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Agarwal S, Germosen C, Bucovsky M, Colon I, Kil N, Walker M. Skeletal Microstructure in Caribbean Hispanic Women. JBMR Plus 2023; 7:e10725. [PMID: 37197315 PMCID: PMC10184017 DOI: 10.1002/jbm4.10725] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023] Open
Abstract
Hispanic individuals are underrepresented in skeletal research. Bone mineral density (BMD) and fracture data are conflicting. We investigated skeletal health in elderly Caribbean Hispanic (HW), non-Hispanic white (NHW), and non-Hispanic black (NHB) women in a population-based study in New York City. We utilized high-resolution peripheral quantitative CT (HRpQCT), dual-energy X-ray absorptiometry (DXA), and finite element analysis (FEA). Of 442, 48.4% were HW, 21.3% NHW, and 30.3% NHB. Adjusted analyses are shown. Compared to NHW, HW had 8.5% (p < 0.01) lower spine areal BMD (aBMD) and 5.1% lower trabecular bone score (TBS). The frequency of morphometric vertebral fractures did not differ between HW and NHW. By HRpQCT, HW had 2.9% higher cortical (Ct) volumetric BMD (vBMD), 7.9% greater Ct area (Ct.Ar) and 9.4% greater Ct thickness (Ct.Th) at the radius compared to NHW. Results were similar at the tibia but trabecular microstructure tended to be worse. Ultimately, failure load (FL) did not differ between HW and NHW at either site. aBMD was 3.8% to 11.1% lower at the spine, femoral neck, and radius in HW compared to NHB (all p < 0.001) and vertebral fractures were twice as common. Compared to NHB, HW had 7.7% to 10.3% lower Ct.Ar at both the radius and tibia as well as 8.4% lower total vBMD, 6.3% lower trabecular number, and 10.3% lower Ct.Th at the tibia associated with 18.2% and 12.5% lower FL at both sites, respectively. In conclusion, HW had lower spine aBMD and TBS versus NHW women, whereas microstructural differences at the radius and tibia were small and not associated with differences in FL. In contrast, HW had lower aBMD, as well as deteriorated radial and tibial microstructure associated with worse FL compared to NHB women. Our results provide insight into racial/ethnic differences in skeletal health, adding to data that may be used to improve osteoporosis screening and treatment in HW. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Sanchita Agarwal
- Division of EndocrinologyColumbia University Irving Medical CenterNew YorkNYUSA
| | - Carmen Germosen
- Division of EndocrinologyColumbia University Irving Medical CenterNew YorkNYUSA
| | - Mariana Bucovsky
- Division of EndocrinologyColumbia University Irving Medical CenterNew YorkNYUSA
| | - Ivelisse Colon
- Division of EndocrinologyColumbia University Irving Medical CenterNew YorkNYUSA
| | - Nayoung Kil
- Division of EndocrinologyColumbia University Irving Medical CenterNew YorkNYUSA
| | - Marcella Walker
- Division of EndocrinologyColumbia University Irving Medical CenterNew YorkNYUSA
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Wohlford EM, Huang PF, Elhawary JR, Millette LA, Contreras MG, Witonsky J, Holweg CTJ, Oh SS, Lee C, Merenda C, Rabin RL, Araojo R, Mak ACY, Eng CS, Hu D, Huntsman S, LeNoir MA, Rodríguez-Santana JR, Borrell LN, Burchard EG. Racial/ethnic differences in eligibility for asthma biologics among pediatric populations. J Allergy Clin Immunol 2021; 148:1324-1331.e12. [PMID: 34536416 PMCID: PMC9211042 DOI: 10.1016/j.jaci.2021.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/24/2021] [Accepted: 09/01/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Asthma is a heterogeneous disease. Clinical blood parameters differ by race/ethnicity and are used to distinguish asthma subtypes and inform therapies. Differences in subtypes may explain population-specific trends in asthma outcomes. However, these differences in racial/ethnic minority pediatric populations are unclear. OBJECTIVE We investigated the association of blood parameters and asthma subtypes with asthma outcomes and examined population-specific eligibility for biologic therapies in minority pediatric populations. METHODS Using data from 2 asthma case-control studies of pediatric minority populations, we performed case-control (N = 3738) and case-only (N = 2743) logistic regressions to quantify the association of blood parameters and asthma subtypes with asthma outcomes. Heterogeneity of these associations was tested using an interaction term between race/ethnicity and each exposure. Differences in therapeutic eligibility were investigated using chi-square tests. RESULTS Race/ethnicity modified the association between total IgE and asthma exacerbations. Elevated IgE level was associated with worse asthma outcomes in Puerto Ricans. Allergic asthma was associated with worse outcomes in Mexican Americans, whereas eosinophilic asthma was associated with worse outcomes in Puerto Ricans. A lower proportion of Puerto Ricans met dosing criteria for allergic asthma-directed biologic therapy than other groups. A higher proportion of Puerto Ricans qualified for eosinophilic asthma-directed biologic therapy than African Americans. CONCLUSIONS We found population-specific associations between blood parameters and asthma subtypes with asthma outcomes. Our findings suggest that eligibility for asthma biologic therapies differs across pediatric racial/ethnic populations. These findings call for more studies in diverse populations for equitable treatment of minority patients with asthma.
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Affiliation(s)
- Eric M Wohlford
- Division of Pediatric Allergy and Immunology, University of California San Francisco, San Francisco, Calif; Department of Medicine, University of California San Francisco, San Francisco, Calif
| | - Peter F Huang
- Department of Medicine, University of California San Francisco, San Francisco, Calif
| | - Jennifer R Elhawary
- Department of Medicine, University of California San Francisco, San Francisco, Calif.
| | | | - Maria G Contreras
- Department of Medicine, University of California San Francisco, San Francisco, Calif
| | - Jonathan Witonsky
- Division of Pediatric Allergy and Immunology, University of California San Francisco, San Francisco, Calif; Department of Medicine, University of California San Francisco, San Francisco, Calif
| | | | - Sam S Oh
- Department of Medicine, University of California San Francisco, San Francisco, Calif
| | - Christine Lee
- Office of Minority Health and Health Equity, US Food and Drug Administration, Silver Spring, Md
| | - Christine Merenda
- Office of Minority Health and Health Equity, US Food and Drug Administration, Silver Spring, Md
| | - Ronald L Rabin
- Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Md
| | - Richardae Araojo
- Office of Minority Health and Health Equity, US Food and Drug Administration, Silver Spring, Md
| | - Angel C Y Mak
- Department of Medicine, University of California San Francisco, San Francisco, Calif
| | - Celeste S Eng
- Department of Medicine, University of California San Francisco, San Francisco, Calif
| | - Donglei Hu
- Department of Medicine, University of California San Francisco, San Francisco, Calif
| | - Scott Huntsman
- Department of Medicine, University of California San Francisco, San Francisco, Calif
| | | | | | - Luisa N Borrell
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY
| | - Esteban G Burchard
- Department of Medicine, University of California San Francisco, San Francisco, Calif; Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, Calif
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Ricardo AC, Chen J, Singh M, Heiss G, Raij L, Ramos A, Redline S, Rosas SE, Shah N, Sotres-Alvarez D, Zee P, Daviglus M, Lash JP. Sleep-Disordered Breathing and Prevalent Albuminuria in Hispanics/Latinos. Kidney Int Rep 2018; 3:1276-1284. [PMID: 30450454 PMCID: PMC6224780 DOI: 10.1016/j.ekir.2018.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/23/2018] [Accepted: 06/18/2018] [Indexed: 01/10/2023] Open
Abstract
Introduction Although sleep-disordered breathing has been found to be associated with higher urine albumin excretion, this association has not been evaluated in Hispanic/Latino populations, which experience a high burden of end-stage renal disease compared with non-Hispanics. We evaluated the association of sleep-disordered breathing with prevalent albuminuria among US Hispanics/Latinos. Methods This was a cross-sectional study of baseline data from participants in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a population-based study that enrolled 16,415 adults in 4 US communities. Sleep-disordered breathing was assessed using a home sleep apnea monitor for overnight recording and was defined using 3 thresholds of the apnea−hypopnea index (AHI; 3% desaturation): ≥5, ≥15, and ≥30. Albuminuria was defined as a urine albumin-to-creatinine ratio of ≥30 mg/g. Results There were 12,572 participants with complete data available for analysis. The age- and sex-adjusted prevalence of albuminuria was 9.1%. Mean age was 41 years, and 48% were men. Age- and sex-adjusted prevalence of sleep-disordered breathing was higher among individuals with albuminuria compared with those without albuminuria (36% vs. 25% had AHI ≥5, 18% vs. 9% had AHI ≥15, and 9% vs. 4% had AHI ≥30). In multivariable logistic regression analyses, AHIs ≥5, ≥15, and ≥30 were associated with greater odds of albuminuria compared with those with AHIs <5, <15, and <30 (odds ratio [OR] 1.42, 95% confidence interval [CI]: 1.14−1.76; OR: 1.71, 95% CI: 1.33−2.20; and OR 1.93, 95% CI 1.34−2.79), respectively. This association varied by Hispanic/Latino background group. Conclusion In US Hispanic/Latinos, sleep-disordered breathing was independently associated with higher odds of prevalent albuminuria.
