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