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肾移植后血脂异常相关临床及遗传风险因素的特征分析

Characterization of clinical and genetic risk factors associated with dyslipidemia after kidney transplantation.

作者信息

Numakura Kazuyuki, Kagaya Hideaki, Yamamoto Ryohei, Komine Naoki, Saito Mitsuru, Hiroshi Tsuruta, Akihama Susumu, Inoue Takamitsu, Narita Shintaro, Tsuchiya Norihiko, Habuchi Tomonori, Niioka Takenori, Miura Masatomo, Satoh Shigeru

机构信息

Department of Urology, Akita University Graduate School of Medicine, Akita 010-8543, Japan.

Department of Pharmacy, Akita University Hospital, Akita 010-8543, Japan.

出版信息

Dis Markers. 2015;2015:179434. doi: 10.1155/2015/179434. Epub 2015 Apr 6.

Abstract

We determined the prevalence of dyslipidemia in a Japanese cohort of renal allograft recipients and investigated clinical and genetic characteristics associated with having the disease. In total, 126 patients that received renal allograft transplants between February 2002 and August 2011 were studied, of which 44 recipients (34.9%) were diagnosed with dyslipidemia at 1 year after transplantation. Three clinical factors were associated with a risk of having dyslipidemia: a higher prevalence of disease observed among female than male patients (P = 0.021) and treatment with high mycophenolate mofetil (P = 0.012) and prednisolone (P = 0.023) doses per body weight at 28 days after transplantation. The genetic association between dyslipidemia and 60 previously described genetic polymorphisms in 38 putative disease-associated genes was analyzed. The frequency of dyslipidemia was significantly higher in patients with the glucocorticoid receptor (NR3C1) Bcl1 G allele than in those with the CC genotype (P = 0.001). A multivariate analysis revealed that the NR3C1 Bcl1 G allele was a significant risk factor for the prevalence of dyslipidemia (odds ratio = 4.6; 95% confidence interval = 1.8-12.2). These findings may aid in predicting a patient's risk of developing dyslipidemia.

摘要

我们确定了日本肾移植受者队列中血脂异常的患病率,并研究了与该病相关的临床和遗传特征。总共对2002年2月至2011年8月期间接受肾移植的126例患者进行了研究,其中44例受者(34.9%)在移植后1年被诊断为血脂异常。有三个临床因素与血脂异常风险相关:女性患者中该病的患病率高于男性(P = 0.021),以及移植后28天每体重使用高剂量霉酚酸酯(P = 0.012)和泼尼松龙(P = 0.023)治疗。分析了血脂异常与38个假定疾病相关基因中60个先前描述的基因多态性之间的遗传关联。糖皮质激素受体(NR3C1)Bcl1 G等位基因的患者中血脂异常的频率显著高于CC基因型患者(P = 0.001)。多变量分析显示,NR3C1 Bcl1 G等位基因是血脂异常患病率的一个显著风险因素(比值比 = 4.6;95%置信区间 = 1.8 - 12.2)。这些发现可能有助于预测患者发生血脂异常的风险。

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