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Affiliation(s)
- Ana C. Ricardo
- Department of Medicine, University of Illinois, Chicago, Illinois, USA
- Correspondence: Ana C. Ricardo, University of Illinois at Chicago, Department of Medicine, Division of Nephrology, 820 S. Wood St. 418W CSN, MC 793, Chicago, Illinois 60612-7315, USA.
| | - Jinsong Chen
- Department of Medicine, University of Illinois, Chicago, Illinois, USA
| | - Manpreet Singh
- Department of Medicine, University of Illinois, Chicago, Illinois, USA
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Leopoldo Raij
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Alberto Ramos
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Susan Redline
- Departments of Medicine and Neurology, Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Sylvia E. Rosas
- Joslin Diabetes Center and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Neomi Shah
- Department of Medicine, Montefiore Medical Center, New York, New York
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Phyllis Zee
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois, Chicago, Illinois, USA
| | - James P. Lash
- Department of Medicine, University of Illinois, Chicago, Illinois, USA
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Desai N, Lora CM, Lash JP, Ricardo AC. CKD and ESRD in US Hispanics. Am J Kidney Dis 2018; 73:102-111. [PMID: 29661541 DOI: 10.1053/j.ajkd.2018.02.354] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 02/08/2018] [Indexed: 12/23/2022]
Abstract
Hispanics are the largest racial/ethnic minority group in the United States, and they experience a substantial burden of kidney disease. Although the prevalence of chronic kidney disease (CKD) is similar or slightly lower in Hispanics than non-Hispanic whites, the age- and sex-adjusted prevalence rate of end-stage renal disease is almost 50% higher in Hispanics compared with non-Hispanic whites. This has been attributed in part to faster CKD progression among Hispanics. Furthermore, Hispanic ethnicity has been associated with a greater prevalence of cardiovascular disease risk factors, including obesity and diabetes, as well as CKD-related complications. Despite their less favorable socioeconomic status, which often leads to limited access to quality health care, and their high comorbid condition burden, the risk for mortality among Hispanics appears to be lower than for non-Hispanic whites. This survival paradox has been attributed to a complex interplay between sociocultural and psychosocial factors, as well as other factors. Future research should focus on evaluating the long-term impact of these factors on patient-centered and clinical outcomes. National policies are needed to improve access to and quality of health care among Hispanics with CKD.
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Affiliation(s)
- Nisa Desai
- Division of Nephrology, Department of Medicine, University of Illinois at Chicago, Chicago, IL
| | - Claudia M Lora
- Division of Nephrology, Department of Medicine, University of Illinois at Chicago, Chicago, IL
| | - James P Lash
- Division of Nephrology, Department of Medicine, University of Illinois at Chicago, Chicago, IL
| | - Ana C Ricardo
- Division of Nephrology, Department of Medicine, University of Illinois at Chicago, Chicago, IL.
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Brown LA, Sofer T, Stilp AM, Baier LJ, Kramer HJ, Masindova I, Levy D, Hanson RL, Moncrieft AE, Redline S, Rosas SE, Lash JP, Cai J, Laurie CC, Browning S, Thornton T, Franceschini N. Admixture Mapping Identifies an Amerindian Ancestry Locus Associated with Albuminuria in Hispanics in the United States. J Am Soc Nephrol 2017; 28:2211-2220. [PMID: 28137830 PMCID: PMC5491288 DOI: 10.1681/asn.2016091010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/29/2016] [Indexed: 11/03/2022] Open
Abstract
Increased urine albumin excretion is highly prevalent in Hispanics/Latinos. Previous studies have found an association between urine albumin excretion and Amerindian ancestry in Hispanic/Latino populations. Admixture between racial/ethnic groups creates long-range linkage disequilibrium between variants with different allelic frequencies in the founding populations and it can be used to localize genes. Hispanic/Latino genomes are an admixture of European, African, and Amerindian ancestries. We leveraged this admixture to identify associations between urine albumin excretion (urine albumin-to-creatinine ratio [UACR]) and genomic regions harboring variants with highly differentiated allele frequencies among the ancestral populations. Admixture mapping analysis of 12,212 Hispanic Community Health Study/Study of Latinos participants, using a linear mixed model, identified three novel genome-wide significant signals on chromosomes 2, 11, and 16. The admixture mapping signal identified on chromosome 2, spanning q11.2-14.1 and not previously reported for UACR, is driven by a difference between Amerindian ancestry and the other two ancestries (P<5.7 × 10-5). Within this locus, two common variants located at the proapoptotic BCL2L11 gene associated with UACR: rs116907128 (allele frequency =0.14; P=1.5 × 10-7) and rs586283 (C allele frequency =0.35; P=4.2 × 10-7). In a secondary analysis, rs116907128 accounted for most of the admixture mapping signal observed in the region. The rs116907128 variant is common among full-heritage Pima Indians (A allele frequency =0.54) but is monomorphic in the 1000 Genomes European and African populations. In a replication analysis using a sample of full-heritage Pima Indians, rs116907128 significantly associated with UACR (P=0.01; n=1568). Our findings provide evidence for the presence of Amerindian-specific variants influencing the variation of urine albumin excretion in Hispanics/Latinos.
