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APOL1 Kidney Risk Variants and Cardiovascular Disease: An Individual Participant Data Meta-Analysis.

Morgan E Grams1,2,3, Aditya Surapaneni2,3, Shoshana H Ballew2,3

  • 1Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; mgrams2@jhmi.edu.

Journal of the American Society of Nephrology : JASN
|August 7, 2019
PubMed
Summary
This summary is machine-generated.

The study found that two kidney-risk variants in the apolipoprotein L1 (APOL1) gene are not linked to cardiovascular disease or death in Black individuals, independent of kidney function. This research clarifies the role of APOL1 variants in cardiovascular health outcomes.

Keywords:
APOL1Blackscardiovascular diseasedeathkidney diseasemeta-analysis

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Area of Science:

  • Genetics and Cardiovascular Health
  • Nephrology and Public Health

Background:

  • Two coding variants in the apolipoprotein L1 (APOL1) gene are strongly associated with kidney disease in Black populations.
  • Kidney disease increases cardiovascular disease (CVD) risk, but the independent effect of APOL1 variants on CVD risk remains unclear due to inconsistent previous findings.

Purpose of the Study:

  • To investigate the association of APOL1 kidney-risk variants with cardiovascular disease events and mortality.
  • To determine if APOL1 variants have an independent effect on CVD risk, separate from kidney function measures.

Main Methods:

  • A two-stage individual participant data meta-analysis was conducted.
  • Included 21,305 Black individuals from eight large cohorts, assessing adjudicated cardiovascular disease events and death.
  • Follow-up averaged 8.9 years, with fully-adjusted analyses considering various health factors.

Main Results:

  • No association was found between two APOL1 kidney-risk variants and incident cardiovascular disease (coronary heart disease, myocardial infarction, stroke, heart failure) or death.
  • Hazard ratio for incident CVD was 1.11 (95% CI, 0.96 to 1.28) for individuals with two risk variants compared to those with zero or one.
  • Associations remained non-significant across individual CVD outcomes and were not influenced by kidney function, age, diabetes, or BMI.

Conclusions:

  • APOL1 kidney-risk variants are not associated with incident cardiovascular disease or death when considered independently of kidney measures.
  • This large-scale meta-analysis provides robust evidence against a direct, independent role of APOL1 variants in cardiovascular risk.