APOL1 Risk Alleles, Cardiac Markers, and Risk of ESKD in African Americans: The Atherosclerosis Risk in Communities Study.
APOL1 Risk Alleles, Cardiac Markers, and Risk of ESKD in African Americans: The Atherosclerosis Risk in Communities Study.
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非裔美国人中的 APOL1 风险等位基因、心脏标志物和 ESKD 风险：社区研究中的动脉粥样硬化风险。
DOI：
10.1016/j.xkme.2020.02.007
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发表时间：
2020
期刊：
影响因子：
3.9
通讯作者：
Grams,MorganE
中科院分区：
文献类型：
--
作者：
Surapaneni,AdityaL;Ballew,ShoshanaH;Coresh,Josef;Ballantyne,ChristieM;Selvin,Elizabeth;Matsushita,Kunihiro;Grams,MorganE
与欧洲血统的人相比，非裔美国人患慢性肾脏疾病和肾衰竭的风险更高。这种风险部分归因于遗传因素。APOL1基因中存在2个风险等位基因，该基因型存在于13%的非裔美国人中，与终末期肾病（ESKD）风险增加2倍相关。然而，并非所有高危基因型患者都会发展为ESKD。有研究表明，“二次打击”，即暴露于增加APOL1高危基因型的风险，是肾功能下降所必需的。2心血管损伤可促进肾功能下降。心肌肌钙蛋白T、肌钙蛋白I和n端前脑利钠肽（NT-proBNP）是心脏损伤的标志物，用于诊断心肌梗死和心力衰竭，并且越来越多地被认为是预后标志物，即使在亚临床水平。3,4,5高敏感性心肌肌钙蛋白T （hs-cTnT）和NT-proBNP与ESKD相关。APOL1基因广泛表达，包括在脉管系统中。最近的一项研究表明，APOL1基因型与临床心血管疾病之间的关联很小；然而，这还没有使用更敏感的亚临床疾病标志物，如hs-cTnT、高灵敏度肌钙蛋白I （hs-TnI）和NT-proBNP进行测试。使用来自社区动脉粥样硬化风险（ARIC）研究中非裔美国参与者的数据，我们研究了APOL1基因型与这些心脏标志物的关系，并测试了较高水平的APOL1是否会增加与ESKD相关的风险。
African Americans face a higher risk for chronic kidney disease and kidney failure compared with people of European ancestry. Part of this risk has been attributed to genetic factors. The presence of 2 risk alleles in the APOL1 gene, a genotype present in 13% of African Americans, is associated with 2-fold increased risk for end-stage kidney disease (ESKD). 1 However, not everyone with the high-risk genotype progresses to ESKD. It has been suggested that a “second hit,” an exposure that increases the risk of the APOL1 high-risk genotype, is required for kidney function decline. 2Cardiovascular damage could play a role in precipitating kidney function decline. Cardiac troponin T, troponin I, and N-terminal pro–brain natriuretic peptide (NT-proBNP) are markers of cardiac damage that are used in diagnosing myocardial infarction and heart failure and are increasingly recognized as prognostic markers, even at subclinical levels. 3, 4, 5 High-sensitivity cardiac troponin T (hs-cTnT) and NT-proBNP have been associated with ESKD. 6 The APOL1 gene is widely expressed, including in the vasculature. A recent study 7 suggested minimal association between APOL1 genotype and clinical cardiovascular disease; however, this has not been tested using the more sensitive markers of subclinical disease, such as hs-cTnT, high-sensitivity troponin I (hs-TnI), and NT-proBNP. Using data from African American participants in the Atherosclerosis Risk in Communities (ARIC) Study, 8 we examined the associations of APOL1 genotypes with these cardiac markers and tested whether higher levels increased the risk of APOL1 associated with ESKD.