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Affiliation(s)
- Lisa A Brown
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington
| | - Tamar Sofer
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington
| | - Adrienne M Stilp
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington
| | - Leslie J Baier
- Epidemiology and Clinical Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona
| | - Holly J Kramer
- Department of Public Health Sciences and Medicine, Division of Nephrology and Hypertension, Loyola University Chicago, Maywood, Illinois
| | - Ivica Masindova
- Epidemiology and Clinical Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona
| | - Daniel Levy
- The Framingham Heart Study, Framingham, Massachusetts, and Population Sciences Branch, National Heart, Lung, and Blood Institute, US National Institutes of Health, Bethesda, Maryland
| | - Robert L Hanson
- Epidemiology and Clinical Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona
| | | | - Susan Redline
- Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Sylvia E Rosas
- Department of Medicine, Division of Nephrology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - James P Lash
- Department of Medicine, Division of Nephrology and Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois
| | - Jianwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | - Cathy C Laurie
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington
| | - Sharon Browning
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington
| | - Timothy Thornton
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington
| | - Nora Franceschini
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
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6
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Arce CM, Quinones H. CKD and Cardiovascular Events: Unraveling the Disparities Among Minorities. Am J Kidney Dis 2016; 68:508-511. [DOI: 10.1053/j.ajkd.2016.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 11/11/2022]
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Kramer HJ, Stilp AM, Laurie CC, Reiner AP, Lash J, Daviglus ML, Rosas SE, Ricardo AC, Tayo BO, Flessner MF, Kerr KF, Peralta C, Durazo-Arvizu R, Conomos M, Thornton T, Rotter J, Taylor KD, Cai J, Eckfeldt J, Chen H, Papanicolau G, Franceschini N. African Ancestry-Specific Alleles and Kidney Disease Risk in Hispanics/Latinos. J Am Soc Nephrol 2016; 28:915-922. [PMID: 27650483 DOI: 10.1681/asn.2016030357] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Accepted: 07/26/2016] [Indexed: 12/15/2022] Open
Abstract
African ancestry alleles may contribute to CKD among Hispanics/Latinos, but whether associations differ by Hispanic/Latino background remains unknown. We examined the association of CKD measures with African ancestry-specific APOL1 alleles that were directly genotyped and sickle cell trait (hemoglobin subunit β gene [HBB] variant) on the basis of imputation in 12,226 adult Hispanics/Latinos grouped according to Caribbean or Mainland background. We also performed an unbiased genome-wide association scan of urine albumin-to-creatinine ratios. Overall, 41.4% of participants were male, 44.6% of participants had a Caribbean background, and the mean age of all participants was 46.1 years. The Caribbean background group, compared with the Mainland background group, had a higher frequency of two APOL1 alleles (1.0% versus 0.1%) and the HBB variant (2.0% versus 0.7%). In the Caribbean background group, presence of APOL1 alleles (2 versus 0/1 copies) or the HBB variant (1 versus 0 copies) were significantly associated with albuminuria (odds ratio [OR], 3.2; 95% confidence interval [95% CI], 1.7 to 6.1; and OR, 2.6; 95% CI, 1.8 to 3.8, respectively) and albuminuria and/or eGFR<60 ml/min per 1.73 m2 (OR, 2.9; 95% CI, 1.5 to 5.4; and OR, 2.4; 95% CI, 1.7 to 3.5, respectively). The urine albumin-to-creatinine ratio genome-wide association scan identified associations with the HBB variant among all participants, with the strongest association in the Caribbean background group (P=3.1×10-10 versus P=9.3×10-3 for the Mainland background group). In conclusion, African-specific alleles associate with CKD in Hispanics/Latinos, but allele frequency varies by Hispanic/Latino background/ancestry.
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Affiliation(s)
- Holly J Kramer
- Department of Public Health Sciences and Medicine, and.,Division of Nephrology and Hypertension, Loyola University Chicago, Maywood, Illinois
| | | | | | - Alex P Reiner
- Fred Hutchinson Cancer Research Center, Division of Public Health Science, University of Washington School of Public Health, Seattle, Washington
| | - James Lash
- Division of Nephrology, Department of Medicine, and.,Institute for Minority Health Research, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Martha L Daviglus
- Institute for Minority Health Research, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Sylvia E Rosas
- Division of Nephrology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Ana C Ricardo
- Division of Nephrology, Department of Medicine, and.,Institute for Minority Health Research, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | | | - Michael F Flessner
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | | | - Carmen Peralta
- Division of Nephrology, Department of Medicine, University of California, San Francisco, California
| | | | | | | | - Jerome Rotter
- Institute for Translational Genomics and Population Sciences Los Angeles, Biomedical Research Institute and Department of Pediatrics, Harbor-University of California at Los Angeles Medical Center, Torrance, California
| | - Kent D Taylor
- Institute for Translational Genomics and Population Sciences Los Angeles, Biomedical Research Institute and Department of Pediatrics, Harbor-University of California at Los Angeles Medical Center, Torrance, California
| | - Jainwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, and
| | - John Eckfeldt
- Advanced Research and Diagnostics Laboratories, Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota; and
| | - Han Chen
- Department of Biostatistics, and
| | - George Papanicolau
- Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Nora Franceschini
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;
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8
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Petrov ME, Buman MP, Unruh ML, Baldwin CM, Jeong M, Reynaga-Ornelas L, Youngstedt SD. Association of sleep duration with kidney function and albuminuria: NHANES 2009-2012. Sleep Health 2016; 2:75-81. [PMID: 29073456 PMCID: PMC8381730 DOI: 10.1016/j.sleh.2015.12.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 11/23/2015] [Accepted: 12/01/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the association between self-reported sleep duration and markers of kidney function. DESIGN A cross-sectional survey from the 2009-2012 National Health and Nutrition Examination Survey. SETTING AND PARTICIPANTS The participants were 8690 adults (e20years) without a previous sleep disorder diagnosis, end-stage kidney failure, or other kidney or liver problems. Subsamples with pre-diabetes and pre-hypertension were examined. MEASUREMENTS Participants reported habitual sleep duration, coded as d5, 6, 7, 8, and e9hours per night. Biomarkers of kidney function were determined, including glomerular filtration rate (eGFR) estimated from the Chronic Kidney Disease Epidemiology Collaboration equation, urine albumin-to-creatinine ratio (ACR), microalbuminuria status, and glomerular hyperfiltration status. Weighted and adjusted general linear models assessed associations between sleep duration with eGFR and ACR. Logistic regression analyses evaluated the associations of microalbuminuria and glomerular hyperfiltration status with sleep duration. RESULTS Greater eGFR was related to short sleep duration in the total sample and among participants with pre-diabetes. Greater ACR was associated with short and long sleep duration. Short sleep duration (d5hours) was associated with an increased odds for glomerular hyperfiltration (OR, 1.41; 95% CI, 0.97-2.06) and microalbuminuria (OR, 1.31; 95% CI, 0.96-1.79). CONCLUSIONS In a US representative sample of adults, self-reported short and long sleep duration were related to higher ACR. Short sleep duration was associated with higher eGFR and microalbuminuria. Research is needed to understand whether these associations indicate increased risk for kidney damage and cardiovascular risk.
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Affiliation(s)
- Megan E Petrov
- College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd Street, Phoenix, AZ, USA.
| | - Matthew P Buman
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, USA.
| | - Mark L Unruh
- Division of Nephrology, University of New Mexico, Albuquerque, NM, USA.
| | - Carol M Baldwin
- College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd Street, Phoenix, AZ, USA.
| | - Mihyun Jeong
- College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd Street, Phoenix, AZ, USA.
| | | | - Shawn D Youngstedt
- College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd Street, Phoenix, AZ, USA; School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, USA.
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9
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Moradi H, Abhari P, Streja E, Kashyap ML, Shah G, Gillen D, Pahl MV, Vaziri ND, Kalantar-Zadeh K. Association of serum lipids with outcomes in Hispanic hemodialysis patients of the West versus East Coasts of the United States. Am J Nephrol 2015; 41:284-95. [PMID: 26044456 DOI: 10.1159/000381991] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 03/25/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Paradoxical associations exist between serum lipid levels and mortality in patients on maintenance hemodialysis (MHD) including those of Hispanic origin. However, there are significant racial and ethnic variations in patients of 'Hispanic' background. We hypothesized that clinically meaningful differences existed in the association between lipids and survival in Hispanic MHD patients on the West versus East Coast. METHODS We examined the survival impact of serum lipids in a 2-year cohort of 15,109 MHD patients of Hispanic origin being treated in California, Texas, representing the West versus New York, New Jersey and Florida representing the East Coast, using Cox models with various degrees of adjustments. RESULTS The association of serum total and HDL cholesterol with mortality follows a U-shaped pattern in Hispanic patients residing in the West. This is in contrast to Hispanic patients in the East Coast whose survival seems to improve with increasing total and HDL cholesterol levels. Elevated serum LDL levels in Hispanic patients on the West Coast are associated with a significant increase in mortality, while this association is not observed in patients residing on the East Coast. CONCLUSIONS Substantial differences exist in the association of serum lipids with mortality in MHD patients of Hispanic background depending on whether they reside on the West or East Coast of the United States. These geographical variances most likely reflect ethnic, racial and genetic distinctions, which are usually ignored. Future studies should take into account these critical variations in a population of patients who make up a significant portion of our society.
