The Association of Toxoplasma gondii IgG Antibody and Chronic Kidney Disease Biomarkers
Abstract
:1. Introduction
1.1. Toxoplasma
1.2. Chronic Kidney Disease
1.3. Toxoplasma and CKD
2. Materials and Methods
2.1. Study Population
2.2. Exposure Variable: T. gondii
2.3. CKD biomarkers
2.3.1. First and Second Albumin-to-Creatinine Ratios
2.3.2. First and Second Albuminuria
2.3.3. Persistent Albuminuria
2.3.4. Serum Creatinine (Scr)
2.3.5. eGFR
2.3.6. CKD
- Stage 1: eGFR ≥ 90 mL/min/1.73 m2 and estimated persistent albuminuria;
- Stage 2: eGFR 60–89 mL/min/1.73 m2 and estimated persistent albuminuria;
- Stage 3: eGFR 30–59 mL/min/1.73 m2;
- Stage 4: eGFR 15–29 mL/min/1.73 m2;
- Stage 5: eGFR < 15mL/min/1.73 m2.
- Negative: Negative;
- Mild CKD: Stage 1 and 2;
- Moderate-to-Severe CKD: Stage 3, 4, and 5.
2.4. Covariates for Models Adjustment
2.5. Statistical Analysis
3. Results
3.1. Data Summary
3.2. Association of Toxoplasma and CKD Biomarkers and CKD Status
3.3. Age Factor
3.4. Association of Toxoplasma and CKD after Adjusting for Co-Variates
4. Discussion
4.1. Overview of Results and Implications
4.2. Implications of Findings
4.3. Limitation
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Description | n | Weighted Percentage/Mean (SE) |
---|---|---|---|
T. gondii IgG antibody | <33 IU/mL (negative) | 3789 | 84.8 |
≥33 IU/mL (positive) | 903 | 15.2 | |
Gender | Male | 2256 | 47.7 |
Female | 2436 | 52.3 | |
Age | 4692 | 47.9 (0.49) | |
Age group | Younger (<45) | 1792 | 41.9 |
Older (≥45) | 2900 | 58.1 | |
Race/ethnicity | Mexican American | 874 | 8.4 |
Other Hispanic | 483 | 4.8 | |
Non-Hispanic White | 2337 | 70.4 | |
Non-Hispanic Black | 754 | 9.9 | |
Other Race | 244 | 6.5 | |
Alcohol use | Yes | 694 | 15.6 |
No | 3046 | 84.4 | |
Smoking use | Every day | 767 | 35.9 |
Some days | 169 | 6.0 | |
Not at all | 1211 | 58.1 | |
Marijuana/hashish use | Yes | 1440 | 58.0 |
No | 1309 | 42.0 | |
Cocaine/heroin/methamphetamine use | Yes | 611 | 18.5 |
No | 2824 | 81.5 | |
BMI | 4659 | 28.9 (0.14) | |
Having diabetes | Yes | 550 | 8.4 |
No | 4045 | 89.7 | |
Borderline | 94 | 1.9 | |
Kidney Biomarker | |||
First albumin creatinine ratio | 4692 | 24.1(2.94) | |
Second albumin creatinine ratio | 4692 | 16.0 (2.06) | |
First albuminuria | Negative | 4183 | 92.0 |
Microalbuminuria | 424 | 6.9 | |
Macroalbuminuria | 85 | 1.1 | |
Second albuminuria | Negative | 4383 | 95.3 |
Microalbuminuria | 248 | 4.0 | |
Macroalbuminuria | 61 | 0.7 | |
Persistent albuminuria | Negative | 4437 | 96.5 |
Positive | 255 | 3.5 | |
eGFR | 4692 | 87.8 (0.74) | |
eGFR stages | Stage 1 | 2150 | 43.2 |
Stage 2 | 2089 | 49.2 | |
Stage 3 | 413 | 7.1 | |
Stage 4 | 29 | 0.4 | |
Stage 5 | 11 | 0.1 | |
CKD | Negative | 4070 | 90.0 |
Positive | 622 | 10.0 | |
CKD levels | Negative | 4070 | 90.0 |
Mild | 169 | 2.4 | |
Moderate-to-Severe | 453 | 7.6 | |
CKD stages | Negative | 4070 | 90.0 |
Stage 1 | 69 | 0.9 | |
Stage 2 | 100 | 1.5 | |
Stage 3 | 413 | 7.1 | |
Stage 4 | 29 | 0.4 | |
