title: Genetic and environmental influences on the associations between change in kidney function and changes in cardiometabolic factors in Koreans.
abstract: BACKGROUND
  This study aimed to evaluate genetic and environmental relations between change in estimated glomerular filtration rate (eGFR) and changes in cardiometabolic factors.
  
  
  METHODS
  In 1772 Korean adults without diabetes and chronic kidney disease at baseline, changes in eGFR using the Chronic Kidney Disease Epidemiology Collaboration equation, blood pressure (BP), fasting serum glucose (FSG), insulin, homeostasis model assessment of insulin resistance index (HOMA-IR), hemoglobin A1c, triglycerides, high and low density lipoprotein cholesterol (HDL and LDL), uric acid, white blood cell (WBC) count, and body mass index (BMI) were calculated as follows: (value at follow-up - value at baseline) × 100/[value at baseline × follow-up interval (years)].
  
  
  RESULTS
  eGFR change was associated with 10 % changes in FSG (Odds ratio, OR = 1.36), uric acid (OR = 2.49), HDL (OR = 0.69), LDL (OR = 1.26), and WBC (OR = 1.15) after adjusting for age, sex, intra-familial and twin correlations, smoking, alcohol use, and physical activity at baseline, and BMI change using a generalized estimating equation. In bivariate variance-component analysis, eGFR change had additive genetic correlations ([Formula: see text]) with changes in insulin (-0.26), HOMA-IR (-0.24), diastolic BP (-0.15), uric acid (-0.45), triglycerides (-0.30), WBC (-0.46), and HDL (0.41), and environmental correlations ([Formula: see text]) with changes in FSG (-0.11), uric acid (-0.32), LDL (-0.14), and WBC (0.10). In co-twin control analyses in 319 monozygotic twin pairs, the ORs for having a greater eGFR decline with a 1 % increase in diastolic BP, uric acid, and LDL were 1.04, 1.09, and 1.03, respectively after adjusting for change in BMI and health behaviors at baseline.
  
  
  CONCLUSIONS
  In these Korean twins and families, additive genetic influences and environmental effects play significant roles in the associations between eGFR change and changes in cardiometabolic factors.
authors.affiliation: Department of Family Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea.
authors.forename: Yun-Mi
authors.initials: YM
authors.lastname: Song
authors.affiliation: Department of Epidemiology, School of Public Health, Seoul National University, Seoul, South Korea.|Institute of Health and Environment, Seoul National University, Seoul, South Korea.
authors.forename: Joohon
authors.initials: J
authors.lastname: Sung
authors.affiliation: Department of Family Medicine, Busan Paik Hospital, School of Medicine, Inje University, Busan, South Korea. kayoung.fmlky@gmail.com.
authors.forename: Kayoung
authors.initials: K
authors.lastname: Lee
mesh_terms: D000328:Adult; D044466:Asian People / Q000235:genetics; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D016009:Chi-Square Distribution; D005260:Female; D059647:Gene-Environment Interaction; D058685:Genetic Pleiotropy; D020022:Genetic Predisposition to Disease; D005919:Glomerular Filtration Rate / Q000235:genetics*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007668:Kidney / Q000503:physiopathology*; D008019:Life Style; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010641:Phenotype; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics* / Q000503:physiopathology; D056910:Republic of Korea; D012307:Risk Factors; D013997:Time Factors; D014527:Uric Acid / Q000097:blood
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D008055:Lipids; D014527:Uric Acid; C517652:hemoglobin A1c protein, human
keywords: Cardiometabolic trait; Change; GFR; Genetic pleiotropy; Kidney function