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Affiliation(s)
- Hamid Moradi
- Division of Nephrology and Hypertension, University of California Irvine School of Medicine, Orange, Calif., USA
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10
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Jiménez-Corona A, Ávila-Hermosillo A, Nelson RG, Ramírez-López G. A Family History of Diabetes Modifies the Association between Elevated Urine Albumin Concentration and Hyperglycemia in Nondiabetic Mexican Adolescents. J Diabetes Res 2015; 2015:437079. [PMID: 26347891 PMCID: PMC4548133 DOI: 10.1155/2015/437079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/08/2015] [Indexed: 11/17/2022] Open
Abstract
We examined the frequency of elevated urine albumin concentration (UAC) and its association with metabolic syndrome (MetS) and metabolic markers in 515 nondiabetic Mexican adolescents stratified by family history of diabetes (FHD). UAC was measured in a first morning urine sample and considered elevated when excretion was ≥20 mg/mL. MetS was defined using International Diabetes Federation criteria. Fasting insulin, insulin resistance, and lipids were evaluated. Multivariate logistic regression was performed. Elevated UAC was present in 12.4% and MetS was present in 8.9% of the adolescents. No association was found between elevated UAC and MetS. Among adolescents with FHD, 18.4% were overweight and 20.7% were obese, whereas, among those without a FHD, 15.9% were overweight and 7.5% were obese. Hyperglycemia was higher in those with elevated UAC than in those without (44.4% versus 5.1%, p = 0.003). Hyperglycemia (OR = 9.8, 95% CI 1.6-59.4) and number of MetS components (OR = 4.5, 95% CI 1.5-13.3) were independently associated with elevated UAC. Among female participants, abdominal obesity was associated with elevated UAC (OR = 4.5, 95% CI 1.2-16.9). Conclusion. Elevated UAC was associated neither with MetS nor with any metabolic markers in nondiabetic adolescents. However, FHD modified the association of elevated UAC with hyperglycemia and the number of MetS components.
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Affiliation(s)
- Aida Jiménez-Corona
- General Directorate of Epidemiology, Health Secretariat, Francisco P Miranda 177, Colonia Lomas de Plateros, Delegación Álvaro Obregón, 01480 Mexico City, DF, Mexico
- Ocular Epidemiology Department, Institute of Ophthalmology Foundation Conde of Valenciana, IAP, Chimalpopoca 14, Colonia Obrera, Delegación Cuauhtémoc, 06800 Mexico City, DF, Mexico
| | - Antonio Ávila-Hermosillo
- Regional General Hospital No. 89, Mexican Institute of Social Security, Washington 1988, Colonia Moderna, Sector Juárez, 44150 Guadalajara, JAL, Mexico
| | - Robert G. Nelson
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix Epidemiology and Clinical Research Branch, 1550 East Indian School Road, Phoenix, AZ 85014, USA
| | - Guadalupe Ramírez-López
- Adolescent Epidemiological and Health Services Research Unit, Mexican Institute of Social Security, Avenida Tonalá 121, 45400 Guadalajara, JAL, Mexico
- *Guadalupe Ramírez-López:
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11
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Udler MS, Nadkarni GN, Belbin G, Lotay V, Wyatt C, Gottesman O, Bottinger EP, Kenny EE, Peter I. Effect of Genetic African Ancestry on eGFR and Kidney Disease. J Am Soc Nephrol 2014; 26:1682-92. [PMID: 25349204 DOI: 10.1681/asn.2014050474] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 09/02/2014] [Indexed: 01/08/2023] Open
Abstract
Self-reported ancestry, genetically determined ancestry, and APOL1 polymorphisms are associated with variation in kidney function and related disease risk, but the relative importance of these factors remains unclear. We estimated the global proportion of African ancestry for 9048 individuals at Mount Sinai Medical Center in Manhattan (3189 African Americans, 1721 European Americans, and 4138 Hispanic/Latino Americans by self-report) using genome-wide genotype data. CKD-EPI eGFR and genotypes of three APOL1 coding variants were available. In admixed African Americans and Hispanic/Latino Americans, serum creatinine values increased as African ancestry increased (per 10% increase in African ancestry, creatinine values increased 1% in African Americans and 0.9% in Hispanic/Latino Americans; P≤1x10(-7)). eGFR was likewise significantly associated with African genetic ancestry in both populations. In contrast, APOL1 risk haplotypes were significantly associated with CKD, eGFR<45 ml/min per 1.73 m(2), and ESRD, with effects increasing with worsening disease states and the contribution of genetic African ancestry decreasing in parallel. Using genetic ancestry in the eGFR equation to reclassify patients as black on the basis of ≥50% African ancestry resulted in higher eGFR for 14.7% of Hispanic/Latino Americans and lower eGFR for 4.1% of African Americans, affecting CKD staging in 4.3% and 1% of participants, respectively. Reclassified individuals had electrolyte values consistent with their newly assigned CKD stage. In summary, proportion of African ancestry was significantly associated with normal-range creatinine and eGFR, whereas APOL1 risk haplotypes drove the associations with CKD. Recalculation of eGFR on the basis of genetic ancestry affected CKD staging and warrants additional investigation.
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Affiliation(s)
- Miriam S Udler
- Departments of Medicine and Genetics and Genomic Sciences, The Charles Bronfman Institute for Personalized Medicine,
| | - Girish N Nadkarni
- Departments of Medicine and The Charles Bronfman Institute for Personalized Medicine, Division of Nephrology
| | - Gillian Belbin
- Genetics and Genomic Sciences, The Charles Bronfman Institute for Personalized Medicine
| | - Vaneet Lotay
- The Charles Bronfman Institute for Personalized Medicine
| | | | - Omri Gottesman
- Departments of Medicine and The Charles Bronfman Institute for Personalized Medicine
| | - Erwin P Bottinger
- Departments of Medicine and The Charles Bronfman Institute for Personalized Medicine, Division of Nephrology
| | - Eimear E Kenny
- Genetics and Genomic Sciences, The Charles Bronfman Institute for Personalized Medicine, The Center for Statistical Genetics, and The Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Inga Peter
- Genetics and Genomic Sciences, The Charles Bronfman Institute for Personalized Medicine, The Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, New York
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12
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Zhou B, Wang J, Stein EM, Zhang Z, Nishiyama KK, Zhang CA, Nickolas TL, Shane E, Guo XE. Bone density, microarchitecture and stiffness in Caucasian and Caribbean Hispanic postmenopausal American women. Bone Res 2014; 2:14016. [PMID: 26273525 PMCID: PMC4472134 DOI: 10.1038/boneres.2014.16] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 07/30/2014] [Accepted: 07/30/2014] [Indexed: 12/24/2022] Open
Abstract
Hispanic Americans of Caribbean origin are a fast-growing subset of the US population, but there are no studies on bone density, microstructure and biomechanical integrity in this minority group. In this study, we aimed to compare Caucasian and Caribbean Hispanic postmenopausal American women with respect to these characteristics. Thirty-three Caribbean Hispanics were age-matched to thirty-three Caucasian postmenopausal women. At the lumbar spine, the Hispanic women had significantly lower areal bone mineral density (aBMD). At the radius by high-resolution peripheral quantitative computed tomography (HR-pQCT), there were minimal differences between Hispanic and Caucasian women. At the tibia, Hispanic women had lower trabecular volumetric bone density and trabecular number, and higher trabecular separation. Individual trabecula segmentation (ITS) analyses indicated that at the tibia, Hispanic women not only had significantly lower bone volume fraction, but also had significantly lower rod bone volume fraction, plate trabecular number, rod trabecular number and lower plate–plate, plate–rod and rod–rod junction densities compared to Caucasian women. The differences in bone quantity and quality contributed to lower whole bone stiffness at the radius, and both whole bone and trabecular bone stiffness at the tibia in Hispanic women. In conclusion, Hispanic women had poorer bone mechanical and microarchitectural properties than Caucasian women, especially at the load-bearing distal tibia.
