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5. Monogenic diabetes

Author

Bonnefond, Amélie, Unnikrishnan, Ranjit, Doria, Alessandro, Vaxillaire, Martine, Kulkarni, Rohit N., Mohan, Viswanathan, Trischitta, Vincenzo, and Froguel, Philippe

Published
2023
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6. New Creatinine- and Cystatin C–Based Equations to Estimate GFR without Race

Author

Inker, Lesley A, Eneanya, Nwamaka D, Coresh, Josef, Tighiouart, Hocine, Wang, Dan, Sang, Yingying, Crews, Deidra C, Doria, Alessandro, Estrella, Michelle M, Froissart, Marc, Grams, Morgan E, Greene, Tom, Grubb, Anders, Gudnason, Vilmundur, Gutiérrez, Orlando M, Kalil, Roberto, Karger, Amy B, Mauer, Michael, Navis, Gerjan, Nelson, Robert G, Poggio, Emilio D, Rodby, Roger, Rossing, Peter, Rule, Andrew D, Selvin, Elizabeth, Seegmiller, Jesse C, Shlipak, Michael G, Torres, Vicente E, Yang, Wei, Ballew, Shoshana H, Couture, Sara J, Powe, Neil R, and Levey, Andrew S

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Kidney Disease, Renal and urogenital, Adult, Aged, Algorithms, Black People, Creatinine, Cystatin C, Datasets as Topic, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Racial Groups, Renal Insufficiency, Chronic, United States, Black or African American, Chronic Kidney Disease Epidemiology Collaboration, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundCurrent equations for estimated glomerular filtration rate (eGFR) that use serum creatinine or cystatin C incorporate age, sex, and race to estimate measured GFR. However, race in eGFR equations is a social and not a biologic construct.MethodsWe developed new eGFR equations without race using data from two development data sets: 10 studies (8254 participants, 31.5% Black) for serum creatinine and 13 studies (5352 participants, 39.7% Black) for both serum creatinine and cystatin C. In a validation data set of 12 studies (4050 participants, 14.3% Black), we compared the accuracy of new eGFR equations to measured GFR. We projected the prevalence of chronic kidney disease (CKD) and GFR stages in a sample of U.S. adults, using current and new equations.ResultsIn the validation data set, the current creatinine equation that uses age, sex, and race overestimated measured GFR in Blacks (median, 3.7 ml per minute per 1.73 m2 of body-surface area; 95% confidence interval [CI], 1.8 to 5.4) and to a lesser degree in non-Blacks (median, 0.5 ml per minute per 1.73 m2; 95% CI, 0.0 to 0.9). When the adjustment for Black race was omitted from the current eGFR equation, measured GFR in Blacks was underestimated (median, 7.1 ml per minute per 1.73 m2; 95% CI, 5.9 to 8.8). A new equation using age and sex and omitting race underestimated measured GFR in Blacks (median, 3.6 ml per minute per 1.73 m2; 95% CI, 1.8 to 5.5) and overestimated measured GFR in non-Blacks (median, 3.9 ml per minute per 1.73 m2; 95% CI, 3.4 to 4.4). For all equations, 85% or more of the eGFRs for Blacks and non-Blacks were within 30% of measured GFR. New creatinine-cystatin C equations without race were more accurate than new creatinine equations, with smaller differences between race groups. As compared with the current creatinine equation, the new creatinine equations, but not the new creatinine-cystatin C equations, increased population estimates of CKD prevalence among Blacks and yielded similar or lower prevalence among non-Blacks.ConclusionsNew eGFR equations that incorporate creatinine and cystatin C but omit race are more accurate and led to smaller differences between Black participants and non-Black participants than new equations without race with either creatinine or cystatin C alone. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases.).

Published
2021

8. A New Panel-Estimated GFR, Including β2-Microglobulin and β-Trace Protein and Not Including Race, Developed in a Diverse Population

Author

Inker, Lesley A, Couture, Sara J, Tighiouart, Hocine, Abraham, Alison G, Beck, Gerald J, Feldman, Harold I, Greene, Tom, Gudnason, Vilmundur, Karger, Amy B, Eckfeldt, John H, Kasiske, Bertram L, Mauer, Michael, Navis, Gerjan, Poggio, Emilio D, Rossing, Peter, Shlipak, Michael G, Levey, Andrew S, Collaborators, CKD-EPI GFR, Andresdottir, Margret B, Gudmundsdottir, Hrefna, Indridason, Olafur S, Palsson, Runolfur, Kimmel, Paul, Weir, Matt, Kalil, Roberto, Pesavento, Todd, Porter, Anna, Taliercio, Jonathan, Hsu, Chi-yuan, Chen, Jing, Sinkeler, Steef, Wyatt, Christina, Krishnasami, Zipporah, Hellinger, James, Margolick, Joseph, Kingsley, Lawrence, Witt, Mallory, Wolinsky, Steven, Shafi, Tariq, Post, Wendy, Doria, Alessandro, and Parving, Hans-Henrik

