Background
Methods
Study population
Satisfied with any of the following? | |||||
---|---|---|---|---|---|
1 | 1) Checking in DM diagnosis of the questionnaire 2) 2 h loading of blood glucose levels ≥ 200 mg/dL 3) HbA1c ≥ 6.5% 4) Overnight fasting blood glucose levels ≥ 126 mg/dL | ✓ | ✓ | ||
2 | 1) Creatinine 1.3 mg/dL (men), 1.0 mg/dL (women) 2) eGFR < 60 mL/min/1.73 m2 3) Albuminuria | ✓ | ✓ | ||
Group | DKD (1) | Only DM (2) | Only CKD (3) | Control (4) |
DKD phenotype definition
Ethics
Genotyping and imputation
Genome-wide association analysis
Conditional analyses
Fine-mapping analysis
Functional annotation analyses
Transcriptome-wide association analysis
Results
Clinical characteristics of the study participants
Entire | VHSMC cohort | KoGES Consortium | P | |||
---|---|---|---|---|---|---|
KARE cohort | HEXA cohort | CAVAS cohort | ||||
Sample size | 33,879 | 908 | 4,899 | 21,693 | 6,379 | - |
Age (years) | 66.19 ± 8.00 | 73.93 ± 5.93 | 68.50 ± 8.40 | 64.57 ± 7.54 | 68.81 ± 7.67 | <0.001a |
Sex (male %) | 15,332 (45%) | 800 (88%) | 2271 (46%) | 12,117 (56%) | 2685 (42%) | <0.001b |
BMI (kg/m2) | 24.47 ± 3.06 | 25.30 ± 2.89 | 24.85 ± 3.19 | 24.33 ± 3.02 | 24.57 ± 3.12 | <0.001a |
DM (%) | 11,376 (34%) | 777 (86%) | 1916 (39%) | 7158 (33%) | 1525 (24%) | <0.001b |
Hypertension (%) | 10,715 (32%) | 752 (83%) | 1803 (37%) | 6,116 (28%) | 2044 (32%) | <0.001b |
HbA1c (%) | 6.09 ± 1.04 | 7.63 ± 1.74 | 6.22 ± 1.17 | 6.05 ± 1.03 | 5.94 ± 0.85 | <0.001a |
Creatinine (mg/dL) | 0.93 ± 0.42 | 1.61 ± 1.60 | 1.01 ± 0.47 | 0.86 ± 0.39 | 1.00 ± 0.34 | <0.001a |
eGFR (mL/min/1.73 m2) | 76.18 ± 16.80 | 56.12 ± 22.47 | 67.25 ± 15.12 | 82.10 ± 18.24 | 65.78 ± 12.40 | <0.001a |
Uric acid (mg/dL) | 4.98 ± 1.38 | 5.74 ± 1.55 | 5.10 ± 1.45 | 4.92 ± 1.34 | 5.01 ± 1.43 | <0.001a |
Proteinuria | <0.001b | |||||
No | 29,690 (88%) | 491 (54%) | 4651 (95%) | 19,726 (91%) | 4822 (76%) | - |
Yes | 2425 (7%) | 403 (44%) | 185 (4%) | 1549 (7%) | 288 (5%) | - |
MLR group (%) | <0.001b | |||||
Normal | 15,664 (46%) | 72 (8%) | 1968 (40%) | 10,518 (49%) | 3106 (49%) | - |
Only DM | 8844 (26%) | 330 (36%) | 1459 (30%) | 5978 (28%) | 1077 (17%) | - |
Only CKD | 6839 (20%) | 59 (7%) | 1015 (21%) | 4017 (18%) | 1748 (27%) | - |
DKD | 2532 (8%) | 447 (49%) | 457 (9%) | 1180 (5%) | 448 (7%) | - |
Genome-wide association analysis for DKD
Chr | Position | rsID | Allelea | AF | GWAS | Gene symbol | ||
---|---|---|---|---|---|---|---|---|
OR (95% CI) | P | |||||||
6 | 29364135 | rs3128852 | C/T | 0.281 | 8.21×10−25 | OR5V1 (intronic) | ||
- only DM vs. normal | 1.079 (1.030–1.132) | 5.81 × 10−4 | ||||||