Stage 5 | 11 | 0.1 |
Variable | Level | T. gondii Negative | T. gondii Positive | p-Value | ||
---|---|---|---|---|---|---|
n | Weighted Percentage or Mean (SE) | n | Weighted Percentage or Mean (SE) | |||
First albumin-to-creatinine ratio | 3789 | 22.5 (3.56) | 903 | 32.9 (4.62) | 0.1222 | |
Second albumin-to-creatinine ratio | 3789 | 14.4 (2.38) | 903 | 24.9 (3.91) | 0.0376 | |
First albuminuria | Negative | 3389 | 85.1 | 794 | 14.9 | 0.0752 |
Microalbuminuria | 336 | 83.5 | 88 | 16.5 | ||
Macroalbuminuria | 64 | 74.1 | 21 | 25.9 | ||
Second albuminuria | Negative | 3555 | 85.2 | 828 | 14.8 | 0.0005 |
Microalbuminuria | 192 | 78.2 | 56 | 21.8 | ||
Macroalbuminuria | 42 | 67.8 | 19 | 32.2 | ||
Persistent albuminuria | Negative | 3594 | 76.9 | 843 | 23.1 | <0.0001 |
Positive | 195 | 85.1 | 60 | 14.9 | ||
eGFR | 3789 | 88.1 (0.76) | 903 | 86.2 (1.22) | 0.0913 | |
eGFR stages | Stage 1 | 1758 | 85.2 | 392 | 14.8 | 0.0014 |
Stage 2 | 1688 | 85.6 | 401 | 14.4 | ||
Stage 3 | 317 | 78.7 | 96 | 21.3 | ||
Stage 4 | 20 | 71.7 | 9 | 28.3 | ||
Stage 5 | 6 | 68.8 | 5 | 31.2 | ||
CKD | Negative | 3314 | 85.6 | 756 | 14.4 | 0.0001 |
Positive | 475 | 77.9 | 147 | 22.1 | ||
CKD levels | Negative | 3314 | 85.6 | 756 | 14.4 | <0.0001 |
Mild | 132 | 76.9 | 37 | 23.1 | ||
Moderate-to-Severe | 343 | 78.2 | 110 | 21.8 | ||
CKD stages | Negative | 3314 | 85.6 | 756 | 14.4 | 0.0004 |
Stage 1 | 58 | 79.8 | 11 | 20.2 | ||
Stage 2 | 74 | 75.1 | 26 | 24.9 | ||
Stage 3 | 317 | 78.7 | 96 | 21.3 | ||
Stage 4 | 20 | 71.1 | 9 | 28.9 | ||
Stage 5 | 6 | 68.8 | 5 | 31.2 |
Toxoplasma IgG Antibody | Younger (<45 Year) | Older (≥45 Year) | ||||
---|---|---|---|---|---|---|
No CKD | CKD | Total | No CKD | CKD | Total | |
Negative (n) | 1505 | 43 | 1548 | 1809 | 432 | 2241 |
Positive (n) | 239 | 5 | 244 | 517 | 142 | 659 |
Stratified risk ratio | RRyoung = 0.76 (95% CI: 0.33–1.76) | RRold = 1.11 (95% CI: 0.95–1.31) | ||||
Unstratified risk ratio (RRcrude) = 1.27 (95% CI: 1.09–1.49) | ||||||
Pooled estimate risk ratio (RRMH) = 1.09 (95% CI: 0.93–1.28) | ||||||
Magnitude of Confounding = 17% |
CKD | ||||
---|---|---|---|---|
Sample Size = 4659 | Odds Ratio | OR 95% Confidence Interval | p-Value | |
Toxoplasma IgG antibody (Positive) | 1.40 | 1.06 | 1.84 | 0.0447 |
Age | ||||
Younger (<45) (reference) | ||||
Older (≥45) | 8.89 | 6.31 | 12.51 | <0.0001 |
Gender | ||||
Male (reference) | ||||
Female | 1.27 | 1.06 | 1.54 | 0.0352 |
Race/ethnicity | ||||
Mexican American (reference) | ||||
Other Hispanic | 0.91 | 0.62 | 1.34 | 0.6524 |
Non-Hispanic White | 1.09 | 0.76 | 1.55 | 0.6649 |
Non-Hispanic Black | 0.93 | 0.59 | 1.49 | 0.7786 |
Other Race | 0.90 | 0.42 | 1.95 | 0.8028 |
BMI | 1.04 | 1.02 | 1.06 | 0.0059 |
Constant | 0.01 | 0.00 | 0.01 | <0.0001 |
AIC = 2697, Pseudo R-Square = 0.07 |
CKD | ||||
---|---|---|---|---|
Sample Size = 3722 | Odds Ratio | OR 95% Confidence Interval | p-Value | |
Toxoplasma IgG antibody (Positive) | 1.27 | 0.97 | 1.64 | 0.1381 |
Age | ||||
Younger (<45) (reference) | ||||
Older (≥45) | 8.59 | 5.48 | 13.47 | 0.0002 |
Gender | ||||
Male (reference) | ||||
Female | 1.15 | 0.93 | 1.42 | 0.2487 |
Race/ethnicity | ||||
Mexican American (reference) | ||||
Other Hispanic | 1.00 | 0.60 | 1.64 | 0.9873 |
Non-Hispanic White | 1.19 | 0.88 | 1.62 | 0.2985 |
Non-Hispanic Black | 0.95 | 0.57 | 1.55 | 0.8334 |
Other Race | 0.79 | 0.35 | 1.79 | 0.5932 |
Alcohol use (No) | 0.94 | 0.71 | 1.25 | 0.7102 |
BMI | 1.04 | 1.01 | 1.06 | 0.0144 |
Has Diabetes (No) | 0.40 | 0.27 | 0.61 | 0.0075 |
Constant | 0.03 | 0.01 | 0.08 | 0.0009 |
AIC = 2120, Pseudo R-Square = 0.08 |
CKD | ||||
---|---|---|---|---|
Sample Size = 3722 | Odds Ratio | OR 95% Confidence Interval | p-Value | |
Toxoplasma IgG antibody (Positive) | 1.56 | 1.20 | 2.04 | 0.0168 |
Gender | ||||
Male (reference) | ||||
Female | 1.18 | 0.98 | 1.43 | 0.1464 |
Race/ethnicity | ||||
Mexican American (reference) | ||||
Other Hispanic | 0.97 | 0.59 | 1.63 | 0.9338 |
Non-Hispanic White | 1.70 | 1.21 | 2.27 | 0.0196 |
Non-Hispanic Black | 1.11 | 0.68 | 1.82 | 0.6845 |
Other Race | 0.81 | 0.39 | 1.73 | 0.6046 |
Alcohol use (No) | 0.89 | 0.67 | 1.17 | 0.4407 |
BMI | 1.03 | 1.01 | 1.05 | 0.0219 |
Has Diabetes (No) | 0.30 | 0.19 | 0.43 | 0.0078 |
Constant | 0.24 | 0.10 | 0.54 | 0.0142 |
AIC = 2299, Pseudo R-Square = 0.03 |
CKD | ||||
---|---|---|---|---|
Sample Size = 1885 | Odds Ratio | OR 95% Confidence Interval | p-Value | |
Toxoplasma IgG antibody (Positive) | 1.81 | 1.26 | 2.60 | 0.0325 |
Gender | ||||
Male (reference) | ||||
Female | 0.99 | 0.73 | 1.33 | 0.9525 |
Race/ethnicity | ||||
Mexican American (reference) | ||||
Other Hispanic | 0.82 | 0.38 | 1.75 | 0.6348 |
Non-Hispanic White | 1.46 | 0.88 | 2.44 | 0.2133 |
Non-Hispanic Black | 1.45 | 0.83 | 2.56 | 0.2593 |
Other Race | 0.53 | 0.17 | 1.68 | 0.3423 |
Alcohol use (No) | 0.89 | 0.64 | 1.27 | 0.5732 |
BMI | 1.02 | 1.01 | 1.04 | 0.0696 |
Has Diabetes (No) | 0.30 | 0.19 | 0.51 | 0.0125 |
Smoking use (No) Reference | ||||
Smoking use (every day) | 0.93 | 0.49 | 1.76 | 0.8512 |
Smoking use (some days) | 1.78 | 1.32 | 2.39 | 0.0187 |
Constant | 0.24 | 0.10 | 0.54 | 0.1556 |
AIC = 1142, Pseudo R-Square = 0.04 |
CKD | ||||
---|---|---|---|---|
Sample Size = 1551 | Odds Ratio | OR 95% Confidence Interval | p-Value | |
Toxoplasma IgG antibody (Positive) | 0.75 | 0.36 | 1.56 | 0.5803 |
Gender | ||||
Male (reference) | ||||
Female | 0.98 | 0.59 | 1.64 | 0.9589 |
Race/ethnicity | ||||
Mexican American (reference) | ||||
Other Hispanic | 1.42 | 0.76 | 2.66 | 0.4678 |
Non-Hispanic White | 0.89 | 0.55 | 1.43 | 0.7176 |
Non-Hispanic Black | 1.12 | 0.61 | 2.06 | 0.7702 |
Other Race | 0.76 | 0.16 | 3.60 | 0.7890 |
Alcohol use (No) | 0.55 | 0.29 | 1.06 | 0.3265 |
BMI | 1.06 | 1.03 | 1.09 | 0.1617 |
Marijuana/hashish use | 1.53 | 0.90 | 2.59 | 0.3589 |
Cocaine/heroin/methamphetamine use | 0.74 | 0.41 | 1.34 | 0.0562 |
Constant | 0.01 | 0.00 | 0.02 | 0.0676 |
AIC = 416, Pseudo R-Square = 0.01 |