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Disparities, Clinical Research, Kidney Disease, Minority Health, 4.2 Evaluation of markers and technologies, Renal and urogenital, Adolescent, Adult, Black or African American, Aged, Aged, 80 and over, Black People, Case-Control Studies, Chromium Radioisotopes, Creatinine, Cystatin C, Edetic Acid, Female, Glomerular Filtration Rate, Humans, Intramolecular Oxidoreductases, Iohexol, Iothalamic Acid, Lipocalins, Male, Middle Aged, Renal Insufficiency, Chronic, Reproducibility of Results, Severity of Illness Index, White People, Young Adult, beta 2-Microglobulin, CKD-EPI GFR Collaborators, African American, Black race, GFR estimation, Glomerular filtration rate, bias, creatinine, cystatin C, estimating equations, filtration marker, kidney disease diagnosis, laboratory testing, race, race-based medicine, renal function, β(2)-microglobulin, β-trace protein, Public Health and Health Services, Urology & Nephrology, Clinical sciences
Abstract

Rationale and objectiveGlomerular filtration rate (GFR) estimation based on creatinine and cystatin C (eGFRcr-cys) is more accurate than estimated GFR (eGFR) based on creatinine or cystatin C alone (eGFRcr or eGFRcys, respectively), but the inclusion of creatinine in eGFRcr-cys requires specification of a person's race. β2-Microglobulin (B2M) and β-trace protein (BTP) are alternative filtration markers that appear to be less influenced by race than creatinine is.Study designStudy of diagnostic test accuracy.Setting and participantsDevelopment in a pooled population of 7 studies with 5,017 participants with and without chronic kidney disease. External validation in a pooled population of 7 other studies with 2,245 participants.Tests comparedPanel eGFR using B2M and BTP in addition to cystatin C (3-marker panel) or creatinine and cystatin C (4-marker panel) with and without age and sex or race.OutcomesGFR measured as the urinary clearance of iothalamate, plasma clearance of iohexol, or plasma clearance of [51Cr]EDTA.ResultsMean measured GFRs were 58.1 and 83.2 mL/min/1.73 m2, and the proportions of Black participants were 38.6% and 24.0%, in the development and validation populations, respectively. In development, addition of age and sex improved the performance of all equations compared with equations without age and sex, but addition of race did not further improve the performance. In validation, the 4-marker panels were more accurate than the 3-marker panels (P < 0.001). The 3-marker panel without race was more accurate than eGFRcys (percentage of estimates greater than 30% different from measured GFR [1 - P30] of 15.6% vs 17.4%; P = 0.01), and the 4-marker panel without race was as accurate as eGFRcr-cys (1 - P30 of 8.6% vs 9.4%; P = 0.2). Results were generally consistent across subgroups.LimitationsNo representation of participants with severe comorbid illness and from geographic areas outside of North America and Europe.ConclusionsThe 4-marker panel eGFR is as accurate as eGFRcr-cys without requiring specification of race. A more accurate race-free eGFR could be an important advance.

Published
2021

13. Contribution of rare variants in monogenic diabetes-genes to early-onset type 2 diabetes

Author

Pezzilli, Serena, Tohidirad, Manoush, Biagini, Tommaso, Scarale, Maria Giovanna, Alberico, Federica, Mercuri, Luana, Mannino, Gaia Chiara, Garofolo, Monia, Filardi, Tiziana, Tang, Yaling, Giuffrida, Fernando, Mendonca, Christine, Andreozzi, Francesco, Baroni, Marco Giorgio, Buzzetti, Raffaella, Cavallo, Maria Gisella, Cossu, Efisio, D'Angelo, Paola, De Cosmo, Salvatore, Lamacchia, Olga, Leonetti, Frida, Morano, Susanna, Morviducci, Lelio, Penno, Giuseppe, Pozzilli, Paolo, Pugliese, Giuseppe, Sesti, Giorgio, Mazza, Tommaso, Doria, Alessandro, Trischitta, Vincenzo, and Prudente, Sabrina

Published
2022
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14. Results of untargeted analysis using the SOMAscan proteomics platform indicates novel associations of circulating proteins with risk of progression to kidney failure in diabetes

Author

Kobayashi, Hiroki, Looker, Helen C., Satake, Eiichiro, Saulnier, Pierre Jean, Md Dom, Zaipul I., O’Neil, Kristina, Ihara, Katsuhito, Krolewski, Bozena, Galecki, Andrzej T., Niewczas, Monika A., Wilson, Jonathan M., Doria, Alessandro, Duffin, Kevin L., Nelson, Robert G., and Krolewski, Andrzej S.

