Hunt Steven C, Coon Hilary, Hasstedt Sandra J, Cawthon Richard M, Camp Nicola J, Wu Lily L, Hopkins Paul N
Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84108, USA.
Am J Hypertens. 2004 Jun;17(6):511-5. doi: 10.1016/j.amjhyper.2004.02.019.
Serum creatinine and creatinine clearance are used as indicators of renal function and may indicate a propensity for development of end-stage renal disease. Identifying genes related to future decreases in renal function could be important in assessing risk and defining abnormal mechanisms amenable to preventive measures. Although creatinine clearance is a better measure of renal function than serum creatinine, proper and complete urine collections in large population studies are sometimes problematic. This can lead to a loss in power to detect linkage. Therefore, in this study we also investigated serum creatinine and estimated glomerular filtration rates (GFR), both of which are more reliably measured.
Linkage was tested in a genome scan using 49 large Utah pedigrees examined three times over 10 years to detect regions harboring genes related to reduced renal function.
Heritability of serum creatinine ranged from 25% to 31% across three examinations, and heritability of GFR ranged from 37% to 42%. The highest log of the odds (LOD) score for serum creatinine was found on chromosome 2 at 145 cM on the Marshfield map (D2S1334). Consistent nonparametric linkage for serum creatinine was found for all three examinations (LOD = 3.15, 2.75, and 2.00, respectively). Estimates of GFR also showed linkage to this region.
The consistency of linkage to chromosome 2 over longitudinally repeated measurements increases the likelihood that this region harbors a gene influencing phenotypic variation in serum creatinine and GFR. Identification of this gene could help to predict which individuals are most likely to progress to renal disease.
血清肌酐和肌酐清除率被用作肾功能指标,可能预示着终末期肾病的发生倾向。识别与未来肾功能下降相关的基因,对于评估风险和明确适合采取预防措施的异常机制可能具有重要意义。尽管肌酐清除率比血清肌酐更能准确反映肾功能,但在大规模人群研究中,准确且完整地收集尿液有时存在问题。这可能导致检测连锁关系的效能降低。因此,在本研究中,我们还调查了血清肌酐和估计肾小球滤过率(GFR),这两者的测量更为可靠。
在一项基因组扫描中,对49个犹他州的大家系进行了检测,这些家系在10年中接受了三次检查,以检测与肾功能降低相关基因所在的区域。
在三次检查中,血清肌酐的遗传度范围为25%至31%,GFR的遗传度范围为37%至42%。在马什菲尔德图谱上,血清肌酐的最高对数优势(LOD)分数出现在2号染色体上145 cM处(D2S1334)。在所有三次检查中均发现了血清肌酐一致的非参数连锁关系(LOD分别为3.15、2.75和2.00)。GFR的估计值也显示与该区域存在连锁关系。
在纵向重复测量中,与2号染色体的连锁关系具有一致性,这增加了该区域存在影响血清肌酐和GFR表型变异基因的可能性。识别该基因有助于预测哪些个体最有可能发展为肾病。