- only CKD vs. normal | 0.977 (0.934–1.024) | 0.342 | ||||||
- DKD vs. normal | 1.421 (1.296–1.572) | 2.32 × 10−24 | ||||||
- only CKD vs. only DM | 0.905 (0.859–0.955) | 2.28 ×10−4 | ||||||
- DKD vs. only DM | 1.317 (1.226–1.416) | 4.72 × 10−14 | ||||||
- DKD vs. only CKD | 1.455 (1.351–1.567) | 3.13 ×10−23 | ||||||
9 | 97149910 | rs117744700 | G/C | 0.249 | 8.28×10−10 | HIATL1 (intronic) | ||
- only DM vs. normal | 0.950 (0.911–0.993) | 0.030 | ||||||
- only CKD vs. normal | 0.967 (0.926–1.017) | 0.216 | ||||||
- DKD vs. normal | 0.769 (0.725–0.818) | 6.22 ×10−11 | ||||||
- only CKD vs. only DM | 1.020 (0.966–1.078) | 0.481 | ||||||
- DKD vs. only DM | 0.809 (0.745–0.879) | 5.22 ×10−7 | ||||||
- DKD vs. only CKD | 0.793 (0.729–0.863) | 7.65 ×10−8 | ||||||
6 | 32565056 | rs28366355 | G/T | 0.498 | 2.04×10−8 | HLA-DRB1(dist=7443), | ||
- only DM vs. normal | 1.117 (1.070–1.169) | 3.38 × 10−8 | HLA-DQA1(dist=40127) | |||||
- only CKD vs. normal | 1.085 (1.037–1.137) | 1.46 × 10−4 | (intergenic) | |||||
- DKD vs. normal | 1.114 (1.040–1.201) | 9.52×10−4 | ||||||
- only CKD vs. only DM | 0.971 (0.925–1.018) | 0.224 | ||||||
- DKD vs. only DM | 0.998 (0.931–1.068) | 0.941 | ||||||
- DKD vs. only CKD | 1.027 (0.958–1.102) | 0.448 | ||||||
11 | 100902053 | rs1824125 | A/C | 0.248 | 6.58 × 10−7 | PGR (UTR3) | ||
- only DM vs. normal | 1.075 (1.026–1.131) | 1.50 × 10−3 | ||||||
- only CKD vs. normal | 1.030 (0.981–1.084) | 0.229 | ||||||
- DKD vs. normal | 1.211 (1.114–1.327) | 1.59 × 10−7 | ||||||
- only CKD vs. only DM | 0.957 (0.907–1.012) | 0.118 | ||||||
- DKD vs. only DM | 1.126 (1.043–1.215) | 2.14×10−3 | ||||||
- DKD vs. only CKD | 1.176 (1.088–1.272) | 4.58×10−5 | ||||||
2 | 206490310 | rs75292524 | A/G | 0.283 | 7.82×10−7 | PARD3B(dist=5424), | ||
- only DM vs. normal | 0.960 (0.921–1.002) | 0.072 | NRP2(dist=56914) | |||||
- only CKD vs. normal | 0.991 (0.947–1.039) | 0.720 | (intergenic) | |||||
- DKD vs. normal | 0.815 (0.768–0.867) | 7.82×10−7 | ||||||
- only CKD vs. only DM | 1.126 (1.043–1.215) | 0.239 | ||||||
- DKD vs. only DM | 0.848 (0.784–0.918) | 4.06×10−5 | ||||||
- DKD vs. only CKD | 0.822 (0.759–0.891) | 1.59×10−6 |
Functional annotation
Chr | SNP | Gene symbol | P | NES | Tissue |
---|---|---|---|---|---|
6 | rs3128852 | TRIM27 | 2.10×10−9 | −0.19 | Whole blood |
HLA-A | 1.60×10−7 | 0.23 | Adipose - Subcutaneous | ||
9 | rs117744700 | - | - | - | - |
6 | rs28366355 | CYP21A1P | 1.30E−11 | 0.30 | Whole blood |
1.50E−08 | 0.28 | Artery - Tibial | |||
HLA-DQA1 | 5.40E−15 | −0.34 | Artery - Aorta | ||
5.00E−12 | −0.22 | Artery - Tibial | |||
6.20E−11 | −0.27 | Adipose - Subcutaneous | |||