Published
2022
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17. Pathogenic variants of MODY-genes in adult patients with early-onset type 2 diabetes

Author

Pezzilli, Serena, Mazza, Tommaso, Scarale, Maria Giovanna, Tang, Yaling, Andreozzi, Francesco, Baroni, Marco Giorgio, Buzzetti, Raffaella, Cavallo, Maria Gisella, Cossu, Efisio, D’Angelo, Paola, De Cosmo, Salvatore, Lamacchia, Olga, Leonetti, Frida, Morano, Susanna, Morviducci, Lelio, Penno, Giuseppe, Pozzilli, Paolo, Pugliese, Giuseppe, Sesti, Giorgio, Doria, Alessandro, Trischitta, Vincenzo, and Prudente, Sabrina

Published
2022
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18. Genetic Variants in CPA6 and PRPF31 are Associated with Variation in Response to Metformin in Individuals with Type 2 Diabetes

Author

Rotroff, Daniel M, Yee, Sook Wah, Zhou, Kaixin, Marvel, Skylar W, Shah, Hetal S, Jack, John R, Havener, Tammy M, Hedderson, Monique M, Kubo, Michiaki, Herman, Mark A, Gao, He, Mychaleckyi, Josyf C, McLeod, Howard L, Doria, Alessandro, Giacomini, Kathleen M, Pearson, Ewan R, Wagner, Michael J, Buse, John B, Motsinger-Reif, Alison A, and Investigators, MetGen Investigators and the ACCORD ACCORDion

Subjects
Biomedical and Clinical Sciences, Genetics, Human Genome, Prevention, Diabetes, Obesity, 2.1 Biological and endogenous factors, Metabolic and endocrine, Carboxypeptidases A, Cohort Studies, Diabetes Mellitus, Type 2, Double-Blind Method, Eye Proteins, Female, Genome-Wide Association Study, Humans, Male, Metformin, Middle Aged, Pharmacogenomic Variants, Polymorphism, Single Nucleotide, STAT3 Transcription Factor, Treatment Outcome, MetGen Investigators, ACCORD/ACCORDion Investigators, Medical and Health Sciences, Endocrinology & Metabolism, Biomedical and clinical sciences
Abstract

Metformin is the first-line treatment for type 2 diabetes (T2D). Although widely prescribed, the glucose-lowering mechanism for metformin is incompletely understood. Here, we used a genome-wide association approach in a diverse group of individuals with T2D from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) clinical trial to identify common and rare variants associated with HbA1c response to metformin treatment and followed up these findings in four replication cohorts. Common variants in PRPF31 and CPA6 were associated with worse and better metformin response, respectively (P < 5 × 10-6), and meta-analysis in independent cohorts displayed similar associations with metformin response (P = 1.2 × 10-8 and P = 0.005, respectively). Previous studies have shown that PRPF31(+/-) knockout mice have increased total body fat (P = 1.78 × 10-6) and increased fasted circulating glucose (P = 5.73 × 10-6). Furthermore, rare variants in STAT3 associated with worse metformin response (q

Published
2018

19. Variants influencing age at diagnosis of HNF1A-MODY

Author

Ludwig-Słomczyńska, Agnieszka H., Seweryn, Michał T., Radkowski, Piotr, Kapusta, Przemysław, Machlowska, Julita, Pruhova, Stepanka, Gasperikova, Daniela, Bellanne-Chantelot, Christine, Hattersley, Andrew, Kandasamy, Balamurugan, Letourneau-Freiberg, Lisa, Philipson, Louis, Doria, Alessandro, Wołkow, Paweł P., Małecki, Maciej T., and Klupa, Tomasz

Published
2022
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22. A New Panel-Estimated GFR, Including β2-Microglobulin and β-Trace Protein and Not Including Race, Developed in a Diverse Population

