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糖尿病肾病:所报道的与单核苷酸多态性的关联是否具有疾病特异性?

Diabetic kidney disease: Are the reported associations with single-nucleotide polymorphisms disease-specific?

作者信息

Saracyn Marek, Kisiel Bartłomiej, Franaszczyk Maria, Brodowska-Kania Dorota, Żmudzki Wawrzyniec, Małecki Robert, Niemczyk Longin, Dyrla Przemysław, Kamiński Grzegorz, Płoski Rafał, Niemczyk Stanisław

机构信息

Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, Warsaw 04-141, Poland.

Clinical Research Support Center, Military Institute of Medicine, Warsaw 04-141, Poland.

出版信息

World J Diabetes. 2021 Oct 15;12(10):1765-1777. doi: 10.4239/wjd.v12.i10.1765.

Abstract

BACKGROUND

The genetic backgrounds of diabetic kidney disease (DKD) and end-stage kidney disease (ESKD) have not been fully elucidated.

AIM

To examine the individual and cumulative effects of single-nucleotide polymorphisms (SNPs) previously associated with DKD on the risk for ESKD of diabetic etiology and to determine if any associations observed were specific for DKD.

METHODS

Fourteen SNPs were genotyped in hemodialyzed 136 patients with diabetic ESKD (DKD group) and 121 patients with non-diabetic ESKD (NDKD group). Patients were also re-classified on the basis of the primary cause of chronic kidney disease (CKD). The distribution of alleles was compared between diabetic and non-diabetic groups as well as between different sub-phenotypes. The weighted multilocus genetic risk score (GRS) was calculated to estimate the cumulative risk conferred by all SNPs. The GRS distribution was then compared between the DKD and NDKD groups as well as in the groups according to the primary cause of CKD.

RESULTS

One SNP (rs841853; SLC2A1) showed a nominal association with DKD ( = 0.048; > 0.05 after Bonferroni correction). The GRS was higher in the DKD group (0.615 ± 0.260) than in the NDKD group (0.590 ± 0.253), but the difference was not significant ( = 0.46). The analysis of associations between GRS and individual factors did not show any significant correlation. However, the GRS was significantly higher in patients with glomerular disease than in those with tubulointerstitial disease ( = 0.014) and in those with a combined group (tubulointerstitial, vascular, and cystic and congenital disease) ( = 0.018).

CONCLUSION

Our results suggest that selected SNPs that were previously associated with DKD may not be specific for DKD and may confer risk for CKD of different etiology, particularly those affecting renal glomeruli.

摘要

背景

糖尿病肾病(DKD)和终末期肾病(ESKD)的遗传背景尚未完全阐明。

目的

研究先前与DKD相关的单核苷酸多态性(SNP)对糖尿病病因所致ESKD风险的个体和累积影响,并确定所观察到的任何关联是否为DKD所特有。

方法

对136例接受血液透析的糖尿病ESKD患者(DKD组)和121例非糖尿病ESKD患者(NDKD组)进行了14个SNP的基因分型。患者还根据慢性肾脏病(CKD)的主要病因进行了重新分类。比较了糖尿病组和非糖尿病组以及不同亚表型之间等位基因的分布。计算加权多位点遗传风险评分(GRS)以估计所有SNP所赋予的累积风险。然后比较DKD组和NDKD组之间以及根据CKD主要病因分组的各组之间的GRS分布。

结果

一个SNP(rs841853;SLC2A1)与DKD存在名义上的关联(P = 0.048;经Bonferroni校正后P>0.05)。DKD组的GRS(0.615±0.260)高于NDKD组(0.590± O.253),但差异无统计学意义(P = 0.46)。GRS与个体因素之间的关联分析未显示任何显著相关性。然而,肾小球疾病患者的GRS显著高于肾小管间质疾病患者(P = O.014)和合并组(肾小管间质、血管以及囊性和先天性疾病)患者(P = 0.018)。

结论

我们的结果表明,先前与DKD相关的特定SNP可能并非DKD所特有,可能会增加不同病因CKD(尤其是影响肾小球的病因)的风险。

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本文引用的文献

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Genetic and Epigenetic Studies in Diabetic Kidney Disease.糖尿病肾病的遗传与表观遗传学研究
Front Genet. 2019 Jun 7;10:507. doi: 10.3389/fgene.2019.00507. eCollection 2019.

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