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Affiliation(s)
- Bin Zhou
- Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University , New York, USA
| | - Ji Wang
- Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University , New York, USA
| | - Emily M Stein
- Division of Endocrinology, Department of Medicine, Columbia University , New York, USA
| | - Zhendong Zhang
- Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University , New York, USA ; Department of Orthopedic Surgery, First Affiliated Hospital, School of Medicine Shihezi University , Shihezi, Xinjiang, China
| | - Kyle K Nishiyama
- Division of Endocrinology, Department of Medicine, Columbia University , New York, USA
| | - Chiyuan A Zhang
- Division of Endocrinology, Department of Medicine, Columbia University , New York, USA
| | - Thomas L Nickolas
- Division of Endocrinology, Department of Medicine, Columbia University , New York, USA
| | - Elizabeth Shane
- Division of Endocrinology, Department of Medicine, Columbia University , New York, USA
| | - X Edward Guo
- Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University , New York, USA
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13
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Weitzel JN, Clague J, Martir-Negron A, Ogaz R, Herzog J, Ricker C, Jungbluth C, Cina C, Duncan P, Unzeitig G, Saldivar JS, Beattie M, Feldman N, Sand S, Port D, Barragan DI, John EM, Neuhausen SL, Larson GP. Prevalence and type of BRCA mutations in Hispanics undergoing genetic cancer risk assessment in the southwestern United States: a report from the Clinical Cancer Genetics Community Research Network. J Clin Oncol 2012; 31:210-6. [PMID: 23233716 DOI: 10.1200/jco.2011.41.0027] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To determine the prevalence and type of BRCA1 and BRCA2 (BRCA) mutations among Hispanics in the Southwestern United States and their potential impact on genetic cancer risk assessment (GCRA). PATIENTS AND METHODS Hispanics (n = 746) with a personal or family history of breast and/or ovarian cancer were enrolled in an institutional review board-approved registry and received GCRA and BRCA testing within a consortium of 14 clinics. Population-based Hispanic breast cancer cases (n = 492) enrolled in the Northern California Breast Cancer Family Registry, negative by sequencing for BRCA mutations, were analyzed for the presence of the BRCA1 ex9-12del large rearrangement. RESULTS Deleterious BRCA mutations were detected in 189 (25%) of 746 familial clinic patients (124 BRCA1, 65 BRCA2); 21 (11%) of 189 were large rearrangement mutations, of which 62% (13 of 21) were BRCA1 ex9-12del. Nine recurrent mutations accounted for 53% of the total. Among these, BRCA1 ex9-12del seems to be a Mexican founder mutation and represents 10% to 12% of all BRCA1 mutations in clinic- and population-based cohorts in the United States. CONCLUSION BRCA mutations were prevalent in the largest study of Hispanic breast and/or ovarian cancer families in the United States to date, and a significant proportion were large rearrangement mutations. The high frequency of large rearrangement mutations warrants screening in every case. We document the first Mexican founder mutation (BRCA1 ex9-12del), which, along with other recurrent mutations, suggests the potential for a cost-effective panel approach to ancestry-informed GCRA.
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Levran O, Awolesi O, Shen PH, Adelson M, Kreek MJ. Estimating ancestral proportions in a multi-ethnic US sample: implications for studies of admixed populations. Hum Genomics 2012; 6:2. [PMID: 23244743 PMCID: PMC3437566 DOI: 10.1186/1479-7364-6-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 07/05/2012] [Indexed: 02/04/2023] Open
Abstract
This study was designed to determine the ancestral composition of a multi-ethnic sample collected for studies of drug addictions in New York City and Las Vegas, and to examine the reliability of self-identified ethnicity and three-generation family history data. Ancestry biographical scores for seven clusters corresponding to world major geographical regions were obtained using STRUCTURE, based on genotypes of 168 ancestry informative markers (AIMs), for a sample of 1,291 African Americans (AA), European Americans (EA), and Hispanic Americans (HA) along with data from 1,051 HGDP-CEPH ‘diversity panel’ as a reference. Self-identified ethnicity and family history data, obtained in an interview, were accurate in identifying the individual major ancestry in the AA and the EA samples (approximately 99% and 95%, respectively) but were not useful for the HA sample and could not predict the extent of admixture in any group. The mean proportions of the combined clusters corresponding to European and Middle Eastern populations in the AA sample, revealed by AIMs analysis, were 0.13. The HA subjects, predominantly Puerto Ricans, showed a highly variable hybrid contribution pattern of clusters corresponding to Europe (0.27), Middle East (0.27), Africa (0.20), and Central Asia (0.14). The effect of admixture on allele frequencies is demonstrated for two single-nucleotide polymorphisms (118A > G, 17 C > T) of the mu opioid receptor gene (OPRM1). This study reiterates the importance of AIMs in defining ancestry, especially in admixed populations.
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15
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Manichaikul A, Palmas W, Rodriguez CJ, Peralta CA, Divers J, Guo X, Chen WM, Wong Q, Williams K, Kerr KF, Taylor KD, Tsai MY, Goodarzi MO, Sale MM, Diez-Roux AV, Rich SS, Rotter JI, Mychaleckyj JC. Population structure of Hispanics in the United States: the multi-ethnic study of atherosclerosis. PLoS Genet 2012; 8:e1002640. [PMID: 22511882 PMCID: PMC3325201 DOI: 10.1371/journal.pgen.1002640] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 02/20/2012] [Indexed: 01/06/2023] Open
Abstract
Using ~60,000 SNPs selected for minimal linkage disequilibrium, we perform population structure analysis of 1,374 unrelated Hispanic individuals from the Multi-Ethnic Study of Atherosclerosis (MESA), with self-identification corresponding to Central America (n = 93), Cuba (n = 50), the Dominican Republic (n = 203), Mexico (n = 708), Puerto Rico (n = 192), and South America (n = 111). By projection of principal components (PCs) of ancestry to samples from the HapMap phase III and the Human Genome Diversity Panel (HGDP), we show the first two PCs quantify the Caucasian, African, and Native American origins, while the third and fourth PCs bring out an axis that aligns with known South-to-North geographic location of HGDP Native American samples and further separates MESA Mexican versus Central/South American samples along the same axis. Using k-means clustering computed from the first four PCs, we define four subgroups of the MESA Hispanic cohort that show close agreement with self-identification, labeling the clusters as primarily Dominican/Cuban, Mexican, Central/South American, and Puerto Rican. To demonstrate our recommendations for genetic analysis in the MESA Hispanic cohort, we present pooled and stratified association analysis of triglycerides for selected SNPs in the LPL and TRIB1 gene regions, previously reported in GWAS of triglycerides in Caucasians but as yet unconfirmed in Hispanic populations. We report statistically significant evidence for genetic association in both genes, and we further demonstrate the importance of considering population substructure and genetic heterogeneity in genetic association studies performed in the United States Hispanic population.
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Affiliation(s)
- Ani Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America.
