Correlation and prognostic value of blood lipid levels with PLA2R antibodies and pathological manifestations in patients with idiopathic membranous nephropathy
Objective To analyze the correlation and prognostic value of serum lipid levels with anti phospholipase A2 re-ceptor(PLA2R)antibodies and pathological manifestations in patients with idiopathic membranous nephropathy(IMN).Methods Totally 124 IMN patients diagnosed and treated in the First People's Hospital of Pingdingshan from April 2020 to April 2023 were selected,and clinical and pathological data were collected.Spearman test and logistic regression were used to analyze the relationship between blood lipid levels and clinicopathological characteristics,and Cox regression was used to evaluate the predictive ability of blood lipid levels on proteinuria remission after treatment.Results The reduction of high-density lipoprotein cholesterol(HDL-C)and the increase of triglycerides(TG)were associated with renal tu-bular atrophy,while the reduction of non-HDL-C and TG were associated with the deposition of complement C1q.Total cholesterol(TC)(r=0.432,P＜0.001),non-HDL-C(r=0.462,P＜0.001),low-density lipoprotein cholesterol(LDL-C)(r=0.315,P＜0.001),and TG(r=0.289,P＜0.001)were positively correlated with proteinuria,whereas HDL-C(r=-0.099,P=0.039)was negatively correlated with proteinuria.TC(r=0.323,P＜0.001),non-HDL-C(r=0.396,P＜0.001),and LDL-C(r=0.401,P＜0.001)were positively correlated with the titer of serum anti-PLA2R antibodies,while HDL-C(r=-0.057,P=0.539)and TG(r=0.110,P=0.229)showed no significant correlation with the titer of serum anti-PLA2R antibodies.The titer of serum anti-PLA2R antibodies(r=0.502,P＜0.001)and the deposition of PLA2R in renal glomeruli(r=6.381,P＜0.001)were positively correlated with proteinuria.Conclusion There is a correlation between dyslipidemia and pathological manifestations of IMN patients.Hy-percholesterolemia is an independent risk factor for glomerular PLA2R deposition and serum anti PLA2R antibody positive.HDL-C,non HDL-C and LDL-C are predictors of Proteinuria remission after treatment.
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