Author

Andresdottir, Margret B., Gudmundsdottir, Hrefna, Indridason, Olafur S., Palsson, Runolfur, Kimmel, Paul, Weir, Matt, Kalil, Roberto, Pesavento, Todd, Porter, Anna, Taliercio, Jonathan, Hsu, Chi-yuan, Chen, Jing, Sinkeler, Steef, Wyatt, Christina, Krishnasami, Zipporah, Hellinger, James, Margolick, Joseph, Kingsley, Lawrence, Witt, Mallory, Wolinsky, Steven, Shafi, Tariq, Post, Wendy, Doria, Alessandro, Parving, Hans-Henrik, Inker, Lesley A., Couture, Sara J., Tighiouart, Hocine, Abraham, Alison G., Beck, Gerald J., Feldman, Harold I., Greene, Tom, Gudnason, Vilmundur, Karger, Amy B., Eckfeldt, John H., Kasiske, Bertram L., Mauer, Michael, Navis, Gerjan, Poggio, Emilio D., Rossing, Peter, Shlipak, Michael G., and Levey, Andrew S.

Published
2021
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24. A genome-wide association study identifies genetic determinants of hemoglobin glycation index with implications across sex and ethnicity.

Author

House, John S., Breeyear, Joseph H., Akhtari, Farida S., Evans, Violet, Buse, John B., Hempe, James, Doria, Alessandro, Mychaleckyi, Josyf C., Fonseca, Vivian, Shi, Mengyao, Li, Changwei, Liu, Shuqian, Kelly, Tanika N., Rotroff, Daniel, and Motsinger-Reif, Alison A.

Subjects
GENOME-wide association studies, GENETIC variation, GENE frequency, DIABETES complications, RACE
Abstract

Introduction: We investigated the genetic determinants of variation in the hemoglobin glycation index (HGI), an emerging biomarker for the risk of diabetes complications. Methods: We conducted a genome-wide association study (GWAS) for HGI in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial (N = 7,913) using linear regression and additive genotype encoding on variants with minor allele frequency greater than 3%. We conducted replication analyses of top findings in the Atherosclerosis Risk in Communities (ARIC) study with inverse variance-weighted meta-analysis. We followed up with stratified GWAS analyses by sex and self-reported race. Results: In ACCORD, we identified single nucleotide polymorphisms (SNPs) associated with HGI, including a peak with the strongest association at the intergenic SNP rs73407935 (7q11.22) (P = 5.8e−10) with a local replication in ARIC. In black individuals, the variant rs10739419 on chromosome 9 in the Whirlin (WHRN) gene formally replicated (meta- P = 2.2e−9). The SNP-based heritability of HGI was 0.39 (P < 1e−10). HGI had significant sex-specific associations with SNPs in or near GALNT11 in women and HECW2 in men. Finally, in Hispanic participants, we observed genome-wide significant associations with variants near USF1 and NXNL2/SPIN1. Discussion: Many HGI-associated SNPs were distinct from those associated with fasting plasma glucose or HbA1c, lending further support for HGI as a distinct biomarker of diabetes complications. The results of this first evaluation of the genetic etiology of HGI indicate that it is highly heritable and point to heterogeneity by sex and race. [ABSTRACT FROM AUTHOR]

Published
2024
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26. The core clock gene, Bmal1, and its downstream target, the SNARE regulatory protein secretagogin, are necessary for circadian secretion of glucagon-like peptide-1

Author

Biancolin, Andrew D., Martchenko, Alexandre, Mitova, Emilia, Gurges, Patrick, Michalchyshyn, Everan, Chalmers, Jennifer A., Doria, Alessandro, Mychaleckyj, Josyf C., Adriaenssens, Alice E., Reimann, Frank, Gribble, Fiona M., Gil-Lozano, Manuel, Cox, Brian J., and Brubaker, Patricia L.

Published
2020
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29. A signature of circulating inflammatory proteins and development of end-stage renal disease in diabetes

Author

Niewczas, Monika A., Pavkov, Meda E., Skupien, Jan, Smiles, Adam, Md Dom, Zaipul I., Wilson, Jonathan M., Park, Jihwan, Nair, Viji, Schlafly, Andrew, Saulnier, Pierre-Jean, Satake, Eiichiro, Simeone, Christopher A., Shah, Hetal, Qiu, Chengxiang, Looker, Helen C., Fiorina, Paolo, Ware, Carl F., Sun, Jennifer K., Doria, Alessandro, Kretzler, Matthias, Susztak, Katalin, Duffin, Kevin L., Nelson, Robert G., and Krolewski, Andrzej S.

