{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:47:23Z","timestamp":1787021243970,"version":"build-2736575974"},"reference-count":42,"publisher":"The Endocrine Society","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>The major histocompatibility complex (MHC) strongly contributes to the development of polyglandular autoimmunity (PGA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the impact of sex on human leukocyte antigen (HLA) association with PGA for the first time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional immunogenetic study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Academic tertiary referral Orphan Disease Center for PGA (ORPHA 282196) and immunogenetics laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects<\/jats:title>\n                    <jats:p>Patients (158) with coexistent type 1 diabetes and autoimmune thyroid disease (adult type 3 PGA, ORPHA 227982) and 479 unrelated healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>All 637 white subjects were typed for HLA-A, -B, -DRB1, -DQA1, and -DQB1 alleles at a two-field level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Modification of the gene-disease association by sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>MHC class I HLA-A association was sex related to both the total white adult type 3 PGA collective (n = 158, P = 0.0065), as well as in PGA patients with autoimmune Hashimoto thyroiditis (n = 91, P = 0.010). Compared with HLA-A*02:01, A*11:01 was over-represented in male patients, yet under-represented in women (OR 1.49, 95% CI 0.55 to 3.88 vs 0.42, 0.12 to 1.17). A*24:02 was under-represented in male but not in female patients (OR 0.37, 95% CI 0.11 to 1.04 vs 1.19, 0.65 to 2.15). With the exclusion of the five most frequent alleles (A*01:01, A*02:01, A*03:01, A*11:01, and A*24:02), the sum of all other identified alleles was under-represented in male patients (OR 0.37, 0.18 to 0.72, P = 0.0046). The strong MHC HLA-B association with PGA (P &amp;lt; 0.0001) was not sex related (P = 0.55). Furthermore, no interaction with sex was observed for the MHC class II HLA-DRB1, -DQA1, and -DQB1 alleles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MHC class I HLA-A association with type 3 PGA is significantly affected by sex.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/jc.2018-01974","type":"journal-article","created":{"date-parts":[[2018,12,5]],"date-time":"2018-12-05T14:03:42Z","timestamp":1544018622000},"page":"1680-1686","source":"Crossref","is-referenced-by-count":13,"title":["Sex Alters the MHC Class I HLA-A Association With Polyglandular Autoimmunity"],"prefix":"10.1210","volume":"104","author":[{"given":"Brigitte K","family":"Flesch","sequence":"first","affiliation":[{"name":"Laboratory of Immunogenetics\/HLA, German Red Cross Blood Service West, Bad Kreuznach and Hagen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochem","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Institute of Medical Biostatistics, Epidemiology and Informatics, Johannes Gutenberg University Medical Center, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Frommer","sequence":"additional","affiliation":[{"name":"Molecular Thyroid Research Laboratory, Johannes Gutenberg University Medical Center, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin P","family":"Hansen","sequence":"additional","affiliation":[{"name":"Molecular Thyroid Research Laboratory, Johannes Gutenberg University Medical Center, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0441-430X","authenticated-orcid":false,"given":"George J","family":"Kahaly","sequence":"additional","affiliation":[{"name":"Molecular Thyroid Research Laboratory, Johannes Gutenberg University Medical Center, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2018,12,5]]},"reference":[{"key":"2020071622051072400_B1","unstructured":"Orphanet. 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