Trends and the Role of Gene-Environment Interactions in Idiopathic Membranous Nephropathy in Northern China.

IF 4.3 3区 医学 Q1 UROLOGY & NEPHROLOGY
Wanyin Hou, Sufang Shi, Zhe Yan, Maodong Liu, Gengxin Guo, Yujing Zhang, Yun Dong, Junjie Gao, Fuyun Sun, Guicai Hu, Zhaoxia Zheng, Liping Duan, Haisong Zhang, Bing Liu, Shaomei Li, Sumin Jiao, Jinwei Wang, Zhao Cui, Suxia Wang, Ying Li, Shuxia Fu, Minghui Zhao
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引用次数: 0

Abstract

Introduction: Idiopathic membranous nephropathy (iMN) has become one of the most prevalent primary glomerular diseases, with a marked increase in prevalence over the past two decades in northern China. Fine particulate matter (PM2.5) is considered to be associated with this rising prevalence. In this study, we aim to evaluate the trends of iMN in relation to improved air quality and conduct a cross-sectional study in Hebei province (northern China, near Beijing) to investigate the role of gene-environment interactions in its development.

Methods: This study established two cohorts. Cohort 1 included 22,937 pathology reports from Peking University First Hospital (2002-2021) to assess iMN prevalence. Cohort 2 comprised 5,635 iMN patients from 11 cities in Hebei Province (2009-2013). DNA samples from 374 iMN patients and 1,259 controls were genotyped for SNPs rs4664608 (PLA2R1) and rs2187668 (HLA-DQA1). Patients were stratified by air pollution risk levels. The annual percentage change (APC) and average annual percentage change (AAPC) were estimated using a join-point regression model. Gene-environment interactions were analyzed using logistic regression and epinet-calculation.

Results: In Cohort 1, 5,586 patients with iMN were identified, representing 24.3% of the 22,937 patients from 2002 to 2021. The general population showed a significant increase in iMN proportion with an APC of +12.7% per year from 2002 to 2014 (95% CI: 10.3 to 17.5, p < 0.001), followed by a decline with an APC of -5.6% per year from 2014 to 2021 (95% CI: -9.6 to -2.6, p < 0.001).In Hebei Province, the iMN frequency rose significantly with an APC of +17.6% per year from 2002 to 2016 (95% CI: 14.5 to 28.6, p < 0.001), peaking at 60%, and then declined with an APC of -5.5% per year from 2016 to 2021 (95% CI: -13.1 to -1.2, p = 0.02). Cohort 2 highlighted significant regional variation in iMN incidence across Hebei Province. Geographic exposure to pollution was identified as an independent risk factor for iMN (RR 1.49, 95% CI 1.38-1.56, p<0.001). Gene-environment interaction analysis revealed that patients with risk alleles in the PLA2R1 gene and exposure to risk environments had a markedly increased risk of developing iMN (OR=38.72, 95% CI 11.95-125.46, p<0.01).

Conclusion: The annual growth rate of iMN in northern China appears to be slowing down. Gene-environment interactions may have contributed to the previously observed increase in iMN prevalence.

中国北方特发性膜性肾病基因-环境相互作用的趋势和作用。
特发性膜性肾病(Idiopathic membranous nephropathy, iMN)已成为最常见的原发性肾小球疾病之一,近二十年来在中国北方地区发病率显著上升。细颗粒物(PM2.5)被认为与患病率上升有关。在这项研究中,我们旨在评估iMN与空气质量改善的关系,并在河北省(中国北部,靠近北京)进行横断面研究,以探讨基因-环境相互作用在其发展中的作用。方法:本研究建立了两个队列。队列1纳入北京大学第一医院2002-2021年的22937份病理报告,以评估iMN的患病率。队列2包括来自河北省11个城市的5635例iMN患者(2009-2013)。来自374名iMN患者和1259名对照者的DNA样本对snp rs4664608 (PLA2R1)和rs2187668 (HLA-DQA1)进行基因分型。根据空气污染风险等级对患者进行分层。采用联结点回归模型估算年变化百分数(APC)和年平均变化百分数(AAPC)。采用逻辑回归和epinet计算分析基因与环境的相互作用。结果:在队列1中,确定了5586例iMN患者,占2002年至2021年22937例患者的24.3%。从2002年到2014年,一般人群的iMN比例显著增加,APC为每年+12.7% (95% CI: 10.3 ~ 17.5, p < 0.001),随后从2014年到2021年,iMN比例下降,APC为每年-5.6% (95% CI: -9.6 ~ -2.6, p < 0.001)。在河北省,iMN频率在2002 - 2016年显著上升,APC为+17.6% /年(95% CI: 14.5 ~ 28.6, p < 0.001),峰值为60%,然后在2016 - 2021年下降,APC为-5.5% /年(95% CI: -13.1 ~ -1.2, p = 0.02)。队列2强调了河北省iMN发病率的显著区域差异。地理污染暴露是iMN的独立危险因素(RR为1.49,95% CI为1.38 ~ 1.56)。结论:中国北方地区iMN的年增长率呈现放缓趋势。基因与环境的相互作用可能促成了先前观察到的iMN患病率的增加。
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
American Journal of Nephrology
American Journal of Nephrology 医学-泌尿学与肾脏学
CiteScore
7.50
自引率
2.40%
发文量
74
审稿时长
4-8 weeks
期刊介绍: The ''American Journal of Nephrology'' is a peer-reviewed journal that focuses on timely topics in both basic science and clinical research. Papers are divided into several sections, including:
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