University of Alabama at Birmingham, Birmingham, Alabama, USA.
Institute for Transplantation in Urology and Nephrology and Ecole Centrale de Nantes, Nantes, France.
Kidney Int. 2018 Mar;93(3):727-732. doi: 10.1016/j.kint.2017.08.019. Epub 2017 Oct 14.
Prior studies reported associations of APOL1 nephropathy risk variants with subclinical atherosclerosis. However, these findings were limited to older individuals with high comorbidities. To evaluate this in younger individuals, we calculated associations of APOL1 risk variants (high risk [2 risk variants] vs. low risk [0-1 risk variant]) with prevalent, incident, or progressive coronary artery calcification, a carotid intima media thickness over the 90th percentile, and left ventricular hypertrophy in 1315 black participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study. The mean age of this cohort was 44.6 years and their mean estimated glomerular filtration rate was 102.5 ml/min/1.73m. High-risk participants were found to be younger and have a higher prevalence of albuminuria than low-risk participants. In Poisson regression models adjusted for comorbidities and kidney function, the risk of prevalent coronary artery calcification (relative risk [95% confidence interval] 1.12 [0.72,1.71]), the incident coronary artery calcification (1.50 [0.87,2.59]), and the progression of coronary artery calcification (1.40 [0.88,2.23]) did not significantly differ in high vs. low-risk participants. Furthermore, the risk of carotid intima media thickness over the 90th percentile (1.28 [0.78,2.10]) and left ventricular hypertrophy (1.02[0.73,1.43]) did not significantly differ in high vs. low-risk participants in fully-adjusted models. Thus, APOL1 risk variants did not associate with subclinical markers of atherosclerosis or left ventricular hypertrophy in middle-aged black adults with preserved kidney function.
先前的研究报告称,APOL1 肾病风险变异与亚临床动脉粥样硬化有关。然而,这些发现仅限于患有多种合并症的老年人。为了在更年轻的人群中评估这一点,我们计算了 APOL1 风险变异(高风险[2 个风险变异]与低风险[0-1 个风险变异])与普遍存在的、新发的或进展性冠状动脉钙化、超过第 90 百分位数的颈动脉内膜中层厚度以及 1315 名黑人参与者的左心室肥厚的关联,这些参与者均来自于年轻人冠状动脉风险发展研究(CARDIA)。该队列的平均年龄为 44.6 岁,平均估算肾小球滤过率为 102.5ml/min/1.73m。高风险组的参与者比低风险组更年轻,且蛋白尿的患病率更高。在调整合并症和肾功能的泊松回归模型中,普遍存在的冠状动脉钙化(相对风险[95%置信区间]1.12[0.72,1.71])、新发冠状动脉钙化(1.50[0.87,2.59])和冠状动脉钙化进展(1.40[0.88,2.23])的风险在高风险与低风险参与者之间没有显著差异。此外,颈动脉内膜中层厚度超过第 90 百分位数(1.28[0.78,2.10])和左心室肥厚(1.02[0.73,1.43])的风险在完全调整的模型中也没有在高风险与低风险参与者之间有显著差异。因此,APOL1 风险变异与肾功能正常的中年黑人亚临床动脉粥样硬化或左心室肥厚标志物无关。