Published
2019
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30. Genetic deficiency and pharmacological stabilization of mast cells reduce diet-induced obesity and diabetes in mice

Author

Liu, Jian, Divoux, Adeline, Sun, Jiusong, Zhang, Jie, Clément, Karine, Glickman, Jonathan N, Sukhova, Galina K, Wolters, Paul J, Du, Juan, Gorgun, Cem Z, Doria, Alessandro, Libby, Peter, Blumberg, Richard S, Kahn, Barbara B, Hotamisligil, Gökhan S, and Shi, Guo-Ping

Subjects
Biomedical and Clinical Sciences, Diabetes, Nutrition, Obesity, 2.1 Biological and endogenous factors, Aetiology, Metabolic and endocrine, Animals, Cromolyn Sodium, Diabetes Mellitus, Experimental, Diabetes Mellitus, Type 2, Diet, Atherogenic, Drug Evaluation, Preclinical, Female, Humans, Male, Mast Cells, Mice, Mice, Transgenic, Organ Specificity, Proto-Oncogene Proteins c-kit, Medical and Health Sciences, Immunology, Biomedical and clinical sciences, Health sciences
Abstract

Although mast cell functions have classically been related to allergic responses, recent studies indicate that these cells contribute to other common diseases such as multiple sclerosis, rheumatoid arthritis, atherosclerosis, aortic aneurysm and cancer. This study presents evidence that mast cells also contribute to diet-induced obesity and diabetes. For example, white adipose tissue (WAT) from obese humans and mice contain more mast cells than WAT from their lean counterparts. Furthermore, in the context of mice on a Western diet, genetically induced deficiency of mast cells, or their pharmacological stabilization, reduces body weight gain and levels of inflammatory cytokines, chemokines and proteases in serum and WAT, in concert with improved glucose homeostasis and energy expenditure. Mechanistic studies reveal that mast cells contribute to WAT and muscle angiogenesis and associated cell apoptosis and cathepsin activity. Adoptive transfer experiments of cytokine-deficient mast cells show that these cells, by producing interleukin-6 (IL-6) and interferon-gamma (IFN-gamma), contribute to mouse adipose tissue cysteine protease cathepsin expression, apoptosis and angiogenesis, thereby promoting diet-induced obesity and glucose intolerance. Our results showing reduced obesity and diabetes in mice treated with clinically available mast cell-stabilizing agents suggest the potential of developing new therapies for these common human metabolic disorders.

Published
2009

33. Cardiovascular Autonomic Neuropathy and Risk of Kidney Function Decline in Type 1 and Type 2 Diabetes: Findings From the PERL and ACCORD Cohorts.

Author

Tang, Yaling, Ang, Lynn, Jaiswal, Mamta, Dillon, Brendan R., Esfandiari, Nazanene H., Shah, Hetal S., Spino, Cathie, Plunkett, Cindy, Perkins, Bruce A., Pop-Busui, Rodica, and Doria, Alessandro

Subjects
TYPE 1 diabetes, TYPE 2 diabetes, KIDNEY physiology, HEART beat, PEOPLE with diabetes
Abstract

Results of previous studies have suggested that cardiovascular autonomic neuropathy (CAN) may predict rapid kidney function decline among people with diabetes. We analyzed the association between baseline CAN and subsequent glomerular filtration rate (GFR) decline among individuals with type 1 diabetes (T1D) from the Preventing Early Renal Loss in Diabetes (PERL) study (N = 469) and with type 2 diabetes (T2D) from Action to Control Cardiovascular Risk in Diabetes (ACCORD) (N = 7,973). Baseline CAN was ascertained with electrocardiogram-derived heart rate variability indices. Its association with GFR slopes, rapid kidney function decline (GFR loss of ≥5 mL/min/1.73 m2/year), and ≥40% GFR loss was evaluated by linear mixed-effects, logistic, and Cox regression, respectively. Participants with CAN experienced more rapid GFR decline, by an excess 1.15 mL/min/1.73 m2/year (95% CI −1.93 to −0.37; P = 4.0 × 10−3) in PERL and 0.34 mL/min/1.73 m2/year (95% CI −0.49 to −0.19; P = 6.3 × 10−6) in ACCORD. This translated to 2.11 (95% CI 1.23–3.63; P = 6.9 × 10−3) and 1.39 (95% CI 1.20–1.61; P = 1.1 × 10−5) odds ratios of rapid kidney function decline in PERL and ACCORD, respectively. Baseline CAN was also associated with a greater risk of ≥40% GFR loss events during follow-up (hazard ratio 2.60 [95% CI 1.15–5.45], P = 0.02, in PERL and hazard ratio 1.54 [95% CI 1.28–1.84], P = 3.8 × 10−6, in ACCORD). These associations remained significant after adjustment for potential confounders, including baseline GFR and albuminuria. Our findings indicate that CAN is a strong, independent predictor of rapid kidney function decline in both T1D and T2D. Further studies of the link between these two complications may help with development of new therapies to prevent kidney function decline in patients with diabetes. Article Highlights: Cardiovascular autonomic neuropathy is a strong and independent predictor of rapid kidney function decline in both type 1 and type 2 diabetes. Autonomic nervous system dysfunction may serve as a novel target to develop new therapies to prevent kidney function loss in diabetes. Electrocardiogram-derived indices of cardiovascular autonomic neuropathy might be useful, when added to known clinical risk factors, to improve the identification of patients at high risk of rapid kidney function loss and select them for intensive preventive treatments. [ABSTRACT FROM AUTHOR]

