Genetic and environmental influences on the associations between change in kidney function and changes in cardiometabolic factors in Koreans.

BACKGROUND

This study aimed to evaluate genetic and environmental relations between change in estimated glomerular filtration rate (eGFR) and changes in cardiometabolic factors.

METHODS

In 1772 Korean adults without diabetes and chronic kidney disease at baseline, changes in eGFR using the Chronic Kidney Disease Epidemiology Collaboration equation, blood pressure (BP), fasting serum glucose (FSG), insulin, homeostasis model assessment of insulin resistance index (HOMA-IR), hemoglobin A1c, triglycerides, high and low density lipoprotein cholesterol (HDL and LDL), uric acid, white blood cell (WBC) count, and body mass index (BMI) were calculated as follows: (value at follow-up - value at baseline) × 100/[value at baseline × follow-up interval (years)].

RESULTS

eGFR change was associated with 10 % changes in FSG (Odds ratio, OR = 1.36), uric acid (OR = 2.49), HDL (OR = 0.69), LDL (OR = 1.26), and WBC (OR = 1.15) after adjusting for age, sex, intra-familial and twin correlations, smoking, alcohol use, and physical activity at baseline, and BMI change using a generalized estimating equation. In bivariate variance-component analysis, eGFR change had additive genetic correlations ([Formula: see text]) with changes in insulin (-0.26), HOMA-IR (-0.24), diastolic BP (-0.15), uric acid (-0.45), triglycerides (-0.30), WBC (-0.46), and HDL (0.41), and environmental correlations ([Formula: see text]) with changes in FSG (-0.11), uric acid (-0.32), LDL (-0.14), and WBC (0.10). In co-twin control analyses in 319 monozygotic twin pairs, the ORs for having a greater eGFR decline with a 1 % increase in diastolic BP, uric acid, and LDL were 1.04, 1.09, and 1.03, respectively after adjusting for change in BMI and health behaviors at baseline.

CONCLUSIONS

In these Korean twins and families, additive genetic influences and environmental effects play significant roles in the associations between eGFR change and changes in cardiometabolic factors.