Association of preeclampsia with infant APOL1 genotype in African Americans
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RESEARCH ARTICLE
Open Access
Association of preeclampsia with infant APOL1 genotype in African Americans Anna K. Miller1, Timur Azhibekov2, John F. O’Toole3, John R. Sedor3,4, Scott M. Williams1,5, Raymond W. Redline6 and Leslie A. Bruggeman3*
Abstract Background: Black women in the United States and Africa are at an increased risk for preeclampsia. Allelic variants in the gene for apolipoprotein LI, APOL1, are found only in populations of African ancestry, and have been shown to contribute significant risk for kidney disease. Recent studies suggest these APOL1 variants also may contribute risk for preeclampsia. Methods: The association of preeclampsia with carriage of APOL1 risk alleles was evaluated in a case-control study of deliveries from black women at a single center in Cleveland, Ohio that included gross and histopathologic evaluations of placental tissues (395 cases and 282 controls). Using logistic regression models, associations between fetal APOL1 genotype and preeclampsia were evaluated using several case definitions based on prematurity and severity of preeclampsia, with uncomplicated term pregnancies as controls. Associations between APOL1 genotype and pathological features were also examined. Results: The infant APOL1 genotype was significantly associated with preeclampsia in a dominant inheritance pattern with odds ratio of 1.41 (P=0.029, 95% CI 1.037, 1.926). Stratifying preeclampsia cases by preterm birth, significant associations were detected for both recessive (O.R.=1.70, P=0.038) and additive (O.R.=1.33, P=0.028) inheritance patterns. APOL1 genotype, however, was not significantly associated with pathological changes or other perinatal observations. Conclusions: Preeclampsia appears to be another disease associated with APOL1 variants, however, further studies are needed to increase confidence in the mode of inheritance. By understanding the association of APOL1 variants with preeclampsia, genetic screening tests for APOL1 may be useful to predict at-risk pregnancies and targeted interventions may be developed to improve pregnancy outcomes. Keywords: African American, Genetics, Pathology, Placenta, Preeclampsia
Background Preeclampsia (PE) is a common complication of pregnancy and occurs more frequently in women of African ancestry (reviewed in [1, 2]). PE prevalence ranges from 3-8% in developed countries and as high as 26% in sub-Saharan African countries, and African American women are three times more likely to die from PE compared to European Americans. The American College of Obstetricians and * Correspondence: [email protected] 3 Departments of Inflammation and Immunity and Nephrology, Cleveland Clinic, Case Western Reserve University School of Medicine, Cleveland, USA Full list of author information is available at the end of the article
Gynecologists [3] defines PE as new onset hypertension of ≥140mmHg systolic or ≥90mmHg diastolic along with proteinuria or other end organ dysfunction. A separate class of PE is defined as severe PE with blood pressures ≥160/ 110mmHg and
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