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16
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Lutsey PL, Wassel CL, Cushman M, Sale MM, Divers J, Folsom AR. Genetic admixture is associated with plasma hemostatic factor levels in self-identified African Americans and Hispanics: the Multi-Ethnic Study of Atherosclerosis. J Thromb Haemost 2012; 10:543-9. [PMID: 22332961 PMCID: PMC3361899 DOI: 10.1111/j.1538-7836.2012.04663.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Epidemiologic studies report that self-identified African Americans typically have higher hemostatic factor levels than do self-identified Caucasians or Hispanics. OBJECTIVE To enhance understanding of phenotypic variation in hemostatic factor levels by race/ethnicity, we evaluated the relationship between genetic ancestry and hemostatic factor levels among Multi-Ethnic Study of Atherosclerosis (MESA) study participants. PATIENTS/METHODS Our sample included 712 African American and 701 Hispanic men and women aged 45 to 84 years. Individual global ancestry was estimated from 199 genetic markers using STRUCTURE. Linear regression models were used to evaluate the relationship between ancestry and hemostatic factor levels, adjusting for age, gender, education, income and study site. RESULTS Among African Americans, mean ± standard deviation (SD) ancestry was estimated as 79.9% ± 15.9% African and 20.1% ± 15.9% European. Each SD (16%) greater African ancestry was associated with 2.1% higher fibrinogen levels (P = 0.007) and 3.5% higher plasmin-antiplasmin (PAP) levels (P = 0.02). Ancestry among African Americans was not related to levels of factor (F)VIII or D-dimer. Mean ± SD estimated ancestry among Hispanics was 48.3% ± 23.8% Native American, 38.8% ± 21.9% European, and 13.0% ± 8.9% African. In Hispanics, each SD (19%) greater African ancestry was associated with 2.7% higher fibrinogen levels (P = 0.009) and 7.9% higher FVIII levels (P = 0.0002). In Hispanics, there was no relation between African ancestry and D-dimer or PAP levels, or between European ancestry and hemostatic factor levels. CONCLUSIONS Greater African ancestry among African Americans and Hispanics was associated with higher levels of several hemostatic factors, notably fibrinogen. These results suggest that genetic heterogeneity contributes, albeit modestly, to racial/ethnic differences in hemostatic factor levels.
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Affiliation(s)
- P L Lutsey
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN 55454, USA.
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Tzur S, Rosset S, Skorecki K, Wasser WG. APOL1 allelic variants are associated with lower age of dialysis initiation and thereby increased dialysis vintage in African and Hispanic Americans with non-diabetic end-stage kidney disease. Nephrol Dial Transplant 2012; 27:1498-505. [PMID: 22357707 DOI: 10.1093/ndt/gfr796] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The APOL1 G1 and G2 genetic variants make a major contribution to the African ancestry risk for a number of common forms of non-diabetic end-stage kidney disease (ESKD). We sought to clarify the relationship of APOL1 variants with age of dialysis initiation and dialysis vintage (defined by the time between dialysis initiation and sample collection) in African and Hispanic Americans, diabetic and non-diabetic ESKD. METHODS We examined APOL1 genotypes in 995 African and Hispanic American dialysis patients with diabetic and non-diabetic ESKD. RESULTS The mean age of dialysis initiation for non-diabetic African-American patients with two APOL1 risk alleles was 48.1 years, >9 years earlier than those without APOL1 risk alleles (t-test, P=0.0003). Similar results were found in the non-diabetic Hispanic American cohort, but not in the diabetic cohorts. G1 heterozygotes showed a 5.3-year lower mean age of dialysis initiation (t-test, P=0.0452), but G2 heterozygotes did not show such an effect. At the age of 70, 92% of individuals with two APOL1 risk alleles had already initiated dialysis, compared with 76% of the patients without APOL1 risk alleles. Although two APOL1 risk alleles are also associated with ∼2 years increased in dialysis vintage, further analysis showed that this increase is fully explained by earlier age of dialysis initiation. CONCLUSIONS Two APOL1 risk alleles significantly predict lower age of dialysis initiation and thereby increased dialysis vintage in non-diabetic ESKD African and Hispanic Americans, but not in diabetic ESKD. A single APOL1 G1, but not G2, risk allele also lowers the age of dialysis initiation, apparently consistent with gain of injury or loss of function mechanisms. Hence, APOL1 mutations produce a distinct category of kidney disease that manifests at younger ages in African ancestry populations.
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Affiliation(s)
- Shay Tzur
- Ruth and Bruce Rappaport Faculty of Medicine and Research Institute, Technion-Israel Institute of Technology, Haifa, Israel
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18
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Arce CM, Mitani AA, Goldstein BA, Winkelmayer WC. Hispanic ethnicity and vascular access use in patients initiating hemodialysis in the United States. Clin J Am Soc Nephrol 2011; 7:289-96. [PMID: 22114148 DOI: 10.2215/cjn.08370811] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND OBJECTIVES Hispanics are the largest minority in the United States (comprising 16.3% of the US population) and have 1.5 times the age-, sex-, and race-adjusted incidence of ESRD compared with non-Hispanics. Poor health care access and low-quality care generally received by Hispanics are well documented. However, little is known regarding dialysis preparation of Hispanic patients with progressive CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Using data from Medical Evidence Report form CMS-2728-U3, 321,996 adult patients of white or black race were identified who initiated hemodialysis (HD) between July 1, 2005 and December 31, 2008. The form captures Hispanic ethnicity, vascular access use at first outpatient HD, sociodemographic characteristics, and comorbidities. This study also examined whether use of an arteriovenous fistula (AVF) or graft (AVG) was reported. RESULTS AVF/AVG use was reported in 14.5% of Hispanics and 17.6% in non-Hispanics (P<0.001). The unadjusted prevalence ratio (PR) was 0.85 (95% confidence interval [95% CI], 0.83-0.88), indicating that Hispanics were 15% less likely to use AVG/AVF for their first outpatient HD. Adjustment for age, sex, and race, as well as a large number of comorbidities and frailty indicators, did not change this association (PR, 0.85; 95% CI, 0.83-0.88). Further adjustment for timing of first predialysis nephrology care, however, attenuated the PR by two-thirds (PR, 0.94; 95% CI, 0.92-0.97). CONCLUSIONS Hispanics are less likely to use arteriovenous access for first outpatient HD compared with non-Hispanics, which seems to be explained by variation in the access to predialysis nephrology care.
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Affiliation(s)
- Cristina M Arce
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA.
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19
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Fetal hemoglobin levels in African American and Hispanic children with sickle cell disease at baseline and in response to hydroxyurea. J Pediatr Hematol Oncol 2011; 33:496-9. [PMID: 21941141 PMCID: PMC3179608 DOI: 10.1097/mph.0b013e31822dcc21] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The degree of fetal hemoglobin (HbF) expression is a major determinant of phenotypic severity of sickle cell disease (SCD). Genetic regulation of HbF production is complex and can vary among ethnic groups. The pediatric sickle cell population at our institution is approximately half Hispanic, nearly all from the Dominican Republic. Hydroxyurea (HU) is the only Food and Drug Administration (FDA)-approved drug to ameliorate symptoms of SCD. We retrospectively compared baseline and HU-induced percent HbF (%HbF) in African American (AA) and Hispanic (H) patients aged 4 to 21 years with homozygous Sickle hemoglobin or HbSβ(0)Thalassemia. No significant differences were detected in average baseline %HbF between AA (N=48) and H (N=58) patients (P=0.63). In the subset of children taking HU who reached maximum tolerated dose (MTD), no differences were found between the ethnic groups in laboratory response to drug, measured by %HbF at MTD (P=0.28), the increase in %HbF (P=0.31) or mean red cell volume (MCV) (P=0.93), or the MTD of HU (P=0.95). Regulation of HbF at baseline and in response to HU are comparable between Hispanics and African Americans at our center. If generalizable, our results support combining these 2 groups in future clinical and translational analyses focused on HbF and response to HU in this ethnically mixed patient population.
