Department of Internal Medicine - Section on Nephrology, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, N.C., USA.
Am J Nephrol. 2013;38(6):453-7. doi: 10.1159/000356244. Epub 2013 Nov 21.
Population ancestry-based differences exist in genetic risk for many kidney diseases. Substantial debate remains regarding returning genetic test results to participants. African-Americans (AAs) and European-Americans (EAs) at risk for end-stage kidney disease were queried for views on the value and use of genetic testing in research.
A standardized survey regarding attitudes toward genetic testing was administered to 130 individuals (64 AA, 66 EA) with first-degree relatives on dialysis. Fisher's exact test was used to assess differences in participant attitudes between population groups.
Mean (SD) age of surveyed AAs and EAs was 45.5 (12.8) and 50.5 (14.4) years, respectively (p = 0.04), with similar familial relationships (p = 0.22). AAs and EAs wished to know their test results if risk could be: (1) reduced by diet or exercise (100 and 98%, p = 0.99); (2) reduced by medical treatment (100 and 98%, p = 0.99), or (3) if no treatments were available (90 and 82%, p = 0.21). If informed they lacked a disease susceptibility variant, 87% of AAs and 88% of EAs would be extremely or pretty likely to inform family members (p = 0.84). If informed they had a disease susceptibility variant, 92% of AAs and 89% of EAs would be extremely or pretty likely to inform their family (p = 0.43).
Attitudes toward obtaining and using genetic test results for disease in research contexts were similar in AAs and EAs at risk for end-stage kidney disease. A substantial majority would want information regardless of available treatments and would share the information with the family. These results have important implications for patient care, study design and the informed consent process.
许多肾脏疾病的遗传风险存在基于人群的差异。关于将基因检测结果返还给参与者,仍存在大量争议。对有患终末期肾病风险的非裔美国人和欧洲裔美国人进行了调查,以了解他们对基因检测在研究中的价值和用途的看法。
对 130 名(64 名非裔美国人,66 名欧洲裔美国人)一级亲属正在接受透析的个体进行了一项关于遗传检测态度的标准化调查。采用 Fisher 精确检验评估人群组间参与者态度的差异。
接受调查的非裔美国人和欧洲裔美国人的平均(SD)年龄分别为 45.5(12.8)和 50.5(14.4)岁(p=0.04),家族关系相似(p=0.22)。如果风险可以:(1)通过饮食或运动降低(100%和 98%,p=0.99);(2)通过医疗治疗降低(100%和 98%,p=0.99),或(3)如果没有治疗方法(90%和 82%,p=0.21),非裔美国人和欧洲裔美国人都希望知道自己的检测结果。如果被告知他们缺乏疾病易感性变异,87%的非裔美国人和 88%的欧洲裔美国人非常或很可能会告知家人(p=0.84)。如果被告知他们有疾病易感性变异,92%的非裔美国人和 89%的欧洲裔美国人非常或很可能会告知家人(p=0.43)。
在有患终末期肾病风险的非裔美国人和欧洲裔美国人中,对在研究背景下获得和使用疾病基因检测结果的态度相似。绝大多数人无论是否有治疗方法都希望获得信息,并将信息与家人分享。这些结果对患者护理、研究设计和知情同意过程具有重要意义。