Apolipoprotein E and kidney function in older adults

作者：Seshasai Rebecca Kurnik; Katz Ronit; de Boer Ian H; Siscovick David; Shlipak Michael G; Rifkin Dena E; Sarnak Mark J^*

来源：Clinical Nephrology, 2012, 78(3): 174-180.

DOI：10.5414/CN107427

• apolipoprotein E
• chronic kidney disease
• kidney function
• elderly

Background: Previous studies suggest that the epsilon 4 and epsilon 2 alleles of apolipoprotein E (APOE) may be associated with decreased and increased risks of CKD, respectively, but there are limited data in older adults. We evaluated the associations of apolipoprotein E alleles with kidney function among older adults in the cardiovascular health study (CHS). Methods: Caucasian participants had APOE allelic analysis and serum creatinine and cystatin C measured at baseline (n = 3,844 for cross sectional analysis) and in follow up (n = 3,226 for longitudinal analysis). APOE variation was evaluated as an additive model with number of epsilon 2, epsilon 3 and epsilon 4 alleles. GFR was estimated using the CKD epidemiology equation (eGFRcreat) and the cystatin C demographic equation (eGFRcys). The primary outcome was CKD defined by eGFR < 60 ml/min/1.73 m(2). The secondary outcome was rapid progression defined by annual loss of eGFR > 3 ml/min/1.73 m(2). Results: Mean eGFRcreat was 72 ml/min/1.73 m(2) (25% CKD). Compared with the epsilon 3 allele, the APOE epsilon 4 allele was associated with reduced risk of CKD by eGFRcreat: unadjusted odds ratio (OR) and 95% confidence interval (CI) 0.79 (0.67-0.93) per allele, fully adjusted OR (95% CI) 0.80 (0.68-0.96) per allele. Results were consistent using eGFRcys. There was no association of the epsilon 2 allele with CKD or between the apolipoprotein E gene with rapid progression. Conclusions: The apolipoprotein epsilon 4 allele was associated with lower odds of CKD in elderly Caucasian individuals. Future research should confirm these findings in other races and explore mechanisms to explain these results.

• 出版日期2012-9