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Wassel CL, Jacobs DR, Duprez DA, Bluemke DA, Sibley CT, Criqui MH, Peralta CA. Association of self-reported race/ethnicity and genetic ancestry with arterial elasticity: the Multi-Ethnic Study of Atherosclerosis (MESA). ACTA ACUST UNITED AC 2011; 5:463-72. [PMID: 21890448 DOI: 10.1016/j.jash.2011.07.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2011] [Revised: 07/19/2011] [Accepted: 07/25/2011] [Indexed: 01/12/2023]
Abstract
African Americans have a disproportionate burden of hypertension compared with white, whereas data on Hispanics is less well-defined. Mechanisms underlying these differences are unclear, but could be in part because of ancestral background and vascular function. We studied 660 African Americans and 635 Hispanics from the Multi-Ethnic Study of Atherosclerosis (MESA) with complete data on genetic ancestry, pulse pressure (PP), and large and small arterial elasticity (LAE, SAE). LAE and SAE were obtained using the HDI PulseWave CR-2000 Research CardioVascular Profiling Instrument. Among African Americans, higher European ancestry was marginally associated with higher LAE (P = .05) and lower PP (P = .05); results for LAE were attenuated after adjustment for potential mediators (P = .30). Among Hispanics, higher Native American ancestry was associated with higher SAE (P = .0006); higher African ancestry was marginally associated with lower SAE (P = .07). Ancestry was not significantly associated with LAE or PP in Hispanics. Among African Americans, higher European ancestry may be associated with less large artery damage, as measured by LAE and PP, although these associations warrant further study. Among Hispanics, ancestry is strongly associated with SAE. Future studies should consider genetic ancestry when studying hypertension in race/ethnic minorities, particularly among Hispanics.
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Design and coverage of high throughput genotyping arrays optimized for individuals of East Asian, African American, and Latino race/ethnicity using imputation and a novel hybrid SNP selection algorithm. Genomics 2011; 98:422-30. [PMID: 21903159 DOI: 10.1016/j.ygeno.2011.08.007] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 08/22/2011] [Indexed: 12/24/2022]
Abstract
Four custom Axiom genotyping arrays were designed for a genome-wide association (GWA) study of 100,000 participants from the Kaiser Permanente Research Program on Genes, Environment and Health. The array optimized for individuals of European race/ethnicity was previously described. Here we detail the development of three additional microarrays optimized for individuals of East Asian, African American, and Latino race/ethnicity. For these arrays, we decreased redundancy of high-performing SNPs to increase SNP capacity. The East Asian array was designed using greedy pairwise SNP selection. However, removing SNPs from the target set based on imputation coverage is more efficient than pairwise tagging. Therefore, we developed a novel hybrid SNP selection method for the African American and Latino arrays utilizing rounds of greedy pairwise SNP selection, followed by removal from the target set of SNPs covered by imputation. The arrays provide excellent genome-wide coverage and are valuable additions for large-scale GWA studies.
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22
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McClellan WM, Warnock DG, Judd S, Muntner P, Kewalramani R, Cushman M, McClure LA, Newsome BB, Howard G. Albuminuria and racial disparities in the risk for ESRD. J Am Soc Nephrol 2011; 22:1721-8. [PMID: 21868498 DOI: 10.1681/asn.2010101085] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The causes of the increased risk for ESRD among African Americans are not completely understood. Here, we examined whether higher levels of urinary albumin excretion among African Americans contributes to this disparity. We analyzed data from 27,911 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who had urinary albumin-to-creatinine ratio (ACR) and estimated GFR (eGFR) measured at baseline. We identified incident cases of ESRD through linkage with the United States Renal Data System. At baseline, African Americans were less likely to have an eGFR <60 ml/min per 1.73 m(2) but more likely to have an ACR ≥ 30 mg/g. The incidence rates of ESRD among African Americans and whites were 204 and 58.6 cases per 100,000 person-years, respectively. After adjustment for age and gender, African Americans had a fourfold greater risk for developing ESRD (HR 4.0; 95% CI 2.8 to 5.9) compared with whites. Additional adjustment for either eGFR or ACR reduced the risk associated with African-American race to 2.3-fold (95% CI 1.5 to 3.3) or 1.8-fold (95% CI 1.2 to 2.7), respectively. Adjustment for both ACR and eGFR reduced the race-associated risk to 1.6-fold (95% CI 1.1 to 2.4). Finally, in a model that further adjusted for both eGFR and ACR, hypertension, diabetes, family income, and educational status, African-American race associated with a nonsignificant 1.4-fold (95% CI 0.9 to 2.3) higher risk for ESRD. In conclusion, the increased prevalence of albuminuria may be an important contributor to the higher risk for ESRD experienced by African Americans.
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Affiliation(s)
- William M McClellan
- Department of Medicine, Rollins School of Public Health, Emory University, Atlanta, GA 30220, USA.
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Fischer MJ, Go AS, Lora CM, Ackerson L, Cohan J, Kusek JW, Mercado A, Ojo A, Ricardo AC, Rosen LK, Tao K, Xie D, Feldman HI, Lash JP. CKD in Hispanics: Baseline characteristics from the CRIC (Chronic Renal Insufficiency Cohort) and Hispanic-CRIC Studies. Am J Kidney Dis 2011; 58:214-27. [PMID: 21705121 DOI: 10.1053/j.ajkd.2011.05.010] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Accepted: 05/09/2011] [Indexed: 01/13/2023]
Abstract
BACKGROUND Little is known regarding chronic kidney disease (CKD) in Hispanics. We compared baseline characteristics of Hispanic participants in the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC (H-CRIC) Studies with non-Hispanic CRIC participants. STUDY DESIGN Cross-sectional analysis. SETTING & PARTICIPANTS Participants were aged 21-74 years with CKD using age-based estimated glomerular filtration rate (eGFR) at enrollment into the CRIC/H-CRIC Studies. H-CRIC included Hispanics recruited at the University of Illinois in 2005-2008, whereas CRIC included Hispanics and non-Hispanics recruited at 7 clinical centers in 2003-2007. FACTOR Race/ethnicity. OUTCOMES Blood pressure, angiotensin-converting enzyme (ACE)-inhibitor/angiotensin receptor blocker (ARB) use, and CKD-associated complications. MEASUREMENTS Demographic characteristics, laboratory data, blood pressure, and medications were assessed using standard techniques and protocols. RESULTS Of H-CRIC/CRIC participants, 497 were Hispanic, 1,650 were non-Hispanic black, and 1,638 were non-Hispanic white. Low income and educational attainment were nearly twice as prevalent in Hispanics compared with non-Hispanics (P < 0.01). Hispanics had self-reported diabetes (67%) more frequently than non-Hispanic blacks (51%) and whites (40%; P < 0.01). Blood pressure >130/80 mm Hg was more common in Hispanics (62%) than blacks (57%) and whites (35%; P < 0.05), and abnormalities in hematologic, metabolic, and bone metabolism parameters were more prevalent in Hispanics (P < 0.05), even after stratifying by entry eGFR. Hispanics had the lowest use of ACE inhibitors/ARBs among the high-risk subgroups, including participants with diabetes, proteinuria, and blood pressure >130/80 mm Hg. Mean eGFR was lower in Hispanics (39.6 mL/min/1.73 m(2)) than in blacks (43.7 mL/min/1.73 m(2)) and whites (46.2 mL/min/1.73 m(2)), whereas median proteinuria was higher in Hispanics (protein excretion, 0.72 g/d) than in blacks (0.24 g/d) and whites (0.12 g/d; P < 0.01). LIMITATIONS Generalizability; observed associations limited by residual bias and confounding. CONCLUSIONS Hispanics with CKD in the CRIC/H-CRIC Studies are disproportionately burdened with lower socioeconomic status, more frequent diabetes mellitus, less ACE-inhibitor/ARB use, worse blood pressure control, and more severe CKD and associated complications than their non-Hispanic counterparts.