Published
2024
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35. Cardiovascular autonomic neuropathy and risk of kidney function decline in type 1 and type 2 diabetes: findings from the PERL and ACCORD cohorts

Author

Tang, Yaling, primary, Ang, Lynn, additional, Jaiswal, Mamta, additional, Dillon, Brendan R., additional, Esfandiari, Nazanene H., additional, Shah, Hetal S., additional, Spino, Cathie, additional, Plunkett, Cindy, additional, Perkins, Bruce A., additional, Busui, Rodica Pop, additional, and Doria, Alessandro, additional

Published
2023
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36. SerpinB1 Promotes Pancreatic β Cell Proliferation

Author

El Ouaamari, Abdelfattah, Dirice, Ercument, Gedeon, Nicholas, Hu, Jiang, Zhou, Jian-Ying, Shirakawa, Jun, Hou, Lifei, Goodman, Jessica, Karampelias, Christos, Qiang, Guifeng, Boucher, Jeremie, Martinez, Rachael, Gritsenko, Marina A., De Jesus, Dario F., Kahraman, Sevim, Bhatt, Shweta, Smith, Richard D., Beer, Hans-Dietmar, Jungtrakoon, Prapaporn, Gong, Yanping, Goldfine, Allison B., Liew, Chong Wee, Doria, Alessandro, Andersson, Olov, Qian, Wei-Jun, Remold-O’Donnell, Eileen, and Kulkarni, Rohit N.

Published
2016
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37. Discordance Between Creatinine-Based and Cystatin C–Based Estimated GFR:Interpretation According to Performance Compared to Measured GFR

Author

Wang, Yeli, Adingwupu, Ogechi M., Shlipak, Michael G., Doria, Alessandro, Estrella, Michelle M., Froissart, Marc, Gudnason, Vilmundur, Grubb, Anders, Kalil, Roberto, Mauer, Michael, Rossing, Peter, Seegmiller, Jesse, Coresh, Josef, Levey, Andrew S., Inker, Lesley A., Wang, Yeli, Adingwupu, Ogechi M., Shlipak, Michael G., Doria, Alessandro, Estrella, Michelle M., Froissart, Marc, Gudnason, Vilmundur, Grubb, Anders, Kalil, Roberto, Mauer, Michael, Rossing, Peter, Seegmiller, Jesse, Coresh, Josef, Levey, Andrew S., and Inker, Lesley A.

