Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany.
J Am Soc Nephrol. 2011 Mar;22(3):555-70. doi: 10.1681/ASN.2010060598.
Identification of genetic risk factors for albuminuria may alter strategies for early prevention of CKD progression, particularly among patients with diabetes. Little is known about the influence of common genetic variants on albuminuria in both general and diabetic populations. We performed a meta-analysis of data from 63,153 individuals of European ancestry with genotype information from genome-wide association studies (CKDGen Consortium) and from a large candidate gene study (CARe Consortium) to identify susceptibility loci for the quantitative trait urinary albumin-to-creatinine ratio (UACR) and the clinical diagnosis microalbuminuria. We identified an association between a missense variant (I2984V) in the CUBN gene, which encodes cubilin, and both UACR (P = 1.1 × 10(-11)) and microalbuminuria (P = 0.001). We observed similar associations among 6981 African Americans in the CARe Consortium. The associations between this variant and both UACR and microalbuminuria were significant in individuals of European ancestry regardless of diabetes status. Finally, this variant associated with a 41% increased risk for the development of persistent microalbuminuria during 20 years of follow-up among 1304 participants with type 1 diabetes in the prospective DCCT/EDIC Study. In summary, we identified a missense CUBN variant that associates with levels of albuminuria in both the general population and in individuals with diabetes.
遗传风险因素鉴定可能会改变慢性肾脏病(CKD)进展的早期预防策略,尤其是在糖尿病患者中。目前对于常见遗传变异对普通人群和糖尿病患者白蛋白尿的影响知之甚少。我们对来自欧洲血统的 63153 名个体的全基因组关联研究(CKDGen 联盟)和大型候选基因研究(CARe 联盟)的数据进行了荟萃分析,以确定尿白蛋白与肌酐比值(UACR)的定量特征和微量白蛋白尿的易感性基因座。我们在 CUBN 基因(编码巨球蛋白)中的一个错义变异(I2984V)与 UACR(P = 1.1×10(-11))和微量白蛋白尿(P = 0.001)之间发现了关联。我们在 CARe 联盟中的 6981 名非裔美国人中观察到了类似的关联。无论糖尿病状态如何,该变异与 UACR 和微量白蛋白尿之间的关联在欧洲血统个体中均具有统计学意义。最后,在前瞻性 DCCT/EDIC 研究中,该变异与 1304 名 1 型糖尿病患者 20 年随访期间持续性微量白蛋白尿的发展风险增加 41%相关。总之,我们鉴定了一个 CUBN 错义变异,该变异与普通人群和糖尿病患者的白蛋白尿水平相关。