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系统性红斑狼疮患者尿液Gal-3BP,VSIG4表达水平与疾病活动度及肾损伤的相关性研究

Study on the Correlation among Urine Gal-3BP,VSIG4 Expression Levels,Disease Activity and Kidney Injury in Patients with Systemic Lupus Erythematosus

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目的 探讨尿半乳糖凝集素-3结合蛋白(galectin-3 binding protein,Gal-3BP)及V-set包含免疫球蛋白域4(V-set containing immunoglobulin domain 4,VSIG4)水平在系统性红斑狼疮(systemic lupus erythematosus,SLE)患者尿液中的表达及其与疾病活动和肾损伤的关系.方法 选取儋州市人民医院收治的SLE患者105例(SLE组)和体检正常者50例(对照组)作为研究对象.105例SLE患者根据SLE疾病活动度指数(SLEDAI)评分分为轻度活动度组(SLEDAI评分≤9分,n=51)、中度活动度组(14分≥SLEDAI≥10分,n=29)和重度活动度组(SLEDAI评分≥15分,n=25).按肾功能受损程度分为肾功能正常组、肾功能轻度受损组和肾功能中重度受损组.采用酶联免疫吸附法检测尿液Gal-3BP,VSIG4表达水平,应用多元Logistic回归分析影响SLE患者发生肾损伤的危险因素,绘制ROC曲线分析尿Gal-3BP及VSIG4水平预测SLE患者发生肾损伤的价值.结果 SLE组尿Gal-3BP(251.38±46.75 ng/ml)及VSIG4(13.40±4.27 ng/ml)水平均明显高于对照组(117.50±18.24 ng/ml,2.73±0.85ng/ml),差异具有统计学意义(t=19.315,15.681,均P<0.001).SLE患者活动度越高,尿Gal-3BP及VSIG4水平越高,重度活动度组>中度活动度组>轻度活动度组,差异具有统计学意义(F=23.416,17.380,均P<0.001).肾功能中重度受损组和轻度受损组尿Gal-3BP及VSIG4水平明显高于肾功能正常组(t=24.580,18.163;20.864,15.947),且中重度受损组尿Gal-3BP及VSIG4水平明显高于轻度受损组(t=19.837,11.215),差异具有统计学意义(均P<0.001).多元Logistic回归分析显示,尿 Gal-3BP(OR=3.472,95%CI:2.685~11.463)及 VSIG4(OR=2.376,95%CI:1.842~9.105)水平升高是影响SLE患者发生肾损伤的危险因素(均P<0.05).ROC曲线分析显示,Gal-3BP及VSIG4二项联合预测SLE患者发生肾损伤的曲线下面积(95%置信区间)[AUC(95%CI)]最大[0.909(0.846~0.973)],其准确度为88.6%.相关分析显示,SLE 患者尿 Gal-3BP 与 VSIG4 水平呈正相关(r=0.813,P<0.05),尿 Gal-3BP 及 VSIG4 水平与 SCr,BUN,24h 尿蛋白、抗dsDNA抗体及SLEDAI评分均呈正相关(r=0.358~0.702,均P<0.05),而与血红蛋白、eGFR均呈负相关(r=-0.479~-0.670,均P<0.05).结论 尿Gal-3BP及VSIG4水平在SLE患者中明显升高,其高表达与疾病活动和肾损伤有关,二项联合预测SLE患者发生肾损伤有较好的价值.
Objective To investigate the expression of urinary galectin-3 binding protein(Gal-3BP)and V-set containing immunoglobulin domain 4(VSIG4)in urine from patient with systemic lupus erythematosus(SLE)and its relationship with disease activity and kidney injury.Methods A total of 105 SLE patients(SLE group)and 50 normal patients(control group)admitted to Danzhou People's Hospital were selected as the study objects.According to SLEDAI score,105 SLE patients were divided into mild active group(SLEDAI≤9 points,n=51),moderate active group(14 point≥SLEDAI≥10 points,n=29)and severe active group(SLEDAI ≥ 15 points,n=25).According to the degree of renal function impairment,they were divided into normal renal function group,mild renal function impairment group and moderate and severe renal function impairment group.Enzyme linked immunosorbent assay was used to detect the expressions of Gal-3BP and VSIG4.Multiple Logistic regression was applied to analyze the risk factors of kidney injury in SLE patients,and ROC curve was drawn to analyze the value of urinary Gal-3BP and VSIG4 levels in predicting kidney injury in SLE patients.Results The urinary Gal-3BP(251.38±46.75 ng/ml)and VSIG4(13.40±4.27 ng/ml)levels in the SLE group were higher than those in the control group(117.50±18.24 ng/ml,2.73±0.85ng/ml),and the differences were statistically significant(t=19.315,15.681,all P<0.001).The higher the activity level of SLE patients,the higher the urinary Gal-3BP and VSIG4 levels,with severe activity group>moderate activity group>mild activity group,and the differences were statistically significant(F=23.416,17.380,all P<0.001).The urinary Gal-3BP and VSIG4 levels in the moderate to severe renal function group and mild renal function group were higher than those in the normal renal function group(t=24.580,18.163,20.864,15.947),and the urinary Gal-3BP and VSIG4 levels in the moderate to severe renal function group were higher than those in the mild renal function group(t=19.837,11.215),and the differences were statistically significant(all P<0.001),respectively.Multiple logistic regression analysis showed that elevated levels of urinary Gal-3BP(OR=3.472,95%CI:2.685~11.463)and VSIG4(OR=2.376,95%CI:1.842~9.105)were risk factors for renal injury in SLE patients(all P<0.05).ROC curve analysis showed that the combination of Gal-3BP and VSIG4 had the highest area under the curve(95%confidence interval)[AUC(95%CI)]for predicting renal injury in SLE patients[0.909(0.846~0.973)],with an accuracy of 88.6%.Correlation analysis showed that the urinary Gal-3BP level was positively correlated with VSIG4 level(r=0.813,P<0.05),and the levels of urinary Gal-3BP and VSIG4 were positively correlated with SCr,BUN,24-hour urine protein,anti-dsDNA antibodies,and SLEDAI scores(r=0.358~0.702,all P<0.05),while urinary Gal-3BP and VS1G4 levels were negatively correlated with hemoglobin and eGFR in SLE patients(r=-0.479~-0.670,all P<0.05).Conclusion Urinary Gal-3BP and VSIG4 levels are elevated in SLE patients,and their high expressions are related to disease activity and renal injury.The combination of the two have good value in predicting renal injury in SLE patients.

systemic lupus erythematosusgalectin-3 binding proteinV-set contains immunoglobulin domain 4disease activitykidney injury

符妹丽、江强、周仕群、符书山

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儋州市人民医院肾内科,海南儋州 571799

系统性红斑狼疮 半乳糖凝集素-3结合蛋白 V-set包含免疫球蛋白域4 疾病活动度 肾脏损伤

2024

现代检验医学杂志
陕西省临床检验中心,陕西省人民医院

现代检验医学杂志

CSTPCD
影响因子:0.713
ISSN:1671-7414
年,卷(期):2024.39(4)