sPLA2-IB Level Correlates with Hyperlipidemia and the Prognosis of Idiopathic Membranous Nephropathy
sPLA2-IB Level Correlates with Hyperlipidemia and the Prognosis of Idiopathic Membranous Nephropathy
复制标题
DOI：
10.1007/s11596-020-2246-5
复制
发表时间：
2020-08
影响因子：
2.4
通讯作者：
Li-yan Yang;Yuansheng Wu;B. Dai;Songhua Lin;Hong Chen;Guoping Li;X. Tao;Jianxin Wan;Yang-bin Pan
中科院分区：
文献类型：
--
作者：
Li-yan Yang;Yuansheng Wu;B. Dai;Songhua Lin;Hong Chen;Guoping Li;X. Tao;Jianxin Wan;Yang-bin Pan
最近的研究表明，特发性膜性肾病(IMN)患者血清分泌型磷脂酶A2-IB(sPLA2-IB)水平升高。然而，在这些研究中没有考虑高脂血症对sPLA2-IB水平的干扰。本研究旨在探讨sPLA2-IB与血脂的相关性，以及sPLA2-IB在预测IMN患者预后中的临床价值。研究对象包括的IMN患者、39例免疫球蛋白A肾病患者和的健康对照组。检测血清sPLA2-IB、血脂和蛋白尿。对50例IMN患者进行了6个月的随访。所有IgAN和IMN患者均行病理分期。结果显示：IMN患者血清sPLA2-IB、胆固醇和低密度脂蛋白胆固醇(LDL-C)水平显著高于正常对照组和IgAN患者，而白蛋白和高密度脂蛋白胆固醇(HDLC)水平显著低于正常对照组和IgAN患者。IgAN患者血清sPLA2-IB水平也高于健康对照组，但血清sPLA2-IB水平与蛋白尿、胆固醇和白蛋白的关系仅在IMN患者中显示。81.3%的IMN患者抗分泌型磷脂酶A2受体(PLA2)抗体阳性。IMN患者可见肾小球sPLA2-IB沉积，足细胞融合突起，增厚的基底膜可见密度沉积，而IgAN患者未见。随访6个月后，sPLA2-IB和蛋白尿水平较低的IMN患者预后较好。IMN患者血清和肾组织中sPLA2-IB水平均显著升高。结论：血清sPLA2-IB水平与尿蛋白、白蛋白、胆固醇密切相关，sPLA2-IB水平越低的IMN患者预后越好。
Recent studies suggested that serum secretory phospholipase A2 group IB (sPLA2-IB) was increased in idiopathic membranous nephropathy (IMN). However, the interference of high lipemia on the sPLA2-IB levels was not taken into account in these studies. The present study aimed to investigate the correlation between sPLA2-IB and lipemia, and the clinical merit of sPLA2-IB in the prediction of prognosis of IMN patients. A total of 64 IMN patients, 39 immunoglobulin A nephropathy (IgAN) patients and 64 healthy controls were included in the study. The levels of serum sPLA2-IB, lipemia and proteinuria were measured. Fifty IMN patients were followed up for 6 months. Pathologic stages were made for all IgAN and IMN patients. The results showed that the levels of serum sPLA2-IB, cholesterol and low-density lipoprotein cholesterol (LDL-C) were significantly higher, and the levels of albumin and high-density lipoprotein cholesterol (HDL-C) were significantly lower in IMN patients than in healthy controls and IgAN patients. Serum sPLA2-IB levels were also found to be higher in IgAN patients than in heathy controls, but the association of serum sPLA2-IB levels with proteinuria, cholesterol and albumin was only shown in IMN patients. Antibody against M-type receptor for secretory phospholipase A2 (PLA2R1) was positive in 81.3% IMN patients. Glomerular sPLA2-IB deposition, podocyte fused processes, and density deposition on thickened basement membrane were seen in IMN patients, but not in IgAN patients. IMN patients with lower sPLA2-IB and proteinuria levels were found to have better outcome after the 6-month follow-up. In IMN patients, sPLA2-IB levels were significantly increased in both serum and renal tissue. In conclusion, serum sPLA2-IB was closely correlated with proteinuria, albumin and cholesterol, and IMN patients with lower sPLA2-IB levels were more likely to achieve a better outcome.