Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
Pediatric Diabetes and Metabolic Disorders Unit, Department of Surgical Sciences, Dentistry, Pediatrics and Gynaecology, University Hospital of Verona, Verona, Italy.
Nutr Metab Cardiovasc Dis. 2023 May;33(5):1093-1097. doi: 10.1016/j.numecd.2023.03.004. Epub 2023 Mar 11.
Little is known about the relationship between patatin-like phospholipase domain-containing protein-3 (PNPLA3) rs738409 variant and decline in estimated glomerular filtration rate (eGFR) over time in individuals with type 2 diabetes (T2DM).
We enrolled an outpatient sample of 46 post-menopausal women with T2DM and preserved kidney function at baseline (in 2017), who were followed through 2022. eGFR and albuminuria were measured annually. Genotyping of PNPLA3 rs738409 was performed by TaqMan-based RT-PCR system. Overall, 25 (54.3%) patients had PNPLA3 rs738409 CC (homozygous wild-type) genotype and 21 had CG or GG genotypes. During the 5-year follow-up, the presence of rs738409 CG/GG genotypes was associated with faster eGFR decline (coefficient: -6.55; 95% CI -11.0 to -2.08; p = 0.004 by random-effects panel data analysis). This association remained significant even after adjustment for 5-year changes in age, hemoglobin A1c, hypertension status, albuminuria and use of sodium-glucose co-transporter-2 inhibitors or glucagon-like peptide-1 receptor agonists.
This pilot study suggests that in post-menopausal T2DM women with preserved kidney function at baseline, the risk allele (G) of PNPLA3 rs738409 is associated with a faster eGFR decline during a 5-year follow-up, independent of annual changes in common renal risk factors and use of certain glucose-lowering medications.
关于 patatin 样磷脂酶结构域蛋白 3（PNPLA3）rs738409 变体与 2 型糖尿病（T2DM）患者肾小球滤过率（eGFR）随时间下降的关系知之甚少。
我们招募了一个门诊样本，其中包括 46 名绝经后 T2DM 女性和基线时肾功能正常（2017 年）的患者，随访至 2022 年。每年测量 eGFR 和蛋白尿。通过 TaqMan 基于 RT-PCR 系统对 PNPLA3 rs738409 进行基因分型。总体而言，25 名（54.3%）患者具有 PNPLA3 rs738409 CC（纯合野生型）基因型，21 名患者具有 CG 或 GG 基因型。在 5 年的随访期间，rs738409 CG/GG 基因型的存在与 eGFR 下降速度更快相关（系数：-6.55；95%CI -11.0 至 -2.08；随机效应面板数据分析，p = 0.004）。即使在调整了 5 年内年龄、糖化血红蛋白、高血压状态、蛋白尿以及钠-葡萄糖共转运蛋白-2 抑制剂或胰高血糖素样肽-1 受体激动剂的使用变化后，这种相关性仍然显著。
这项初步研究表明，在基线时肾功能正常的绝经后 T2DM 女性中，PNPLA3 rs738409 的风险等位基因（G）与 5 年随访期间 eGFR 下降速度更快相关，独立于常见肾脏危险因素的年度变化和某些降糖药物的使用。
