Lopes A A, Port F K, James S A, Silveira M A, Martinelli R, Brito E, Rocha H
Nephrology and Epidemiology, Federal University of Bahia, Brazil.
Clin Nephrol. 2002 Nov;58(5):333-6. doi: 10.5414/cnp58333.
BACKGROUND/AIMS: United States investigators have shown evidence of higher susceptibility to focal segmental glomerulosclerosis (FSGS) in blacks than in whites. This association between race and FSGS has not been assessed outside the US. The present study assesses the association between race and type of glomerulonephritis in a sample of Brazilian patients, taking into account the presence of the hepatosplenic form of Schistosomiasis mansoni (HSM).
Eighty patients with focal segmental glomerulosclerosis (FSGS) were compared to 50 with membranoproliferative glomerulonephritis (MPGN). The association between race (i.e. black versus white) and type of glomerulonephritis was adjusted for age, gender and HSM by logistic regression.
Blacks were more likely than whites to have FSGS (as compared to MPGN), both among patients with HSM (odds ratio (OR) = 2.67; 95% confidence interval (CI) = 0.81 - 8.81) and without HSM (OR = 2.19; 95% CI = 0.79 - 6.05). After adjustment for age, gender and HSM, the odds of FSGS remained significantly greater for blacks (OR = 2.49; 95% CI = 1.05 - 5.95).
The increased likelihood of FSGS in Brazilian blacks is consistent with findings from US patients. The association between race and type of glomerulonephritis was similar between patients with and without HSM. Future investigations should focus on the mediators factors that might explain these findings.
背景/目的:美国研究人员已证实,黑人比白人更易患局灶节段性肾小球硬化症(FSGS)。在美国以外地区尚未评估种族与FSGS之间的这种关联。本研究在巴西患者样本中评估种族与肾小球肾炎类型之间的关联,并考虑曼氏血吸虫病肝脾型(HSM)的存在情况。
将80例局灶节段性肾小球硬化症(FSGS)患者与50例膜增生性肾小球肾炎(MPGN)患者进行比较。通过逻辑回归对种族(即黑人与白人)和肾小球肾炎类型之间的关联进行年龄、性别和HSM校正。
在患有HSM的患者(优势比(OR)=2.67;95%置信区间(CI)=0.81 - 8.81)和未患有HSM的患者(OR = 2.19;95% CI = 0.79 - 6.05)中,黑人比白人更易患FSGS(与MPGN相比)。在对年龄、性别和HSM进行校正后,黑人患FSGS的几率仍然显著更高(OR = 2.49;95% CI = 1.05 - 5.95)。
巴西黑人中FSGS患病可能性增加与美国患者的研究结果一致。患有和未患有HSM的患者中,种族与肾小球肾炎类型之间的关联相似。未来的研究应聚焦于可能解释这些结果的介导因素。