6.60E−09 | −0.13 | Whole blood | |||
HLA-DQA2 | 1.00E−97 | 0.90 | Whole blood | ||
6.70E−80 | 1.00 | Adipose - Subcutaneous | |||
2.30E−77 | 0.91 | Artery - Tibial | |||
8.50E−45 | 0.93 | Heart - Left ventricle | |||
HLA-DQB1 | 4.30E−13 | −0.25 | Whole blood | ||
2.90E−11 | −0.34 | Adipose - Subcutaneous | |||
8.30E−08 | −0.34 | Heart - Left ventricle | |||
2.00E−07 | −0.22 | Artery - Tibial | |||
2.00E−07 | −0.28 | Artery - Aorta | |||
HLA-DQB2 | 2.00E−24 | 0.44 | Whole blood | ||
1.90E−15 | 0.38 | Artery - Tibial | |||
8.10E−15 | 0.46 | Adipose - Subcutaneous | |||
HLA-DRB1 | 1.70E−25 | −0.18 | Whole blood | ||
1.90E−22 | −0.24 | Artery - Tibial | |||
5.20E−22 | −0.37 | Heart - Left ventricle | |||
1.20E−21 | −0.32 | Adipose - Subcutaneous | |||
4.70E−19 | −0.31 | Artery - Aorta | |||
HLA-DRB6 | 2.40E−95 | 1.00 | Adipose - Subcutaneous | ||
4.70E−75 | 0.7 | Whole blood | |||
1.20E−67 | 0.67 | Artery - Tibial | |||
3.30E−41 | 0.71 | Artery - Aorta | |||
3.20E−16 | 0.34 | Whole blood | |||
XXbac-BPG154L12.4 | 5.30E−10 | 0.34 | Adipose - Subcutaneous |
Gene symbol | log FC | AveExpr | P-value | B |
---|---|---|---|---|
TRIM27 | −0.506 | 0.066 | 4.10×10−3 | −0.556 |
HLA-A | −1.053 | 0.071 | 1.19×10−3 | −0.904 |
CYP21A1P | 0.162 | 0.013 | 0.261 | −5.750 |
HLA-DQA1 | −1.758 | 0.951 | 8.09×10−3 | −2.783 |
HLA-DQA2 | NA | NA | NA | NA |
HLA-DQB1 | −1.234 | 0.307 | 4.78×10−4 | −0.132 |
HLA-DQB2 | −0.450 | 0.170 | 2.21×10−2 | −3.698 |
HLA-DRB1 | NA | NA | NA | NA |
HLA-DRB6 | −0.725 | 0.018 | 3.53×10−5 | 2.347 |
XXbac-BPG154L12.4 | NA | NA | NA | NA |
KEGG ID | Pathway description | Counts in network | Strength | FDR | Matching proteins in the network |
---|---|---|---|---|---|
hsa04612 | Antigen processing and presentation | 2/63 | 2.09 | 0.011 | HLA-DQA1, HLA-A |
hsa04940 | Type I diabetes mellitus | 2/39 | 2.30 | 0.011 | HLA-DQA1, HLA-A |
hsa05320 | Autoimmune thyroid disease | 2/48 | 2.21 | 0.011 | HLA-DQA1, HLA-A |
hsa05330 | Allograft rejection | 2/34 | 2.36 | 0.011 | HLA-DQA1, HLA-A |
hsa05332 | Graft-versus-host disease | 2/36 | 2.34 | 0.011 | HLA-DQA1, HLA-A |
hsa05416 | Viral myocarditis | 2/55 | 2.15 | 0.011 | HLA-DQA1, HLA-A |
hsa04145 | Phagosome | 2/142 | 1.74 | 0.024 | HLA-DQA1, HLA-A |
hsa04514 | Cell adhesion molecules | 2/137 | 1.76 | 0.024 | HLA-DQA1, HLA-A |
hsa05169 | Epstein-Barr virus infection | 2/193 | 1.61 | 0.036 | HLA-DQA1, HLA-A |
hsa05166 | Human T cell leukemia virus 1 infection | 2/211 | 1.57 | 0.039 | HLA-DQA1, HLA-A |
DM | CKD | DKD | |
---|---|---|---|
V(G)/Vp | 0.176 | 0.054 | 0.064 |
SE | 0.012 | 0.011 | 0.011 |
LRT | 36.867 | 1.488 | 6.437 |
P | 6.32×10−10 | 0.111 | 5.58×10−3 |