Association among Genetic Polymorphisms in the Renin-Angiotensin System and their Interactions with Chronic Kidney Disease: a Case-Control Study and Meta-Analysis.

• Main Authors: CHEN,YU-HSUAN, 陳昱亘
• Other Authors: SU,SUI-LUNG
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/4gcz6z

碩士 === 國防醫學院 === 公共衛生學研究所 === 104 === Introduction: Chronic kidney disease (CKD) is an important public issue. Previous studies suggested that the single nucleotide polymorphisms (SNPs) of the renin- angiotensin system (RAS) are related to RAS-imbalance and CKD. Due to the complexity of the pathogenesis of CKD, circumferential consideration of various SNPs and other risk factors is important. This study presents a meta-analysis which explores whether AGT M235T or AGTR1 A1166C is related to CKD, as well as the possible CKD-associated gene-environment interactions and gene-gene interactions. Materials and methods: In the first stage of this study, we recruited 634 patients with ESRD and 560 healthy controls. Associations between the SNPs and CKD were analyzed. We further searched electronic databases such as PudMed and Cochrane Library for relevant studies. Meta-regression and ETMA were utilized to test the gene-environment interactions and gene-gene interactions. Result: Studies including data from 35 populations and 26 populations were included, in AGT M235T meta-analysis and AGTR1 A1166C meta-analysis, respectively. We confirmed that the T-allele carriers had higher risk of CKD, and the CC genotype will increase the risk of CKD development. In meta-regression analysis, race and hypertension are important mediators. In addition, the association between CKD gene-gene interaction is confirmed. Conclusion: Compared to other races and blood pressure variations, hypertensive patients among Asians had the highest relative risk of CKD development. We suggested that genetic testing for CKD among the high-susceptibility population could be an effective strategy in CKD prevention.