Patients with vitiligo should be aware of a potential increased risk of developing rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), according to recent findings published in Skin Research and Technology.
Background and Methods
Rheumatic diseases, which impact the musculoskeletal system including joints, bones, muscles, and surrounding soft tissues, are frequently associated with autoimmune reactions. Previous research has established a higher incidence of various autoimmune conditions among individuals with vitiligo, such as alopecia areata, psoriasis, thyroid diseases, inflammatory bowel disease, type 1 diabetes, RA, and SLE. Recent studies suggest a genetic causal link between vitiligo and autoimmune thyroid diseases.
Observational studies, like one published in Dermatology, indicate that people with vitiligo have a significantly elevated risk of developing rheumatic diseases. To address limitations in these observational studies, Zhao et al. conducted a two-sample Mendelian randomization analysis to investigate the potential causal relationship between vitiligo and common rheumatic diseases, specifically RA, SLE, Sjögren’s syndrome, and ankylosing spondylitis.
Genetic instrumental variables for vitiligo and the rheumatic diseases were sourced from large-scale genome-wide association studies. Data for vitiligo came from the largest genome-wide association study meta-analysis, encompassing 4,680 cases and 39,586 controls of European ancestry. Outcome datasets for RA and SLE were obtained from the IEU OpenGWAS database, while data for Sjögren’s syndrome and ankylosing spondylitis were extracted from the FinnGen Biobank.
Findings
The analysis revealed a significant genetic connection between vitiligo and RA. Using the inverse variance weighted method, the odds ratio was 1.47, with a 95% confidence interval of 1.29 to 1.68, and a p-value of less than 0.001. This indicates that individuals with vitiligo have a 47% higher risk of developing RA compared to those without vitiligo. The weighted median method yielded similar results, further supporting this finding with an odds ratio of 1.28. Sensitivity analyses confirmed these results.
Regarding the relationship between vitiligo and SLE, initial analysis did not show a significant association. However, sensitivity analyses revealed significant variability. After removing outliers and reanalyzing, researchers noted a significant genetic link between vitiligo and SLE, suggesting individuals with vitiligo have a 22% higher risk of developing SLE.
The analysis did not find a significant genetic link between vitiligo and Sjögren’s syndrome or ankylosing spondylitis.
Conclusions
“Our Mendelian randomization study provides evidence supporting the idea that vitiligo leads to a higher risk of RA and SLE,” Zhao et al. stated. “This finding emphasizes the need for patients with vitiligo to remain vigilant and aware of the possible risk of developing RA and SLE. Regular monitoring is essential to manage and address this potential complication.”
These findings are corroborated by previous studies, including a large-scale epidemiological study (Choi CW, Eun SH, Choi KH, Bae JM, 2017) and a systematic study (Lee JH, Ju HJ, Seo JM, et al., 2023). Researchers recommend further validation of these findings through larger studies and samples.
Related Topics:
