Serum homocysteine is associated with tubular interstitial lesions at the early stage of IgA nephropathy.
Serum homocysteine is associated with tubular interstitial lesions at the early stage of IgA nephropathy.
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血清同型半胱氨酸与IgA肾病早期肾小管间质病变相关
DOI：
10.1186/s12882-021-02632-3
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发表时间：
2022-02-23
期刊：
影响因子：
2.3
通讯作者：
Yang Q
中科院分区：
文献类型：
--
作者：
Li Z;Han Q;Ye H;Li J;Wei X;Zhang R;Huang Q;Xu Y;Liu G;Li B;Yang Q
背景：同型半胱氨酸（Hcy）与IgA肾病（IgAN）之间的关系尚不清楚。我们旨在探讨Hcy与IgAN患者临床病理特征之间的关系。方法本研究共纳入337例IgAN患者和150例性别和年龄匹配的健康对照。按Hcy≤10 μmol/L或> 10 μmol/L分为低、高Hcy组。采用多因素logistic回归分析Hcy升高的危险因素。结果IgAN患者血清Hcy高于健康对照组[11.6 (9.1,15.3)vs. 8.8 （7.5,10.6) μmol/L，P< 0.001]， 156例估计肾小球滤过率(eGFR)≥90 ml/min/1.73 m2）患者亚组一致[9.9 (7.6,12.4)vs. 8.8 (7.5,10.6) μmol/L，P< 0.001]。与低Hcy组比较，高Hcy组血清肌酐（Scr）、血尿氮（BUN）、尿酸（UA）、毛细血管内高细胞性(E)和小管萎缩/间质纤维化病变(T)升高。Hcy水平与Scr、BUN、UA、24小时尿蛋白、E、T病变呈正相关，与eGFR、超氧化物歧化酶（SOD）呈负相关。在eGFR正常的亚组中，Hcy较高的患者持续存在较高的Scr、BUN和T病变。多因素logistic回归模型显示，病理性T患者Hcy升高的风险增加2.87倍。T病变能更好地预测高Hcy， eGFR正常亚组的比值比（OR）为14.20。结论病理性T是Hcy升高的独立危险因素，尤其是在IgAN早期。
BackgroundThe association between homocysteine (Hcy) and IgA nephropathy (IgAN) is not well understood. We aimed to investigate the relationship between Hcy and clinicopathologic features in IgAN patients.MethodsA total of 337 IgAN patients and 150 sex- and age- matched healthy controls were enrolled in this single-center retrospective study. According to Hcy ≤ 10 μmol/L or > 10 μmol/L, patients were divided into low and high Hcy groups. Multivariate logistic regression was performed to explore the risk factors for elevated Hcy.ResultsSerum Hcy was higher in IgAN patients than in healthy controls [11.6 (9.1,15.3) vs. 8.8 (7.5,10.6) μmol/L,P< 0.001], unanimously in the subgroup of 156 patients with a normal estimated glomerular filtration rate (eGFR) (≥ 90 ml/min/1.73 m2) [9.9 (7.6,12.4) vs. 8.8 (7.5,10.6) μmol/L,P< 0.001]. Compared to the low Hcy group, serum creatinine (Scr), blood urine nitrogen (BUN), uric acid (UA), endocapillary hypercellularity (E) and tubular atrophy/interstitial fibrosis lesion (T) were higher in the high Hcy group. Hcy levels were positively correlated with Scr, BUN, UA, 24-h urine protein, and E and T lesions, but negatively correlated with eGFR and superoxide dismutase (SOD). In the subgroup with normal eGFR, patients with higher Hcy were persistent with higher Scr, BUN and T lesions. A multivariate logistic regression model showed that the risk of elevated Hcy in patients with pathological T increased by 2.87-fold. T lesions could better predict high Hcy, with an odds ratio (OR) of 14.20 in the subgroup with normal eGFR.ConclusionsPathologic T was an independent risk factor associated with elevated Hcy, especially at the early stage of IgAN.
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