EMAIL THIS PAGE TO A FRIEND

Clinical nephrology

Risk of microalbuminuria in relatives of subjects with diabetic nephropathy: a predictive model based on multivariable dimensionality reduction approach.


PMID 25546024

Abstract

To evaluate a predictive model of microalbuminuria by using anthropometric, clinical and genetic variables in relatives of subjects with diabetic nephropathy. Eligible subjects, aged 18-63 years with body mass index<35 kg/m2, and first degree relatives of patients with type 2 diabetes and diabetic nephropathy were enrolled in a cross-sectional study. A total of 70 individuals with microalbuminuria were compared with 60 individuals without microalbuminuria. Based on a morning urinary sample, microalbuminuria was defined as albumin≥30<300 mg/dL. Genotyping of single nucleotide polymorphisms (SNPs) G-174C of IL6 (rs1800795), G-308A of TNF (rs1800629), and Pro12Ala of PPARγ2 (rs1801282) genes were determined. The multivariable dimensionality reduction analysis was performed using the software multifactor dimensionality reduction package. The multivariable dimensionality reduction analysis showed that obesity and SNP G-308A of TNF gene exhibited main effects with 1.10 and 1.98% of information gain (IG), respectively. The IL6 showed synergy (interaction) with HDL-c (IG 1.27%) and sex (IG 1.02%); also high-sensitivity C-reactive protein and triglycerides levels showed synergy (IG 1.08%). The consistency of the cross-validation for this model was 0.6836, with sensitivity and specificity of 0.58 and 0.76 (odds ratio 4.64; 95% CI 4.0-10.0, p<0.0001). Our results indicate that obesity and/or high blood pressure, in synergism with high-sensitivity C-reactive protein and high-density lipoprotein cholesterol levels, is the main predictive risk factor of diabetic nephropathy in healthy subjects, relatives of patients with type 2 diabetes and diabetic nephropathy.