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Peralta CA, Katz R, DeBoer I, Ix J, Sarnak M, Kramer H, Siscovick D, Shea S, Szklo M, Shlipak M. Racial and ethnic differences in kidney function decline among persons without chronic kidney disease. J Am Soc Nephrol 2011; 22:1327-34. [PMID: 21700831 DOI: 10.1681/asn.2010090960] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Whether the rate of kidney function decline before the onset of CKD differs among racial and ethnic groups remains unclear. Here, we evaluated kidney function decline and incident CKD among white, black, Hispanic, and Chinese participants in the Multi-Ethnic Study of Atherosclerosis (MESA) during 5 years of follow-up. We estimated GFR using both cystatin C (eGFRcys) and creatinine (eGFRcreat). The definition of incident CKD required eGFRcys <60 ml/min per 1.73 m(2) and a decline in eGFRcys ≥1 ml/min per year. Among participants with eGFRcreat >60 ml/min per 1.73 m(2) at baseline, blacks had a significantly higher rate of kidney function decline than whites (0.31 ml/min per 1.73 m(2)/yr faster on average, P=0.001), even after adjusting for multiple potential confounders. Among Hispanics, Dominicans and Puerto Ricans had faster rates of decline than whites (0.55 and 0.47 ml/min per 1.73 m(2)/yr faster, respectively). Mexicans, South Americans, or other Hispanics had similar rates of decline compared to whites. We did not detect significant differences in the rates of kidney function decline among Chinese and white participants. Among those with normal or near-normal kidney function at baseline, blacks and Hispanics had the highest rates of incident CKD during follow-up. Adjustment for comorbidities attenuated some of these differences. In conclusion, the average rate of kidney function decline before the onset of CKD differs among racial and ethnic groups. Traditional risk factors do not explain these differences fully, highlighting the need to explore these disparities.
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Affiliation(s)
- Carmen A Peralta
- Department of Medicine, University of California San Francisco, San Francisco, California 94121, USA.
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Buckalew VM, Freedman BI. Effects of race on albuminuria and risk of cardiovascular and kidney disease. Expert Rev Cardiovasc Ther 2011; 9:245-9. [PMID: 21453219 DOI: 10.1586/erc.10.185] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The literature describing the relationship between urinary protein excretion and risk of cardiovascular disease and renal disease is rapidly proliferating. Several studies have demonstrated racial differences in the relationship between albuminuria and associated disorders. The purpose of this article is to summarize the effects of race on the relationship between albuminuria and renal and cardiovascular disease risk, propose explanatory hypotheses, and suggest directions for future investigation.
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Affiliation(s)
- Vardaman M Buckalew
- Department of Internal Medicine, Section on Nephrology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1053, USA
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Hung AM, Ikizler TA, Griffin MR, Glenn K, Greevy RA, Grijalva CG, Siew ED, Crawford DC. CRP polymorphisms and chronic kidney disease in the third national health and nutrition examination survey. BMC MEDICAL GENETICS 2011; 12:65. [PMID: 21569369 PMCID: PMC3119179 DOI: 10.1186/1471-2350-12-65] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 05/11/2011] [Indexed: 12/27/2022]
Abstract
BACKGROUND CRP gene polymorphisms are associated with serum C-reactive protein concentrations and may play a role in chronic kidney disease (CKD) progression. We recently reported an association between the gene variant rs2808630 and CKD progression in African Americans with hypertensive kidney disease. This association has not been studied in other ethnic groups. METHODS We used data from 5955 participants from Phase 2 of The Third National Health and Nutrition Examination Survey (1991-1994) to study the association between CRP polymorphisms and CKD prevalence in a population-based sample. The primary outcome was CKD defined as estimated glomerular filtration rate (eGFR) <60 ml/min or the presence of albuminuria. Secondary outcomes were the presence of albuminuria (any degree) and continuous eGFR. Six single nucleotide polymorphisms (SNPs) from the CRP gene, rs2808630, rs1205, rs3093066, rs1417938, rs3093058, and rs1800947, were evaluated. RESULTS CRP rs2808630 AG compared to the referent AA genotype was associated with CKD in non-Hispanic blacks (n = 1649, 293 of whom had CKD) with an adjusted odds ratio (OR) of 3.09 (95% CI 1.65-5.8; p = 0.001). For the secondary outcomes, rs2808630 AG compared to the referent AA genotype was associated with albuminuria with an adjusted OR of 3.07 (95% CI 1.59-5.94; p = 0.002), however not with eGFR. There was no association between the SNPs and CKD, albuminuria or eGFR in non-Hispanic whites or Mexicans Americans. CONCLUSIONS In this cross-sectional study, the 3' flanking CRP gene variant rs2808630 was associated with CKD, mainly through its association with albuminuria in the non-Hispanic blacks. Despite not finding an association with eGFR, our results support our previous study demonstrating an association between CRP gene variant rs2808630 and CKD progression in a longitudinal cohort of African American with hypertensive kidney disease.
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Affiliation(s)
- Adriana M Hung
- Veterans Administration Tennessee Valley Healthcare System Nashville, TN, USA.
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Day EC, Li Y, Diez-Roux A, Kandula N, Moran A, Rosas S, Shlipak MG, Peralta CA. Associations of acculturation and kidney dysfunction among Hispanics and Chinese from the Multi-Ethnic Study of Atherosclerosis (MESA). Nephrol Dial Transplant 2010; 26:1909-16. [PMID: 21051500 DOI: 10.1093/ndt/gfq676] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Acculturation affects health, but it has never been studied with kidney disease. METHODS We studied the association of language spoken at home, generation and birth place with kidney function among Hispanics and Chinese in the Multi-Ethnic Study of Atherosclerosis (n = 2999). Kidney function was determined by cystatin C (eGFRcys) and albumin/creatinine ratio (ACR). We evaluated mediators in models: Model 1 = age, sex, income, education; Model 2 = Model 1 + behaviors; and Model 3 = Model 1 + comorbidities. RESULTS Among Hispanics, speaking mixed Spanish/English was significantly associated with lower eGFRcys (- 2.83 mL/min/1.73 m(2), - 5.69-0.04) and higher ACR (RD 40%, 17-68%) compared with speaking Spanish only; this was mildly attenuated by behaviors (- 2.29, - 5.33-0.75; RD 42%, 18-72%) but not comorbidities (- 3.04, - 5.83 to - 0.23); RD 35%, 14-59%). US-born Hispanics had lower eGFRcys compared with foreign-born Hispanics [1.83 mL/min/1.73 m(2) lower (0.97-1.31) for Generation 1; 1.37 mL/min/1.73 m(2) lower (0.75-1.57) for Generation ≥ 2]. In contrast, Chinese who spoke any English had higher eGFRcys (2.53, 95% CI: - 1.70-6.78), but similar ACR (RD - 5%, 95% CI: - 26-23%) compared with those speaking Chinese only, but associations were not statistically significant. CONCLUSION Higher acculturation was associated with worse kidney function in Hispanics, mediated perhaps by behavioral factors but not comorbidities. Associations may be in the opposite direction among Chinese. Future studies are needed to elucidate these mechanisms.
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Affiliation(s)
- Erica Chan Day
- San Francisco VA Medical Center, San Francisco, CA, USA.
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Drawz PE, Schelling JR. Albuminuria risk in Hispanic populations: not so black and white. CIRCULATION. CARDIOVASCULAR GENETICS 2010; 3:223-225. [PMID: 20551417 PMCID: PMC3555405 DOI: 10.1161/circgenetics.110.957282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Paul E. Drawz
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Jeffrey R. Schelling
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH
- MetroHealth Medical Center, Center for Research and Education, Cleveland, OH
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