Department of Physiology, American University of Beirut, Beirut, Lebanon.
Nephrol Dial Transplant. 2010 Dec;25(12):3962-9. doi: 10.1093/ndt/gfq302. Epub 2010 Jun 4.
Differences in epidemiology of kidney disease across the Middle East may arise from variations in indication for biopsy, environmental exposure and socio-economic status. The Lebanese population is composed of different ethnicities, with distinct ancestry and religion, enabling comparison of their effect on the prevalence of kidney disease within a confined geographic setting and uniform practices. Here we report 5 years' detailed epidemiology of renal diseases, based on histological diagnosis, in a sample from three large pathology centres in Lebanon.
Records of renal biopsies analysed at the American University of Beirut Medical Center, Hotel Dieu de France Hospital and the Institut National de Pathologie from January 2003 till December 2007 were retrospectively examined. We recorded the following data for each patient: age, gender, indication for renal biopsy and histopathological diagnosis. Religious affiliation and parents' consanguinity were recorded when feasible.
The mean age at renal biopsy was 36.76 ± 20 years (range 1-84). The most common diagnosis was mesangioproliferative glomerulonephritis (GN; 20%), followed by focal segmental glomerulosclerosis (13.2%). While there were no differences in age, gender or indications for biopsy among different religious affiliations, mesangioproliferative GN was significantly more frequent among Muslims (P = 0.039) and offspring of consanguineous unions (P = 0.036). On the other hand, focal segmental glomerulosclerosis was most prevalent in Christians (P < 0.001).
Variation in the distribution of diagnoses between Muslim and Christian groups likely reflects differences in population structure and ancestry. In particular, the increased prevalence of mesangioproliferative GN among offspring of consanguineous unions in Muslims suggests a recessive genetic component to this disease which may be identified via homozygosity mapping. These findings have important implications for formulating renal health policies and designing research studies in this population.
中东地区肾脏病的流行病学差异可能源于活检指征、环境暴露和社会经济地位的差异。黎巴嫩人口由不同的种族组成，具有不同的祖先和宗教，这使得我们能够在一个有限的地理环境和统一的实践中比较他们对肾脏病患病率的影响。在这里，我们报告了基于组织学诊断的 5 年来黎巴嫩三个大型病理中心样本的肾脏疾病详细流行病学。
回顾性分析了 2003 年 1 月至 2007 年 12 月贝鲁特美国大学医学中心、法国医院和国家病理学研究所的肾脏活检记录。我们记录了每位患者的以下数据：年龄、性别、肾脏活检指征和组织病理学诊断。在可行的情况下，记录了宗教信仰和父母近亲结婚情况。
肾脏活检的平均年龄为 36.76 ± 20 岁（范围 1-84 岁）。最常见的诊断是系膜增生性肾小球肾炎（GN；20%），其次是局灶节段性肾小球硬化症（FSGS；13.2%）。虽然不同宗教信仰之间的年龄、性别或活检指征没有差异，但系膜增生性 GN 在穆斯林中明显更为常见（P = 0.039），在近亲结婚的后代中也更为常见（P = 0.036）。另一方面，局灶节段性肾小球硬化症在基督教徒中最为常见（P < 0.001）。
在穆斯林和基督教群体之间，诊断分布的差异可能反映了人群结构和祖先的差异。特别是，在穆斯林近亲结婚的后代中，系膜增生性 GN 的发病率增加，这表明这种疾病可能存在隐性遗传成分，可以通过纯合性作图来识别。这些发现对制定该人群的肾脏健康政策和设计研究具有重要意义。
