The expression of urinary HMGB1 and IGFBP7 in patients with primary IgA nephropathy and their relationship with disease severity and prognosis
Objective To analyze the expression of high mobility group protein B1(HMGB1)and insulin-like growth factor binding protein-7(IGFBP7)in urine of patients with primary immunoglobulin A(IgA)nephropathy and their relationship with disease severity and prognosis.Methods A total of 104 patients with primary IgA nephropathy who were diagnosed and treated in Enshi Tujia and Miao Autonomous Prefecture Central Hospital from January 2018 to December 2020 were regarded as the study subjects.They were grouped into mild group(33 cases),moderate group(44 cases),and severe group(27 cases)based on the severity of the disease.The pa-tients were followed up and divided into the good prognosis group(78 cases)and the poor prognosis group(26 cases).Pearson and Spearman methods were used to analyze urine HMGB1 and IGFBP7 levels and their correlation with serum creatinine and 24-hour urine protein quantification,disease severity and poor prognosis,respectively;logistic regression was applied to analyze the influencing factors of poor prognosis in patients with severe primary IgA nephropathy and primary IgA nephropathy;receiver operating characteris-tic(ROC)curve was applied to analyze the evaluation value of urine HMGB1 and IGFBP7 in severe primary IgA nephropathy and poor prognosis of patients with primary IgA nephropathy.Results The levels of serum creatinine,24-hour urine protein,CRP,PCT and WBC,urine HMGB1[(6.72±1.02)μg/L,(9.61±2.17)μg/L,(12.51±3.14)μg/L]and IGFBP7[(2.25±0.58)μg/L,(5.32±1.26)μg/L,(15.72±3.65)μg/L]were significantly increased in the mild,moderate and severe groups.The levels of HMGB1[(14.92±4.45)μg/L vs.(7.62±1.26)μg/L]and IGFBP7[(18.73±3.57)μg/L vs.(3.15±1.03)μg/L]in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).According to the correlation analysis,the levels of urine HMGB1 and IGFBP7 were positively correlat-ed(P<0.05),and both were positively correlated with serum creatinine,24-hour urine protein quantification,CRP,PCT and WBC,dis-ease severity and poor prognosis(P<0.05).According to logistic regression analysis,HMGB1 and IGFBP7 were risk factors for severe primary IgA nephropathy(P<0.05),and HMGB1 and IGFBP7 were also risk factors for poor prognosis in patients with primary IgA ne-phropathy(P<0.05).According to the ROC curve,the combination of urine HMGB1 and IGFBP7 was superior to their respective indi-vidual diagnosis of severe primary IgA nephropathy(Zcombination vs.HMGB1=2.41,Zcombination vs.IGFBP7=2.32,P<0.05).The combination of urine HMGB1 and IGFBP7 was superior to each other in predicting poor prognosis in patients with primary IgA nephropathy(Zcombination vs.HMGB1=2.33,Zcombination vs.IGFBP7=2.12,P<0.05).Conclusions The expression levels of HMGB1 and IGFBP7 in urine of patients with primary IgA nephropathy are obviously increased,which are closely related to the severity and prognosis of the disease.The combination of the two can better evaluate the severity of condition and prognosis of the patients.
Autoimmune kidney diseaseImmunoglobulin AHigh mobility group protein B1Insulin like growth factor binding protein-7SeverityPrognosis
万方数据
维普
