Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany.
Medical Clinic V, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany.
Sci Rep. 2019 Feb 26;9(1):2750. doi: 10.1038/s41598-019-39055-y.
Chronic kidney disease (CKD) is an independent risk factor for onset and progression of coronary artery disease (CAD). Discovery of predisposing loci for kidney function in CAD patients was performed using a genome-wide association approach. Inclusion criteria were CAD with ≥50% stenosis (≥1 coronary artery) and a creatinine-based estimated glomerular filtration rate (eGFR) of 30-75 ml/min/1.73 m. An association of rs139401390 located to a region 58.8 kb upstream of renalase (RNLS) with eGFR was detected in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study (n = 499, p = 7.88 × 10, mean eGFR 60.7 ml/min/1.73 m). Direct genotyping of rs139401390A > G suggested increased eGFR by 12.0 ml/min/1.73 m per A allele (p = 0.000004). Genome-wide replication of rs139401390A > G in the Coronary Artery Disease and Renal Failure (CAD-REF) registry with a mean eGFR of 47.8 ml/min/1.73 m (n = 574, p = 0.033) was only nominally significant. Comparison of rs139401390 genotypes for risk of reduced kidney function in the overall LURIC study revealed higher adjusted odds ratios (OR) for eGFR <60 ml/min/1.73 m for CAD patients (n = 1992, OR = 2.36, p = 0.008, G/A + G/G vs A/A) compared to patients with/without CAD (n = 2908, OR = 1.97, p = 0.014, G/A + G/G vs A/A). No significant risk elevation was detected in patients without CAD (n = 948, p = 0.571). rs139401390 may affect kidney function in CAD patients with mild reduction in eGFR.
慢性肾脏病 (CKD) 是冠状动脉疾病 (CAD) 发病和进展的独立危险因素。使用全基因组关联方法发现 CAD 患者肾功能易感性基因座。纳入标准为≥50%狭窄(≥1 支冠状动脉)的 CAD 和基于肌酐的估算肾小球滤过率(eGFR)为 30-75ml/min/1.73m。在路德维希港风险和心血管健康 (LURIC) 研究中,发现位于肾酶 (RNLS) 上游 58.8kb 处的 rs139401390 与 eGFR 相关(n=499,p=7.88×10,平均 eGFR 为 60.7ml/min/1.73m)。rs139401390A>G 的直接基因分型表明,每个 A 等位基因使 eGFR 增加 12.0ml/min/1.73m(p=0.000004)。在平均 eGFR 为 47.8ml/min/1.73m 的冠状动脉疾病和肾衰竭 (CAD-REF) 登记处进行的全基因组 rs139401390A>G 复制,p=0.033,仅具有名义显著性。在整个 LURIC 研究中,比较 rs139401390 基因型对肾功能下降风险的影响发现,对于 eGFR<60ml/min/1.73m 的 CAD 患者(n=1992,OR=2.36,p=0.008,G/A+G/G 与 A/A),调整后的比值比(OR)更高与有/无 CAD 的患者(n=2908,OR=1.97,p=0.014,G/A+G/G 与 A/A)相比。在无 CAD 的患者中未发现显著的风险升高(n=948,p=0.571)。rs139401390 可能会影响 eGFR 轻度降低的 CAD 患者的肾功能。