Association of preeclampsia with infant APOL1 genotype in African Americans
Anna K Miller1, Timur Azhibekov2, John F O'Toole3
1Department of Genetics and Genome Sciences, Case Western Reserve University School of Medicine, Cleveland, USA.
Insights
Apolipoprotein L1 (APOL1) gene variants increase preeclampsia risk in Black women. This study found a significant association between APOL1 genotype and preeclampsia, suggesting potential for genetic screening and targeted interventions.
Area of Science:
- Genetics
- Obstetrics
- Nephrology
Background:
- Black women face higher preeclampsia risk.
- APOL1 gene variants, common in African ancestry populations, are linked to kidney disease.
- Emerging evidence suggests APOL1 variants may also contribute to preeclampsia risk.
Purpose of the Study:
- To investigate the association between APOL1 gene variants and preeclampsia in Black women.
- To explore APOL1 genotype's relationship with preeclampsia severity and placental pathology.
Main Methods:
- A case-control study involving 395 preeclampsia cases and 282 controls.
- Analysis of fetal APOL1 genotype using logistic regression models.
- Evaluation of placental gross and histopathologic features.
Main Results:
- Infant APOL1 genotype showed a significant dominant association with preeclampsia (OR=1.41, P=0.029).
- Significant associations were found for recessive (OR=1.70, P=0.038) and additive (OR=1.33, P=0.028) inheritance patterns when stratifying by preterm birth.
- No significant association was observed between APOL1 genotype and placental pathological changes.
Conclusions:
- APOL1 variants are associated with preeclampsia, indicating a potential genetic link.
- Further research is needed to confirm the inheritance patterns.
- APOL1 genetic screening could aid in identifying at-risk pregnancies for targeted interventions.
Background:
Black women in the United States and Africa are at an increased risk for preeclampsia. Allelic variants in the gene for apolipoprotein LI, APOL1, are found only in populations of African ancestry, and have been shown to contribute significant risk for kidney disease. Recent studies suggest these APOL1 variants also may contribute risk for preeclampsia.
Methods:
The association of preeclampsia with carriage of APOL1 risk alleles was evaluated in a case-control study of deliveries from black women at a single center in Cleveland, Ohio that included gross and histopathologic evaluations of placental tissues (395 cases and 282 controls). Using logistic regression models, associations between fetal APOL1 genotype and preeclampsia were evaluated using several case definitions based on prematurity and severity of preeclampsia, with uncomplicated term pregnancies as controls. Associations between APOL1 genotype and pathological features were also examined.
Results:
The infant APOL1 genotype was significantly associated with preeclampsia in a dominant inheritance pattern with odds ratio of 1.41 (P=0.029, 95% CI 1.037, 1.926). Stratifying preeclampsia cases by preterm birth, significant associations were detected for both recessive (O.R.=1.70, P=0.038) and additive (O.R.=1.33, P=0.028) inheritance patterns. APOL1 genotype, however, was not significantly associated with pathological changes or other perinatal observations.
Conclusions:
Preeclampsia appears to be another disease associated with APOL1 variants, however, further studies are needed to increase confidence in the mode of inheritance. By understanding the association of APOL1 variants with preeclampsia, genetic screening tests for APOL1 may be useful to predict at-risk pregnancies and targeted interventions may be developed to improve pregnancy outcomes.
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