Abstract

Rationale & Objective Use of cystatin C in addition to creatinine to estimate glomerular filtration rate (estimated glomerular filtration rate based on cystatin C [eGFRcys] and estimated glomerular filtration rate based on creatinine [eGFRcr], respectively) is increasing. When eGFRcr and eGFRcys are discordant, it is not known which is more accurate, leading to uncertainty in clinical decision making. Study Design Cross-sectional analysis. Setting & Participants Four thousand fifty participants with measured glomerular filtration rate (mGFR) from 12 studies in North America and Europe. Exposures Serum creatinine and serum cystatin C. Outcome(s) Performance of creatinine-based and cystatin C–based glomerular filtration rate estimating equations compared to mGFR. Analytical Approach We evaluated the accuracy of eGFRcr, eGFRcys, and the combination (eGFRcr-cys) compared to mGFR according to the magnitude of the difference between eGFRcr and eGFRcys (eGFRdiff). We used CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equations to estimate glomerular filtration rate. eGFRdiff was defined as eGFRcys minus eGFRcr and categorized as less than −15, −15 to <15, and ≥15 mL/min/1.73 m2 (negative, concordant, and positive groups, respectively). We compared bias (median of mGFR minus eGFR) and the percentage of eGFR within 30% of mGFR. Results Thirty percent of participants had discordant eGFRdiff (21.0% and 9.6% negative and positive eGFRdiffs, respectively). In the concordant eGFRdiff group, all equations displayed similar accuracy. In the negative eGFRdiff groups, eGFRcr had a large overestimation of mGFR (−13.4 [−14.5 to −12.2] mL/min/1.73 m2) and eGFRcys had a large underestimation (9.9 [9.1-11.2] mL/min/1.73m2), with opposite results in the positive eGFRdiff group. In both negative and positive eGFRdiff groups, eGFRcr-cys was more accurate than either eGFRcr or eGFRcys. T, Rationale & Objective: Use of cystatin C in addition to creatinine to estimate glomerular filtration rate (estimated glomerular filtration rate based on cystatin C [eGFRcys] and estimated glomerular filtration rate based on creatinine [eGFRcr], respectively) is increasing. When eGFRcr and eGFRcys are discordant, it is not known which is more accurate, leading to uncertainty in clinical decision making. Study Design: Cross-sectional analysis. Setting & Participants: Four thousand fifty participants with measured glomerular filtration rate (mGFR) from 12 studies in North America and Europe. Exposures: Serum creatinine and serum cystatin C. Outcome(s): Performance of creatinine-based and cystatin C–based glomerular filtration rate estimating equations compared to mGFR. Analytical Approach: We evaluated the accuracy of eGFRcr, eGFRcys, and the combination (eGFRcr-cys) compared to mGFR according to the magnitude of the difference between eGFRcr and eGFRcys (eGFRdiff). We used CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equations to estimate glomerular filtration rate. eGFRdiff was defined as eGFRcys minus eGFRcr and categorized as less than −15, −15 to <15, and ≥15 mL/min/1.73 m2 (negative, concordant, and positive groups, respectively). We compared bias (median of mGFR minus eGFR) and the percentage of eGFR within 30% of mGFR. Results: Thirty percent of participants had discordant eGFRdiff (21.0% and 9.6% negative and positive eGFRdiffs, respectively). In the concordant eGFRdiff group, all equations displayed similar accuracy. In the negative eGFRdiff groups, eGFRcr had a large overestimation of mGFR (−13.4 [−14.5 to −12.2] mL/min/1.73 m2) and eGFRcys had a large underestimation (9.9 [9.1-11.2] mL/min/1.73m2), with opposite results in the positive eGFRdiff group. In both negative and positive eGFRdiff groups, eGFRcr-cys was more accurate than either eGFRcr or eGFRcys. These results were largely consistent ac

Published
2023

38. CKD-EPI and EKFC GFR Estimating Equations:Performance and Other Considerations for Selecting Equations for Implementation in Adults

Author

Inker, Lesley A., Tighiouart, Hocine, Adingwupu, Ogechi M., Shlipak, Michael G., Doria, Alessandro, Estrella, Michelle M., Froissart, Marc, Gudnason, Vilmundur, Grubb, Anders, Kalil, Roberto, Mauer, Michael, Rossing, Peter, Seegmiller, Jesse, Coresh, Josef, Levey, Andrew S., Inker, Lesley A., Tighiouart, Hocine, Adingwupu, Ogechi M., Shlipak, Michael G., Doria, Alessandro, Estrella, Michelle M., Froissart, Marc, Gudnason, Vilmundur, Grubb, Anders, Kalil, Roberto, Mauer, Michael, Rossing, Peter, Seegmiller, Jesse, Coresh, Josef, and Levey, Andrew S.