CKD Stages | ||||
---|---|---|---|---|
Sample Size = 4659 | Odds Ratio | OR 95% Confidence Interval | p-Value | |
Toxoplasma IgG antibody (Positive) | 1.41 | 1.07 | 1.86 | 0.0424 |
Age | ||||
Younger (<45) (reference) | ||||
Older (≥45) | 8.97 | 6.38 | 12.60 | <0.0001 |
Gender | ||||
Male (reference) | ||||
Female | 1.32 | 1.10 | 1.60 | 0.0195 |
Race/ethnicity | ||||
Mexican American (reference) | ||||
Other Hispanic | 0.95 | 0.65 | 1.40 | 0.8087 |
Non-Hispanic White | 1.14 | 0.81 | 1.60 | 0.4615 |
Non-Hispanic Black | 0.96 | 0.61 | 1.51 | 0.8650 |
Other Race | 0.91 | 0.43 | 1.94 | 0.8250 |
BMI | 1.04 | 1.01 | 1.06 | 0.0058 |
Negative|Stage 1 | 0.13 | 0.02 | 0.69 | 0.0742 |
Stage 1|Stage 2 | 0.15 | 0.08 | 0.26 | 0.0852 |
Stage 2|Stage 3 | 0.18 | 0.13 | 0.27 | 0.1131 |
Stage 3|Stage 4 | 3.68 | 3.13 | 4.32 | 0.2157 |
Stage 4|Stage 5 | 18.25 | 12.39 | 26.86 | 0.0223 |
CKD Levels | ||||
---|---|---|---|---|
Sample Size = 4659 | Odds Ratio | OR 95% Confidence Interval | p-Value | |
Toxoplasma IgG antibody (Positive) | 1.23 | 0.93 | 1.63 | 0.1799 |
Age | ||||
Younger (<45) (reference) | ||||
Older (≥45) | 2.94 | 2.17 | 3.97 | <0.0001 |
Gender | ||||
Male (reference) | ||||
Female | 1.52 | 1.25 | 1.84 | 0.0027 |
Race/ethnicity | ||||
Mexican American (reference) | ||||
Other Hispanic | 1.50 | 1.11 | 2.03 | 0.0297 |
Non-Hispanic White | 2.25 | 1.79 | 2.83 | 0.0001 |
Non-Hispanic Black | 0.96 | 0.61 | 1.51 | 0.8650 |
Other Race | 1.53 | 1.10 | 2.12 | 0.8250 |
BMI | 1.01 | 0.99 | 1.02 | 0.6051 |
Mild|Negative | 0.10 | 0.06 | 0.16 | 0.0001 |
Negative|Moderate-to-Severe | 76.14 | 70.78 | 81.90 | 0.0001 |
CKD Levels | ||||
---|---|---|---|---|
Sample Size = 4659 | Odds Ratio | OR 95% Confidence Interval | p-Value | |
Toxoplasma IgG antibody (Positive) | 1.42 | 1.07 | 1.90 | 0.0371 |
Gender | ||||
Male (reference) | ||||
Female | 1.54 | 1.28 | 1.85 | 0.0011 |
Race/ethnicity | ||||
Mexican American (reference) | ||||
Other Hispanic | 1.50 | 1.07 | 2.04 | 0.0417 |
Non-Hispanic White | 2.78 | 2.16 | 3.58 | 0.0001 |
Non-Hispanic Black | 1.34 | 0.86 | 2.12 | 0.2245 |
Other Race | 1.53 | 1.10 | 2.12 | 0.8250 |
BMI | 1.01 | 0.99 | 1.02 | 0.2861 |
Mild|Negative | 0.08 | 0.05 | 0.14 | 0.0001 |
Negative|Moderate-to-Severe | 50.53 | 47.75 | 53.48 | 0.0001 |
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Babekir, A.; Mostafa, S.; Obeng-Gyasi, E. The Association of Toxoplasma gondii IgG Antibody and Chronic Kidney Disease Biomarkers. Microorganisms 2022, 10, 115. https://doi.org/10.3390/microorganisms10010115
Babekir A, Mostafa S, Obeng-Gyasi E. The Association of Toxoplasma gondii IgG Antibody and Chronic Kidney Disease Biomarkers. Microorganisms. 2022; 10(1):115. https://doi.org/10.3390/microorganisms10010115
Chicago/Turabian StyleBabekir, Amani, Sayed Mostafa, and Emmanuel Obeng-Gyasi. 2022. "The Association of Toxoplasma gondii IgG Antibody and Chronic Kidney Disease Biomarkers" Microorganisms 10, no. 1: 115. https://doi.org/10.3390/microorganisms10010115