Objective To explore predictive value of the monocyte/high-density lipoprotein ratio(MHR)on the severity of glomerulosclerosis in patients with immunoglobulin A nephropathy(IgAN).Methods The clinical and renal pathological data of 296 IgAN patients admitted to Longyan People's Hospital from January 2016 to June 2022 were analyzed retrospectively,and the patients were divided into no segmental sclerosis group(S0),segment sclerosis group(S1)and glomerular sclerosis group according to Oxford classification;the patients were divided into low group,middle group and high group according to Katafuchi score.MHR levels in patients with different degrees of glomerular sclerosis and different Katafuchi score were compared,the relationship between MHR and Katafuchi glomerular integration was analyzed,and ROC curves were drawn to analyze the predictive efficacy of MHR on the degree of glomerular sclerosis.Results Monocyte counts in the S1 and glomerular sclerosis groups[(0.41±0.11)109/L,(0.45±0.10)109/L]were all significantly higher than the S0 group(0.30±0.06)109/L,with statistically significant difference(t1=10.381,P1＜0.001,t2=12.169,P2＜0.001).The HDL level(1.14±0.16)mmoL/L was significantly lower than that in the S0 group(1.26±0.24)mmoL/L(t2=2.992,P2=0.003).The MHR in S1 and glomerular sclerosis group[(0.36±0.04),(0.44±0.05)]were significantly greater than S0(0.24±0.02)(t1=37.852,P1＜0.001,t2=42.037,P2＜0.001),and the MHR in glomerular sclerosis group was significantly greater than that of S1(t3=9.673,P3＜0.001).The monocyte counts of middle and high group[(0.34±0.06)109/L,(0.48±0.10)109/L]were significantly higher than the low group(0.27±0.05)109/L(t1=9.017,P1＜0.001;t2=20.080,P2＜0.001)and high group was significantly higher than middle group(t3=8.855,P3＜0.001).The HDL level of high group(0.96±0.12)mmoL/L was significantly lower than the low group(1.23±0.21)mmoL/L and middle group(1.19±0.16)mmoL/L,with statistically significance(t2=8.132,P2＜0.001,t3=7.954,P3＜0.001).The MHR(0.49±0.07)in the high group was significantly greater than the low group(0.25±0.03)and middle group(0.26±0.08),with statistically significance(t2=35.382,P2＜0.001,t3=15.146,P3＜0.001).Correlation analysis showed that monocytes were positively correlated with Katafuchi score(r=0.58,P＜0.05),HDL negatively with Katafuchi score(r=-0.52,P＜0.05),and MHR positively with Katafuchi score(r=0.66,P＜0.05).The AUC of MHR predicting segmental sclerosis was 0.609(95%CI:0.325～0.917),when the cut-off was 0.29,sensitivity was 68.42%and specificity of 65.45%.The AUC of MHR predicting glomerulosclerosis was 0.735(95%CI:0.527～1.001),when the cut-off was 0.40,sensitivity was 73.08%and specificity was 66.14%.Conclusions MHR has the potential in predicting the degree of glomerulosclerosis in IgAN patients.
关键词
单核细胞/高密度脂蛋白胆固醇比值/免疫球蛋白A肾病/肾小球硬化/预测价值
Key words
monocyte/high-density lipoprotein cholesterol ratio/immunoglobulin A nephropathy/glomerulosclerosis/predictive value
维普
万方数据