Plasma proenkephalin A and incident chronic kidney disease and albuminuria in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
Plasma proenkephalin A and incident chronic kidney disease and albuminuria in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
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DOI：
10.1186/s12882-023-03432-7
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发表时间：
2024-01-10
期刊：
影响因子：
2.3
通讯作者：
Rifkin, Dena E.
中科院分区：
文献类型：
--
作者：
Bullen, Alexander L.;Katz, Ronit;Poursadrolah, Sayna;Short, Samuel A. P.;Long, D. Leann;Cheung, Katharine L.;Sharma, Shilpa;Al-Rousan, Tala;Fregoso, Alma;Schulte, Janin;Gutierrez, Orlando M.;Shlipak, Michael G.;Cushman, Mary;Ix, Joachim H.;Rifkin, Dena E.
血浆脑啡肽原A（PENK-A）是活性脑啡肽的前体。在欧洲人群中，较高的血药浓度与估计的肾小球滤过率（eGFR）下降相关。由于白色人和黑人之间慢性肾病（CKD）发病率的显著差异，我们在美国的一个birthday队列中评估了PENK-A与CKD发病率和其他肾脏结局的相关性。在一个4,400名参与者的嵌套队列中，我们使用肌酐-半胱氨酸蛋白酶抑制剂C CKD-EPI 2021方程确定了基线PENK-A浓度和CKD事件之间的关系，该方程没有种族系数，显著的eGFR下降，和9.4年后随访访视之间的蛋白尿事件。我们测试了种族和性别的相互作用。我们使用逆概率抽样权重来解释抽样设计。基线时，平均（SD）年龄为64（8）岁，49%为女性，52%为黑人参与者。8.5%发生CKD，21%发生eGFR下降≥ 30%，18%发生蛋白尿。PENK-A与CKD事件之间没有关联，种族或性别之间也没有差异。然而，较高的PENK-A与进行性eGFR下降的几率增加相关（OR：1.12; 95% CI 1.00，1.25）。在非糖尿病患者中，较高的PENK-A浓度与蛋白尿事件密切相关（OR：1.29; 95% CI 1.09，1.53）。虽然PENK-A与CKD事件无关，但在无糖尿病患者中，其与CKD进展和蛋白尿事件的相关性表明，它可能是评价白色和黑人患者肾脏疾病的有用工具。
Plasma proenkephalin A (PENK-A) is a precursor of active enkephalins. Higher blood concentrations have been associated with estimated glomerular filtration rate (eGFR) decline in European populations. Due to the significant disparity in incident chronic kidney disease (CKD) between White and Black people, we evaluated the association of PENK-A with incident CKD and other kidney outcomes among a biracial cohort in the U.S. In a nested cohort of 4,400 participants among the REasons for Geographic And Racial Differences in Stroke, we determined the association between baseline PENK-A concentration and incident CKD using the creatinine-cystatin C CKD-EPI 2021 equation without race coefficient, significant eGFR decline, and incident albuminuria between baseline and a follow-up visit 9.4 years later. We tested for race and sex interactions. We used inverse probability sampling weights to account for the sampling design. At baseline, mean (SD) age was 64 (8) years, 49% were women, and 52% were Black participants. 8.5% developed CKD, 21% experienced ≥ 30% decline in eGFR and 18% developed albuminuria. There was no association between PENK-A and incident CKD and no difference by race or sex. However, higher PENK-A was associated with increased odds of progressive eGFR decline (OR: 1.12; 95% CI 1.00, 1.25). Higher PENK-A concentration was strongly associated with incident albuminuria among patients without diabetes mellitus (OR: 1.29; 95% CI 1.09, 1.53). While PENK-A was not associated with incident CKD, its associations with progression of CKD and incident albuminuria, among patients without diabetes, suggest that it might be a useful tool in the evaluation of kidney disease among White and Black patients.
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影响因子：
2.6
作者：
Kieneker, Lyanne M.;Hartmann, Oliver;Bakker, Stephan J. L.
通讯作者：
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影响因子：
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作者：
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DOI：
10.1038/s41581-022-00538-3
发表时间：
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作者：
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作者：
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