国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
2023-07-10
已发表文章
主要研究背景及目的
糖尿病肾病（DKD）影响约30%至40%的糖尿病患者，是终末期肾病的主要原因。蛋白尿增多、肾脏滤过功能受损是DKD进展的主要决定因素，然而早期识别2型糖尿病患者进展至终末期肾衰竭的高危因素一直是个挑战。全基因组关联研究（GWAS）已经确定了几十个与2型糖尿病相关的位点，也有一些证据表明2型糖尿病位点与糖尿病肾病有关，如PPARG、KCNQ1、TCF7L2等。考虑到近期发现的大量新的2型糖尿病位点，这些基因与肾损伤的相关性值得在亚洲人群中进行研究，而卒中人群糖尿病、CKD高发。 因此我们拟对GWAS验证的2型糖尿病相关的SNP与糖尿病肾病发生、进展的相关性进行分析。
方法
The association of eight LPL single nucleotide polymorphisms (SNPs) with DKD was analysed in 2793 patients with T2D from the third China National Stroke Registry. DKD was defined as either an urine albumin-to-creatinine ratio (UACR) of 30 mg/g or higher at baseline and 3 months, or an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m2 at baseline and 3 months. Rapid decline in kidney function (RDKF) was defined as a reduction in the eGFR of 3 mL/min/1.73 m2 or greater per year. Logistic regression models were used to evaluate the association of LPL SNP and DKD with an additive model.
结论
These results suggest that LPL-related SNPs are new candidate factors for conferring susceptibility to DKD and may promote rapid loss of renal function in Chinese patients with T2D.
主要结果
The SNPs rs285 C>T (OR = 1.40, P = .0154), rs328 C>G (OR = 2.24, P = .0104) and rs3208305 A>T (OR = 1.85, P = .0015) were identified to be significantly associated with DKD defined by eGFR. Among 1241 participants with followup data, 441 (35.5%) showed RDKF over a mean follow-up period of 1 year, and the rs285 C allele was associated with higher odds of RDKF (OR = 1.31, 95% CI 1.04-1.66; P = .025) after adjustment for multiple variables.