Objective To investigate the relationship between serum levels of fibroblast growth factor 23(FGF-23),growth arrest specific protein 6(Gas6)and disease activity in patients with lupus nephritis(LN).Methods One hundred and nineteen patients with LN admitted to the Department of Rheumatology and Immunology of Yan'an People's Hospital from March 2021 to March 2024 were selected as LN group,and were divided into active subgroup(70 cases)and inactive subgroup(49 cases)according to SLEDAI-2000 score.Another 105 healthy subjects were selected as the control group.Ser-um levels of FGF-23 and Gas6 were detected by enzyme-linked immunosorbent assay.The correlations between serum FGF-23 and Gas6 levels and renal function indexes and SLEDAI-2000 scores were analyzed by Pearson correlation analysis.The influencing factors of disease activity in LN patients were analyzed by multivariate Logistic regression.Receiver operating characteristic(ROC)curve to evaluate the diagnostic value of serum FGF-23 and Gas6 levels in disease activity in LN pa-tients.Results The levels of FGF-23 and Gas6 in LN group were higher than those in healthy control group(t/P=21.040/＜0.001 and 7 389/＜0.001).Systolic blood pressure,diastolic blood pressure,urea nitrogen(BUN),blood creatinine(SCr),urinary protein,SLEDAI-2000 score,FGF-23 and Gas6 in active subgroup were higher than those in inactive subgroup.The levels of C3 and C4 were lower than those of inactive subgroups(t/P=2356/0.020,3.717/＜0.001,11.867/＜0.001,17.152/＜0.001,30.579/＜0.001,19.439/＜0.001,11284/＜0.001,10.818/＜0.001,6233/＜0.001,12329/＜0.001);SerumFGF-23 and Gas6 levels were positively correlated with BUN,SCr,urinary protein and SLEDAI-2000 scores,respectively(r/P=0.410/＜0.001,0.395/＜0.001,0.326/0.002,0.563/＜0.001;0.352/＜0.001,0.384/＜0.001,0.311/0.008,0.509/＜0.001)were negatively correlated with the levels of C3 and C4(r/P=-0.408/＜0.001,-0.377/＜0.001;-0376/＜0.001,-0.321/＜0.001);Multivariate Logistic regression analysis showed that High levels of FGF-23,Gas6 and urinary protein were independent risk factors for disease activity in LN patients[OR(95％CI)=2.136(1224-3.727),1.865(1.171-2.967),2.539(1.416-4.554)].The levels of serum FGF-23 and Gas6,as well as the area under the curve(AUC)of their combined diagnosis of disease activity in LN patients,were 0.804,0.834,and 0.938,respectively.The AUC of their combined diagnosis was greater than that of their individual di-agnosis(Z/P=3.843/＜0.001,3270/＜0.001).Conclusion SerumFGF-23 and Gas6 levels are increased in LN patients,which are related to renal function injury,decreased complement level and increased disease activity in LN patients.The combina-tion of FGF-23 and Gas6 can effectively identify the disease activity of LN.
Lupus nephritisDisease activityFibroblast growth factor 23Growth arrest-specific protein 6
维普
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