Changes and significances of serum MCSF and SVEP1 levels in patients with lupus nephritis
Objective To observe the changes of serum MCSF and SVEP1 in patients with lupus nephritis(LN),and to investigate their relationships with the activity of LN and degree of renal injury as well as their values to the diagnosis of LN.Methods Totally 171 patients with systemic lupus erythematosus(SLE)were diagnosed and treated in Qingdao Municipal Hospital from January 2021 to March 2023(SLE group),and were divided into LN group(n=126)and non-LN group(n=45),and another 90 healthy volunteers received physical examination during the same period(control group).ELISA was used to detect serum MCSF and SVEP1 levels on admission.The clinical symptoms,blood routine,renal function,estimated glomerular filtration rate(eGFR),complement C3,complement C4,antibody positivity of antinuclear antibodies,24-h urine protein,serum MCSF and SVEP1 were compared between LN group and non-LN group.The activity index and chronicity index scores were assessed in LN patients after diagnosis.Spearman's correlation coefficient was used to analyze the correlations of serum MCSF and SVEP1 levels with the activity index and chronicity index scores in LN patients.Multivariate logistic regression was used to analyze the influencing factors of LN in SLE patients.ROC curves were plotted to assess the efficiencies of serum MCSF and SVEP1 on diagnosing LN in SLE patients.Results(1)The serum levels of MCSF and SVEP1 were higher in SLE group[(28.78±11.72),(1 098.18±404.84)ng/L]than those in control group[(7.06±2.16),(437.13±154.39)ng/L](t=23.486,P＜0.001;t=18.900.P＜0.001).(2)The proportions of pleural effusion,gross hematuria and anti-dsDNA antibody-positive,and the levels of blood creatinine,blood urea,serum MCSF,serum SVEP1 and 24-h urine protein were higher in LN group[51.59％,56.35％,51.59％,(103.01±51.89)μmol/L,22.15(12.43,36.88)mmol/L,(32.90±10.07)ng/L,(1 231.73±363.04)ng/L,(1.20(0.73,1.83)g]than those in non-LN group[31.11％,24.44％,31.11％,(73.91±33.32)μmol/L,13.33(10.73,15.95)mmol/L,(17.23±7.61)ng/L,(724.25±254.43)ng/L,0.29(0.21,0.41)g](x2=5.593,x2=13.523,x2=5.593,t=4.288,t=-4.265,t=9.512,t=8.642,U=-8.188;all P values＜0.05),and the albumin,eGFR and complement C3 were lower in LN group[(26.11±6.54)g/L,(72.70±30.53)mL/(min·1.73 m2),0.29(0.22,0.39)g/L]than those in non-LN group[(31.73±7.26)g/L,(99.38±40.53)mL/(min·1.73 m2),0.41(0.27,0.57)g/L](t=-4.811,t=-4.597,U=-3.844;all P values＜0.05).(3)The activity index score of 126 patients with LN was 13.00(11.00,15.00),and the chronicity index score was 6.00(4.00,7.00).The serum MCSF level in patients with LN was positively correlated with the activity index score and the chronicity index score(r=0.716,P＜0.001;r=0.814,P＜0.001),and the serum SVEP1 level was positively correlated with the activity index score and the chronicity index score(r=0.761,P＜0.001;r=0.809,P＜0.001).(4)Albumin(OR=0.979,95％CI:0.960-0.998,P=0.030),eGFR(OR=0.977,95％CI:0.956-0.998,P=0.035),24-h urine protein(OR=1.012,95％CI:1.001-1.023,P=0.031),serum MCSF(OR=1.261,95％CJ:1.029-1.546,P=0.025)and serum SVEP1(OR=1.005,95％CI:1.001-1.009,P=0.023)were the influencing factors of LN in SLE patients.(5)When the optimal cut-off values of serum MCSF and SVEP1 were 25.11 ng/L and 929.82 ng/L,the AUCsfor diagnosing LN were 0.888(95％CI:0.831-0.931,P＜0.001)and 0.875(95％CI:0.816-0.921,P＜0.001),the sensitivities were 73.81％and 78.57％,and the specificities were 86.67％and 84.44％,respectively.The AUC of the combination of them two was 0.945(95％CI:0.899-0.974,P＜0.001),with a sensitivity of 83.33％and a specificity of 88.89％.Conclusion The serum MCSF and SVEP1 levels are elevated in SLE patients,which can reflect the degree of renal injury and are the risk factors of LN in SLE patients,and the combination of them two is of high value to the diagnosis of LN.
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