Takkavatakarn Kullaya, Mohottige Dinushika, Charney Alexander W, Horowitz Carol, Rundle Andrew G, Chan Lili, Nadkarni Girish N
Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Division of Nephrology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Kidney Int Rep. 2025 Feb 25;10(5):1476-1485. doi: 10.1016/j.ekir.2025.02.015. eCollection 2025 May.
Apolipoprotein L1 () risk alleles G1 and G2, confer a higher risk of kidney outcomes but are influenced by other genetic and environmental factors. The interaction between neighborhood socioeconomic status (SES) and associated risk of kidney outcomes is unknown.
This retrospective study included self-reported Black individuals with genetic, clinical, and residential data. We defined the neighborhood as a 1 km radius circle around their primary residence and used a negative binomial regression model to analyze the interaction between variants and neighborhood SES, specifically poverty rate and median household income, for a composite kidney outcome of a sustained 30% estimated glomerular filtration rate (eGFR) decline or end-stage kidney disease (ESKD) over 8 years.
Of 4296 participants, 829 (19%) had the composite kidney outcome; 20% with and 9% without the composite outcome had high-risk genotypes. Higher poverty was associated with increased kidney risk (adjusted relative risk [aRR]: 1.08; 95% confidence interval [CI]: 1.01-1.17), whereas higher income was protective (aRR: 0.94; 95% CI: 0.89-0.98). Significant interactions were observed between and SES ( < 0.05). Among high-risk individuals, higher poverty was linked to lower risk (aRR: 0.86; 95% CI: 0.43-2.75), whereas higher income increased the risk (aRR: 1.07; 95% CI: 0.51-2.13).
Significant interactions between genotypes and neighborhood SES on kidney outcomes suggest that genetic risk may influence the impact of neighborhood SES on kidney health. Among individuals with high-risk variants, a higher neighborhood poverty rate was unexpectedly linked to lower risk, whereas higher neighborhood household income was associated with increased risk.
载脂蛋白L1（APOL1）风险等位基因G1和G2会增加肾脏疾病发生的风险，但会受到其他遗传和环境因素的影响。社区社会经济地位（SES）与APOL1相关的肾脏疾病发生风险之间的相互作用尚不清楚。
这项回顾性研究纳入了有基因、临床和居住数据的自我报告的黑人个体。我们将社区定义为其主要居住地周围半径1公里的圆圈，并使用负二项回归模型分析APOL1变体与社区SES（具体为贫困率和家庭收入中位数）之间的相互作用，以评估8年内持续30%的估计肾小球滤过率（eGFR）下降或终末期肾病（ESKD）这一复合肾脏结局。
在4296名参与者中，829名（19%）出现了复合肾脏结局；出现复合结局的参与者中有20%携带APOL1高风险基因型，未出现复合结局的参与者中有9%携带APOL1高风险基因型。更高的贫困程度与肾脏疾病风险增加相关（调整后相对风险[aRR]：1.08；95%置信区间[CI]：1.01 - 1.17），而更高的收入具有保护作用（aRR：0.94；95%CI：0.89 - 0.98）。观察到APOL1与SES之间存在显著的相互作用（P < 0.05）。在APOL1高风险个体中，更高的贫困程度与较低的风险相关（aRR：0.86；95%CI：0.43 - 2.75），而更高的收入会增加风险（aRR：1.07；95%CI：0.51 - 2.13）。
APOL1基因型与社区SES之间在肾脏结局方面存在显著相互作用，这表明APOL1遗传风险可能会影响社区SES对肾脏健康的影响。在携带APOL1高风险变体的个体中，社区贫困率较高意外地与较低风险相关，而社区家庭收入较高则与风险增加相关。
