ABSTRACT
<p><b>BACKGROUND</b>Chronic kidney disease (CKD) is a growing public health problem with well-established risk factors. Other contributing factors, however, remain to be identified. Systemic inflammation in asthma plays a significant role in the development of other diseases. We therefore initiated a study to assess whether the growing prevalence of asthma is associated with an increase in the risk of CKD.</p><p><b>METHODS</b>We conducted a retrospective cohort study using data from 3015 patients with asthma aged 14 years and older who were registered and followed up in Asthma Control Study at the Department of Respiratory Medicine of three medical centers from 2005 to 2011. History, asthma control test (ACT), and asthma stage were used to assess the traits of asthma. CKD was defined as proteinuria and/or reduced estimated glomerular filtration rate (eGFR) (<60 ml×min(-1)×1.73 m(-2)) in two consecutive follow-up surveys. We used logistic regression models, adjusting for age, sex, and other confounding factor to determine associations between the traits of asthma and CKD. Kaplan-Meier curves were used to analyze patient outcomes.</p><p><b>RESULTS</b>A total of 2354 subjects with complete data were recruited for this study with mean age (45.4±10.4) years. After 6 years of follow-up, 9.6% (n = 227) of the analytic cohort developed proteinuria and 3.1% (n = 72) progressed to eGFR <60 ml×min(-1)×1.73 m(-2). The patients with >20 years asthma history, not well-controlled or persistent asthma patients had higher incidence of proteinuria and reduced eGFR compared with patients with ≤20 years asthma history, at least well-controlled or remission asthma, respectively. The multivariable adjusted OR for proteinuria and reduced eGFR in participants with persistent asthma was 1.49; (95% confidence interval (CI) 1.17-1.91) and 2.07 (95% CI 1.34-4.42). Compared to patients with no asthma traits, there was a significant risk (OR, 3.39; 95% CI 1.36-8.73) for those who met all three traits, including asthma history >20 years, not well-controlled and persistent stage, after adjusting for potential confounding factors.</p><p><b>CONCLUSIONS</b>In this retrospective cohort study, we found that persistent asthma was associated with an increased risk of CKD, which was independent of obesity, diabetes, hypertension, and other well-established risk factors. Future studies should be directed to elucidate the mechanisms underlying the association between asthma and CKD.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Asthma , Glomerular Filtration Rate , Physiology , Renal Insufficiency, Chronic , Retrospective Studies , Risk FactorsABSTRACT
Objective To investigate the correlation between the single nucleotide polymorphism(SNP) of macrophage migration inhibitory factor(MIF) gene -173G/C and the susceptibility in patients with juvenile idiopathic arthritis(JIA).Methods Study group consisted of 97 children of JIA.All patients included in this study met the International League of Associations for Rheumatology criteria for JIA.Control group consisted of 102 healthy individuals.Germline DNA was extracted from peripheral blood by AxyPrep blood genomic DNA miniprep kit.Polymerase chain reaction-restrictivon fragment length polymorphism(PCR-RFLP) was used for genotyping the -173G/C polymorphism of MIF.Genotype distribution and allele frequencies were obtained by direct counting.Statistical analysis was performed by using SPSS Bosoftware.Allele and genotype distributions were compared using the chi-square test.The relative risk of alleles was described by odds ratios (OR) and 95% confidence intervals (95%CI).Hardy-weinberg equilibrium was confirmed with the chi-square test.Results We detected 3 kinds of genotypes at the MIF-173 locus.The frequency of each genotype was 54.6%(GG),42.3%(GC),3.1%(CC) in JIA group,and 79.4%(GG),20.6%(GC),0(CC) in control group.The C allele frequencies in the JIA and control group were 24.7% and 10.3%,respectively.There was significant difference was observed between the JIA and control group in the frequencies of mutant genotype(GC and CC) of MIF-173G/C polymorphism(?2=13.872 P=0).Individuals possessing a MIF-173C allele did have an increased risk of JIA(OR=2.79,95% CI 1.62-4.81 P=0).When the genotype and allele distributions of the MIF-173 gene in the subtypes of JIA and contronl group were compared,a significant difference wad found in the systemic JIA and control group (P0.05).Conclusions MIF-173G/C SNP may be associated with the sensitivity of JIA.MIF-173 C allele may increase susceptibility to JIA.
ABSTRACT
Objective To study the correlation between single nucleotide polymorphisms of -238,-308 G/A in promoter region of tumor necrosis factor -?(TNF-?) gene and the type of juvenile idiopathic arthritis (JIA).Methods Clinical data and blood preparation of 127 children with JIA and 106 healthy children were evaluated.Subgroups of JIA were defined according to the Edmonton criteria.The -238 G/A and -308 G/A polymorphisms in DNA analysis in this study were extracted from the whole blood.The restricted fragment length polymorphisms were determined in the cases of all JIA children and control group.Results 1.The TNF-?-238 G/A allele frequencies of JIA group and control group:allele frequency of JIA group was 92.9% and 7.1%,and the control group was 95.3% and 4.7%.The distribution of allele frequencies was no significantly different between JIA group and control group(?2=1.149 P=0.284).But there were significant difference between polyarticular JIA (RF negative) and control group(?2=7.621 P=0.006).2.The TNF-?-308 G/A allele frequencies of JIA group and control group:allele frequency of JIA group was 94.1% and 5.9%,the control group was 95.3% and 4.7%.The distributions of allele frequencies was no significantly different between JIA group and control group(?2=0.322 P=0.571).There were significantly difference between polyarticular JIA (RF negative) and control group (?2=7.621 P=0.006).Conclusions The TNF-?-238,-308 polymorphisms of A in the-238 and-308 TNF-? gene are important to the joint destruction of JIA.The study will be beneficial to provide indirect support to the application of anti-TNF drugs to the treatment of JIA.