APOL1 Kidney Risk Variants and Cardiovascular Disease: An Individual Participant Data Meta-Analysis
APOL1 Kidney Risk Variants and Cardiovascular Disease: An Individual Participant Data Meta-Analysis
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DOI：
10.1681/asn.2019030240
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发表时间：
2019-10-01
影响因子：
13.6
通讯作者：
Freedman, Barry, I
中科院分区：
文献类型：
--
作者：
Grams, Morgan E.;Surapaneni, Aditya;Freedman, Barry, I
背景载脂蛋白L1基因（APOL 1）的两个编码变异与黑人肾脏疾病密切相关。肾脏疾病本身会增加心血管疾病的风险，但这些变异是否对心血管疾病的风险有独立的直接影响尚不清楚。以前的研究有不一致的结果。方法我们进行了两个阶段的个人参与者数据荟萃分析，以评估APOL 1肾脏风险变异与裁定的心血管疾病事件和死亡的关联，独立于肾脏措施。该分析包括21,305黑人从8个大cohols.Results超过8.9 +/- 5.0年的后续行动，2076事件心血管疾病事件发生在16,216参与者谁没有心血管疾病在研究登记。在完全校正的分析中，与零或一个肾脏风险变异的个体相比，拥有两个APOL 1肾脏风险变异的个体发生心血管疾病（冠心病，心肌梗死，中风和心力衰竭;风险比1.11，95%置信区间，0.96至1.28）的风险相似。APOL 1基因型与冠心病、心肌梗死、中风和心力衰竭的风险也有可比性。APOL 1基因型也与死亡无关。有调整协会的肾功能，年龄，糖尿病状态，或body-mass index.Conclusions水平没有差异，在这个大的，两个阶段的个人参与者数据荟萃分析，APOL 1肾脏风险变异与独立的肾脏措施的心血管疾病或死亡事件无关。
Background Two coding variants in the apo L1 gene (APOL1) are strongly associated with kidney disease in blacks. Kidney disease itself increases the risk of cardiovascular disease, but whether these variants have an independent direct effect on the risk of cardiovascular disease is unclear. Previous studies have had inconsistent results.Methods We conducted a two-stage individual participant data meta-analysis to assess the association of APOL1 kidney-risk variants with adjudicated cardiovascular disease events and death, independent of kidney measures. The analysis included 21,305 blacks from eight large cohorts.Results Over 8.9 +/- 5.0 years of follow-up, 2076 incident cardiovascular disease events occurred in the 16,216 participants who did not have cardiovascular disease at study enrollment. In fully-adjusted analyses, individuals possessing two APOL1 kidney-risk variants had similar risk of incident cardiovascular disease (coronary heart disease, myocardial infarction, stroke and heart failure; hazard ratio 1.11, 95% confidence interval, 0.96 to 1.28) compared to individuals with zero or one kidney-risk variant. The risk of coronary heart disease, myocardial infarction, stroke and heart failure considered individually was also comparable by APOL1 genotype. APOL1 genotype was also not associated with death. There was no difference in adjusted associations by level of kidney function, age, diabetes status, or body-mass index.Conclusions In this large, two-stage individual participant data meta-analysis, APOL1 kidney-risk variants were not associated with incident cardiovascular disease or death independent of kidney measures.