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CD2AP is associated with end-stage renal disease in patients with type 1 diabetes
Authors:Mervi E. Hyvönen  Pekka Ihalmo  Niina Sandholm  Monica Stavarachi  Carol Forsblom  Amy Jayne McKnight  Maria Lajer  Anna Maestroni  Gareth Lewis  Lise Tarnow  Silvia Maestroni  Gianpaolo Zerbini  Hans-Henrik Parving  Alexander P. Maxwell  Per-Henrik Groop  Sanna Lehtonen
Affiliation:1. Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland
2. Children’s Hospital, University of Helsinki, Helsinki, Finland
3. Folkh?lsan Institute of Genetics, Folkh?lsan Research Center, University of Helsinki, PO Box 63, 00014, Helsinki, Finland
4. Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
5. Department of Biomedical Engineering and Computational Science, Aalto University, Espoo, Finland
6. Nephrology Research, Centre for Public Health, Queen’s University of Belfast, Belfast, UK
7. Steno Diabetes Center, Gentofte, Denmark
8. Complications of Diabetes Unit, Division of Metabolic and Cardiovascular Sciences, San Raffaele Scientific Institute, Milan, Italy
9. Faculty of Health, University of Aarhus, Aarhus, Denmark
10. Department of Medical Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
11. Baker IDI Heart and Diabetes Institute, Melbourne, Australia
Abstract:CD2-associated protein (CD2AP) is essential for podocyte function. CD2AP mutations have been found in patients with focal segmental glomerulosclerosis, a disease histologically resembling diabetic nephropathy and often progressing to end-stage renal disease (ESRD). We hypothesised that variations in the CD2AP gene may contribute to susceptibility to glomerular injury in diabetes and investigated if single-nucleotide polymorphisms (SNPs) in CD2AP are associated with diabetic nephropathy in patients with type 1 diabetes. The discovery cohort consisted of 2,251 Finnish patients with type 1 diabetes. SNPs were selected from the HapMap database to cover the CD2AP gene. The associations between genotyped SNPs and diabetic nephropathy or ESRD were analysed with the chi-squared test and logistic regression. Three SNPs were selected for replication in cohorts from Denmark, Italy, the United Kingdom and Ireland. None of the 15 successfully genotyped SNPs were associated with diabetic nephropathy when compared to patients with normal albumin excretion rate. However, when genotype frequencies in patients with ESRD were compared with all other patients, two CD2AP SNPs, rs9369717 and rs9349417, were found to be associated with ESRD. The meta-analysis of the original and two additional European cohorts resulted in significant p values <0.01 for these SNPs. A third SNP, rs6936632, was suggestively associated with ESRD in the Finnish patients and in the meta-analysis of four cohorts. CD2AP gene variants may contribute to susceptibility to ESRD in patients with type 1 diabetes.
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