Abstract

Background New CKD-EPI and EKFC eGFR equations using eGFRcr, eGFRcys, and both (eGFRcr-cys) have sufficient accuracy for use in clinical practice. A better understanding of the equations, including their performance in race, sex and age subgroups, is important for selection of eGFR equations for global implementation. Methods We evaluated performance (bias and P30) of equations and methods used for equation development in an independent study population comprising 4050 adults pooled from 12 studies. The mean (SD) measured GFR was 76.4 (29.6) ml/min per 1.73 m2 and age 57.0 (17.4) years, with 1557 (38%) women and 579 (14%) Black participants. Results Coefficients for creatinine, cystatin C, age, and sex in the CKD-EPI and EKFC equations are similar. Performance of the eGFRcr-cys equations in the overall population (bias <±5 ml/min per 1.73 m2 and P30 >90%) was better than the eGFRcr or eGFRcys equations, with fewer differences among race, sex, and age subgroups. Differences in performance across subgroups reflected differences in diversity of source populations and use of variables for race and sex for equation development. Larger differences among eGFRcr equations reflected regional population differences in non-GFR determinants of creatinine. Conclusion CKD-EPI and EKFC equations are approaching convergence. It is not possible to maximize both accuracy and uniformity in selecting one of the currently available eGFRcr equations for implementation across regions. Decisions should consider methods for equation development in addition to performance. Wider use of cystatin C with creatinine could maximize both accuracy and uniformity of GFR estimation using currently available equations., Background New CKD-EPI and EKFC eGFR equations using eGFRcr, eGFRcys, and both (eGFRcr-cys) have sufficient accuracy for use in clinical practice. A better understanding of the equations, including their performance in race, sex and age subgroups, is important for selection of eGFR equations for global implementation. Methods We evaluated performance (bias and P30) of equations and methods used for equation development in an independent study population comprising 4050 adults pooled from 12 studies. The mean (SD) measured GFR was 76.4 (29.6) ml/min per 1.73 m2 and age 57.0 (17.4) years, with 1557 (38%) women and 579 (14%) Black participants. Results Coefficients for creatinine, cystatin C, age, and sex in the CKD-EPI and EKFC equations are similar. Performance of the eGFRcr-cys equations in the overall population (bias,65 ml/min per 1.73 m2 and P30 .90%) was better than the eGFRcr or eGFRcys equations, with fewer differences among race, sex, and age subgroups. Differences in performance across subgroups reflected differences in diversity of source populations and use of variables for race and sex for equation development. Larger differences among eGFRcr equations reflected regional population differences in non-GFR determinants of creatinine. Conclusion CKD-EPI and EKFC equations are approaching convergence. It is not possible to maximize both accuracy and uniformity in selecting one of the currently available eGFRcr equations for implementation across regions. Decisions should consider methods for equation development in addition to performance. Wider use of cystatin C with creatinine could maximize both accuracy and uniformity of GFR estimation using currently available equations.

Published
2023

43. Joint effect of insulin signaling genes on all-cause mortality

Author

Menzaghi, Claudia, Fontana, Andrea, Copetti, Massimiliano, Rizza, Stefano, Spoto, Belinda, Buranasupkajorn, Patinut, Tripepi, Giovanni, Marucci, Antonella, Bailetti, Diego, Hastings, Timothy, Testa, Alessandra, Mendonca, Christine, Mallamaci, Francesca, De Cosmo, Salvatore, Bacci, Simonetta, Federici, Massimo, Doria, Alessandro, Zoccali, Carmine, and Trischitta, Vincenzo

Published
2014
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46. Joint effect of insulin signaling genes on cardiovascular events and on whole body and endothelial insulin resistance

Author

Bacci, Simonetta, Prudente, Sabrina, Copetti, Massimiliano, Spoto, Belinda, Rizza, Stefano, Baratta, Roberto, Di Pietro, Natalia, Morini, Eleonora, Di Paola, Rosa, Testa, Alessandra, Mallamaci, Francesca, Tripepi, Giovanni, Zhang, Yuan-Yuan, Mercuri, Luana, Di Silvestre, Sara, Lauro, Renato, Malatino, Lorenzo, Consoli, Agostino, Pellegrini, Fabio, Pandolfi, Assunta, Frittitta, Lucia, Zoccali, Carmine, Federici, Massimo, Doria, Alessandro, and Trischitta, Vincenzo

Published
2013
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50. Neuroblastoma suppressor of tumorigenicity 1 is a circulating protein associated with progression to end-stage kidney disease in diabetes

Author

Kobayashi, Hiroki, primary, Looker, Helen C., additional, Satake, Eiichiro, additional, D’Addio, Francesca, additional, Wilson, Jonathan M., additional, Saulnier, Pierre Jean, additional, Md Dom, Zaipul I., additional, O’Neil, Kristina, additional, Ihara, Katsuhito, additional, Krolewski, Bozena, additional, Badger, Hannah S., additional, Petrazzuolo, Adriana, additional, Corradi, Domenico, additional, Galecki, Andrzej, additional, Wilson, Parker C., additional, Najafian, Behzad, additional, Mauer, Michael, additional, Niewczas, Monika A., additional, Doria, Alessandro, additional, Humphreys, Benjamin D., additional, Duffin, Kevin L., additional, Fiorina, Paolo, additional, Nelson, Robert G., additional, and Krolewski, Andrzej S., additional

Published
2022
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