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Subjects and Methods: Using two-sample and multivariable Mendelian randomization (MR), we examined the causal effects of serum lipids and apolipoproteins on kidney function, indicated by glomerular filtration rate estimated using creatinine (eGFRcrea) or cystatin C (eGFRcys), and urinary albumin to creatinine ratio (UACR). We obtained lipid- and apolipoprotein-associated genetic variants from the Global Lipids Genetics Consortium (n=331,368) and UK Biobank (n=441,016), respectively, and kidney function markers from the Trøndelag Health Study (HUNT; n=69,736) and UK Biobank (n=464,207). The reverse causal direction was examined using variants associated with kidney function markers selected from recent genome wide association studies (GWASs).
Results: There were no strong associations between genetically predicted lipid and apolipoprotein levels with kidney function markers. Some, but inconsistent evidence suggested a weak association of higher genetically predicted atherogenic lipid levels (indicated by low-density lipoprotein cholesterol (LDL-C), triglycerides and apolipoprotein B) with increased eGFR and UACR. For high-density lipoprotein cholesterol (HDL-C), results differed between eGFRcrea and eGFRcys, but neither analysis suggested substantial effects. We found no clear evidence of a reverse causal effect of eGFR on lipid or apolipoprotein traits, but higher UACR was associated with higher LDL-C, triglyceride and apolipoprotein B levels.
Conclusion: Our MR estimates suggest that serum lipid and apolipoproteins levels do not cause substantial changes in kidney function. A possible weak effect of higher atherogenic lipids on increased eGFR and UACR warrants further investigation. Processes leading to higher UACR may lead to more atherogenic lipid levels.
Bibliographical noteFunding Information:
Dr Zhang is supported by the Vice-Chancellor fellowship and Dr Sanderson was supported by Medical Research Council (MC_UU_00011/1) during the study. Professors Davey Smith and Gaunt work in the Medical Research Council Integrative Epidemiology Unit at the University of Bristol (MC_UU_00011/1and4) and have received research funding from GlaxoSmithKline and Biogen
© 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the International Epidemiological Association.
- Mendelian randomization
- urinary albumen to creatinine ratio
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- 1 Finished
Gaunt, L. F. & Davey Smith, G.
1/04/18 → 31/03/23