Association Between Cognitive Function and Risk of Chronic Kidney Disease: A Longitudinal Cohort and Mendelian Randomization Study

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings Pub Date : 2024-09-01 DOI:10.1016/j.mayocp.2024.04.017

Sisi Yang MD, Chun Zhou MD, Ziliang Ye MD, Mengyi Liu MD, Yanjun Zhang MD, Xiaoqin Gan MD, Yu Huang MD, Hao Xiang MD, Panpan He MD, Yuanyuan Zhang MD, Xianhui Qin MD

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引用次数: 0

Abstract

Objective

To investigate the causal dose-response association between cognitive function and the risk of chronic kidney disease (CKD) by a longitudinal cohort and mendelian randomization study.

Methods

The longitudinal cohort study included 396,600 participants without prior dementia and CKD from the UK Biobank. Cognitive function (including prospective memory, numeric memory, visuospatial memory, reaction time, and reasoning ability) was assessed by computerized touchscreen tests. Global cognitive function was defined as a composite score of those specific cognitive domains. A 2-stage mendelian randomization analysis was conducted with 12,979 cases of CKD and 379,424 controls. Genetically predicted global cognitive function was instrumented with 91 confirmed genome-wide significant variants. The study outcome was new-onset CKD. The study was conducted from March 13, 2006, to September 30, 2021.

Results

During a median follow-up of 12.5 years, new-onset CKD developed in 13,090 participants. Per 1 SD score increments in reaction time (adjusted hazard ratio [HR], 0.97; 95% CI, 0.95 to 0.99), reasoning ability (adjusted HR, 0.91; 95% CI, 0.88 to 0.94), and global cognitive function (adjusted HR, 0.96; 95% CI, 0.95 to 0.98) were associated with a significantly lower risk of new-onset CKD. Compared with an incorrect answer in the prospective memory test, a correct answer was associated with a lower risk of new-onset CKD (adjusted HR, 0.82; 95% CI, 0.76 to 0.88). Mendelian randomization analyses found that per 1 SD score increments in genetically predicted global cognitive function resulted in a significantly (7%; 95% CI, 2% to 12%) lower risk of new-onset CKD.

Conclusion

A better cognitive function is causally associated with a lower risk of CKD in participants without prior dementia.

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认知功能与慢性肾病风险之间的关系：纵向队列和孟德尔随机化研究

研究目的通过一项纵向队列和亡羊补牢随机研究，探讨认知功能与慢性肾脏病（CKD）风险之间的因果剂量反应关系：纵向队列研究包括英国生物库中 396,600 名无痴呆症和慢性肾脏病史的参与者。认知功能（包括前瞻记忆、数字记忆、视觉空间记忆、反应时间和推理能力）通过电脑触摸屏测试进行评估。总体认知功能被定义为这些特定认知领域的综合得分。对 12,979 例慢性肾脏病患者和 379,424 例对照者进行了两阶段孟德尔随机分析。通过 91 个已证实的全基因组重大变异对基因预测的全球认知功能进行了分析。研究结果为新发 CKD。研究时间为 2006 年 3 月 13 日至 2021 年 9 月 30 日：在中位随访 12.5 年期间，13,090 名参与者出现了新发 CKD。反应时间（调整后危险比 [HR]，0.97；95% CI，0.95 至 0.99）、推理能力（调整后危险比，0.91；95% CI，0.88 至 0.94）和整体认知功能（调整后危险比，0.96；95% CI，0.95 至 0.98）每增加 1 SD 分，新发 CKD 的风险就会显著降低。与前瞻性记忆测试中的错误答案相比，正确答案与较低的新发 CKD 风险相关（调整后 HR 为 0.82；95% CI 为 0.76 至 0.88）。孟德尔随机分析发现，基因预测的总体认知功能每增加 1 SD 分，新发 CKD 的风险就会显著降低（7%；95% CI，2% 至 12%）：结论：在没有痴呆症病史的参与者中，较好的认知功能与较低的慢性肾脏病风险有因果关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Mayo Clinic proceedings 医学-医学：内科

CiteScore

16.80

自引率

1.10%

发文量

383

审稿时长

37 days

期刊介绍： Mayo Clinic Proceedings is a premier peer-reviewed clinical journal in general medicine. Sponsored by Mayo Clinic, it is one of the most widely read and highly cited scientific publications for physicians. Since 1926, Mayo Clinic Proceedings has continuously published articles that focus on clinical medicine and support the professional and educational needs of its readers. The journal welcomes submissions from authors worldwide and includes Nobel-prize-winning research in its content. With an Impact Factor of 8.9, Mayo Clinic Proceedings is ranked #20 out of 167 journals in the Medicine, General and Internal category, placing it in the top 12% of these journals. It invites manuscripts on clinical and laboratory medicine, health care policy and economics, medical education and ethics, and related topics.