衰竭的家族史,APOL-1风险变体,健康的社会决定因素和CKD进展风险:CRIC研究的发现
Wei Lin1, Alexander R Chang2, Deidra C Crews3
1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland.
概括
患有衰竭的家族病史增加了慢性病 (CKD) 的进展风险,特别是在黑人个体中. 即使考虑到健康的社会决定因素 (SDoH) 和APOL1风险等位基因,这种关联仍然存在,这强调了需要进一步研究的必要性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 遗传学 是一个遗传学.
- 公共卫生 公共卫生
背景情况:
- 病常常聚集在家庭内,特别是黑人家庭.
- 这种家族聚类可能源于共同的不良健康社会决定因素 (SDoH) 和/或遗传因素.
- 阿波利波蛋白L1 (APOL1) 基因是非洲血统个体病的重要遗传风险因素.
研究的目的:
- 调查衰竭家族病史与慢性病 (CKD) 进展之间的关联.
- 为了确定这种关联是否通过调整不良SDoH和APOL1风险等位基因状态来减弱.
- 探索衰竭家族史中的种族和民族差异.
主要方法:
- 从慢性功能不全队列 (CRIC) 研究中对5623名参与者进行了长度观察性研究.
- 家庭衰竭史定义为为衰竭 (透析或移植) 接受治疗的第一级亲属.
- 用于评估关联的物流和考克斯比例危险模型,调整种族-种族,APOL1风险等位基因状态,SDoH和临床因素.
主要成果:
- 17%的参与者报告说,他们的家庭有衰竭病史.
- 黑人参与者更有可能报告患有功能衰竭的家族病史,无论APOL1风险等位基因的状态如何.
- 在多变量调整后,家族衰竭史仍然与慢性病进展风险增加有显著的关联 (aHR=1.16,95% CI:1.02-1.33).
结论:
- 患有衰竭的家族病史是慢性病进展的重要风险因素.
- 家庭衰竭史和CKD进展之间的关联并不能完全由SDoH或APOL1风险等位基因解释.
- 需要进一步的研究来阐明CKD家族聚合背后的机制.
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