Baek Joo Eun, Chang Jai Won, Min Won Ki, Cho Yong Mee, Park Jung Sik, Kim Soon Bae
Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
Nephron Clin Pract. 2008;108(1):c35-40. doi: 10.1159/000112527. Epub 2007 Dec 17.
BACKGROUND/AIMS: The development of renal injury in glomerulonephritis (GN) has been related to systemic inflammatory mediators. We investigated whether serum high-sensitivity C-reactive protein (hs-CRP) is a marker reflecting the inflammatory pathogenesis of primary GN.
We compared serum hs-CRP levels in 192 patients with IgA nephropathy (IgAN), 43 patients with membranous nephropathy (MN), and 25 patients with minimal change disease (MCD) undergoing kidney biopsy and 638 matched controls.
There were no differences in hs-CRP levels between controls (median 0.08 mg/dl; range 0.03-1.87 mg/dl) and patients with IgAN (0.08 mg/dl; 0.03-3.13 mg/dl), MN (0.07 mg/dl; 0.03-0.99 mg/dl) or MCD (0.08 mg/dl; 0.03-1.75 mg/dl). In patients with IgAN, hs-CRP levels did not differ according to Haas' pathological subclasses or subsequent renal outcomes. In the IgAN group, hs-CRP showed positive correlations with IgA, uric acid, systolic blood pressure, BMI and age. Hs-CRP level was significantly higher in male than in female IgAN patients. Serum IgA concentration was the strongest independent correlate with hs-CRP levels, and gender and BMI were also independently associated with hs-CRP. There were no correlations between hs-CRP and markers of disease activity.
It is likely that hs-CRP does not closely reflect inflammatory pathogenesis in patients with IgAN, MN and MCD.
背景/目的:肾小球肾炎(GN)中肾损伤的发展与全身炎症介质有关。我们研究了血清高敏C反应蛋白(hs-CRP)是否为反映原发性GN炎症发病机制的标志物。
我们比较了192例接受肾活检的IgA肾病(IgAN)患者、43例膜性肾病(MN)患者、25例微小病变病(MCD)患者以及638例匹配对照者的血清hs-CRP水平。
对照组(中位数0.08mg/dl;范围0.03 - 1.87mg/dl)与IgAN患者(0.08mg/dl;0.03 - 3.13mg/dl)、MN患者(0.07mg/dl;0.03 - 0.99mg/dl)或MCD患者(0.08mg/dl;0.03 - 1.75mg/dl)的hs-CRP水平无差异。在IgAN患者中,hs-CRP水平根据Haas病理亚类或随后的肾脏结局并无差异。在IgAN组中,hs-CRP与IgA、尿酸、收缩压、体重指数和年龄呈正相关。男性IgAN患者的hs-CRP水平显著高于女性。血清IgA浓度是与hs-CRP水平最强的独立相关因素,性别和体重指数也与hs-CRP独立相关。hs-CRP与疾病活动标志物之间无相关性。
hs-CRP可能并不能密切反映IgAN、MN和MCD患者的炎症发病机制。