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遗传风险评分与日本人群慢性肾脏病的关联。

Association of genetic risk score and chronic kidney disease in a Japanese population.

机构信息

Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Nephrology (Carlton). 2019 Jun;24(6):670-673. doi: 10.1111/nep.13479. Epub 2019 Apr 29.

Abstract

Chronic kidney disease (CKD) is a public health problem worldwide including Japan. Recent genome-wide association studies have discovered CKD susceptibility variants. We developed a genetic risk score (GRS) based on CKD-associated variants and assessed a possibility that the GRS can improve the discrimination capability for the prevalence of CKD in a Japanese population. The present study consists of 11 283 participants randomly selected from 12 Japan Multi-Institutional Collaborative Cohort Study sites. Individual GRS was constructed combining 18 single-nucleotide polymorphisms identified in a Japanese population. Participants with eGFR <60 mL/min per 1.73 m was defined as case (stage 3 CKD or higher) in this study. Logistic regression analysis was used to examine the association between the GRS and CKD risk with adjustment for sex, age, hypertension and type 2 diabetes mellitus. The frequency of individuals with CKD was 8.3%, which was relatively low compared with those previously reported in a Japanese population. The odds ratio of having CKD was 1.120 (95% confidence interval: 1.042-1.203) per 10 GRS increment in the fully adjusted model (P = 0.002). The C-statistic was significantly increased in the model with the GRS, comparing with the model without the GRS (0.720 vs 0.719, P  = 0.008). Increment of the GRS was associated with increased risk of CKD. Additionally, the GRS significantly improved the discriminatory ability of CKD prevalence in a Japanese population; however, the improvement of discriminatory ability brought about by the GRS seemed to be small compared with that of non-genetic CKD risk factors.

摘要

慢性肾脏病(CKD)是一个全球性的公共卫生问题,包括日本。最近的全基因组关联研究发现了 CKD 易感性变异。我们基于与 CKD 相关的变异开发了一个遗传风险评分(GRS),并评估了该 GRS 是否可以提高日本人群 CKD 患病率的区分能力。本研究包括从 12 个日本多机构合作队列研究地点随机选择的 11283 名参与者。个体 GRS 是通过结合在日本人群中鉴定出的 18 个单核苷酸多态性构建的。在本研究中,将 eGFR<60 mL/min/1.73 m 的个体定义为病例(CKD 3 期或更高)。使用 logistic 回归分析来检验 GRS 与 CKD 风险之间的关联,调整性别、年龄、高血压和 2 型糖尿病。CKD 患者的频率为 8.3%,与之前报道的日本人群相比相对较低。在完全调整的模型中,GRS 每增加 10 个单位,CKD 的优势比为 1.120(95%置信区间:1.042-1.203)(P=0.002)。与不包含 GRS 的模型相比,包含 GRS 的模型的 C 统计量显著增加(0.720 比 0.719,P=0.008)。GRS 的增加与 CKD 风险的增加相关。此外,GRS 显著提高了日本人群 CKD 患病率的区分能力;然而,与非遗传 CKD 危险因素相比,GRS 带来的区分能力的提高似乎较小。

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