meta-regression analyses undertaken to investigate effects of selected study-level parameters on pooled OR
Heterogeneity assessed using I2 statistic
Pooled results were used to calculate population-attributable risks (PAR) for BD in relationship to HLA-B51/B5

Results

4,800 patients with BD from 78 independent studies (published 1975-2007)
16,289 controls from 78 independent studies (published 1975-2007) selected
Pooled OR of HLA-B51/B5 allele carriers to develop BD compared with noncarriers was 5.78 (95% CI 5.00-6.67), with moderate between-study heterogeneity (I2 = 61%)
Subgroup analyses stratifying studies by geographic locations (Eastern Asia, Middle East/North Africa, Southern Europe, Northern/Eastern Europe) yielded consistent OR ranges (5.31-7.20), with I2 ranges of 52-70%
Univariate random-effects meta-regression indicated percentage of male BD cases as source of heterogeneity
PAR within the various geographic areas estimated at 32-52%