Dataset Information

Identification of modifiable chronic kidney disease risk factors by gender in an African-American metabolic syndrome cohort.

ABSTRACT: African Americans experience a disproportionately greater burden of chronic kidney disease (CKD) Stage 5 than Caucasians and other minority groups. Precursors to CKD may also be components of metabolic syndrome. This study identified modifiable risk factors for CKD in an African-American metabolic syndrome cohort and compared results by gender. Both men and women (52%) had blood pressure values of 130/80 or higher, impaired fasting glucose levels of 100 to 125 mg/dL (25.5%), and body mass index greater than 25 (98.9%). There was no significant difference between genders. Appropriate clinical management of these factors may prevent or delay the onset of CKD.

SUBMITTER: Brown LJ

PROVIDER: S-EPMC3088518 | biostudies-other | 2010 Mar-Apr

REPOSITORIES: biostudies-other

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Identification of modifiable chronic kidney disease risk factors by gender in an African-American metabolic syndrome cohort.

Brown Loretta Jackson LJ Clark Patricia C PC Armstrong Karen A KA Liping Zhao Z Dunbar Sandra B SB

Nephrology nursing journal : journal of the American Nephrology Nurses' Association 20100301 2

African Americans experience a disproportionately greater burden of chronic kidney disease (CKD) Stage 5 than Caucasians and other minority groups. Precursors to CKD may also be components of metabolic syndrome. This study identified modifiable risk factors for CKD in an African-American metabolic syndrome cohort and compared results by gender. Both men and women (52%) had blood pressure values of 130/80 or higher, impaired fasting glucose levels of 100 to 125 mg/dL (25.5%), and body mass index ...[more]

PMID: 20462073

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Project description:Background:African Americans are at high risk for chronic kidney disease (CKD). Obesity may increase the risk for CKD by exacerbating features of the metabolic syndrome and promoting glomerular hyperfiltration. Whether other factors also affecting these pathways may amplify or mitigate obesity-CKD associations has not been investigated. Methods:We studied interactions between obesity and these candidate factors in 2043 African Americans without baseline kidney disease enrolled in the Jackson Heart Study. We quantified obesity as body mass index (BMI), sex-normalized waist circumference and visceral adipose volume measured by abdominal computed tomography at an interim study visit. Interactions were hypothesized with (i) metabolic risk factors (dietary quality and physical activity, both quantified by concordance with American Heart Association guidelines) and (ii) factors exacerbating or mitigating hyperfiltration (dietary protein intake, APOL1 risk status and use of renin-angiotensin system blocking medications). Using multivariable regression, we evaluated associations between obesity measures and incident CKD over the follow-up period, as well as interactions with metabolic and hyperfiltration factors. Results:Assessed after a median of 8?years (range 6-11?years), baseline BMI and waist circumference were not associated with incident CKD. Higher visceral adipose volume was independently associated with incident CKD (P?=?0.008) in a nonlinear fashion, but this effect was limited to those with lower dietary quality (P?=?0.001; P-interaction?=?0.04). In additional interaction models, higher waist circumference was associated with greater risk of incident CKD among those with the low-risk APOL1 genotype (P?=?0.04) but not those with a high-risk genotype (P-interaction?=?0.02). Other proposed factors did not modify obesity-CKD associations. Conclusions. Higher risks associated with metabolically active visceral adipose volume and interactions with dietary quality suggest that metabolic factors may be key determinants of obesity-associated CKD risk. Interactions between obesity and APOL1 genotype should be considered in studies of African Americans.

Project description:Cannabis use disorders (CUDs) cause substantial neuropsychiatric morbidity and comorbidity. There is evidence for gender-based differences in CUDs, for instance, a greater prevalence in males than in females. The main active component of cannabis is delta 9-tetrahydrocannabinol (delta 9-THC), a partial agonist of the cannabinoid type 1 receptor. Preclinical studies show that genetic or pharmacological manipulation of the kappa opioid receptor/dynorphin system modulates the effects of delta 9-THC.In this case-control study of adult African Americans (n=476; 206 females, 270 males), we examined the association of the functional prodynorphin 68 bp (PDYN 68 bp) promoter repeats with categorical diagnoses of cannabis dependence (Diagnostic and Statistical Manual of Mental Disorders-IV criteria), as well as with a rapid dimensional measure of maximum lifetime cannabis exposure (the Kreek-McHugh-Schluger-Kellogg cannabis scale).The PDYN 68 bp genotype (examined as short-short [SS], short-long [SL], or long-long [LL], based on the number of repeats) was not significantly associated with categorical cannabis-dependence diagnoses, either in males or in females. However, in males, the PDYN 68 bp SS+SL genotype was associated with both greater odds of any use of cannabis (p<0.05) and earlier age of first cannabis use, compared to the LL genotype (ie, 15 versus 16.5 years of age; p<0.045). Males in the SS+SL group also had greater odds of high lifetime exposure to cannabis, compared to the LL group (p<0.045). Of interest, none of the aforementioned genetic associations were significant in females.This study provides the first data on how the PDYN 68 bp genotype is associated with gender-specific patterns of exposure to cannabis. Overall, this study shows that PDYN 68 bp polymorphisms affect behaviors involved in early stages of nonmedical cannabis use and potentially lead to increasing self-exposure. These data may eventually lead to improvements in personalized medicine for the prevention and treatment of highly prevalent CUDs and neuropsychiatric comorbidities.

Dataset Information

Identification of modifiable chronic kidney disease risk factors by gender in an African-American metabolic syndrome cohort.

Publications

Identification of modifiable chronic kidney disease risk factors by gender in an African-American metabolic syndrome cohort.

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