Wu Jiabin, Wei Lixin, Wang Weiming, Zhang Xianghui, Chen Li, Lin Changda
Department of Nephrology, Fujian Provincial Hospital, Fujian Medical University, No. 134 East Street, Gulou District, Fuzhou, 350001, Fujian Province, China.
Rheumatol Int. 2016 Jun;36(6):759-67. doi: 10.1007/s00296-016-3458-7. Epub 2016 Mar 11.
The aim of this study was to explore whether progranulin (PGRN) can be a useful marker not only for accurate diagnosis of patients with active lupus nephritis (LN), but also for prediction of the disease activity in this population. A total of 154 LN patients were enrolled in this study, 76 of which were diagnosed as having active LN and 78 as having stable LN. Additionally, 71 age-matched non-LN patients were enrolled as controls. The serum and urine PGRN levels of each study population were measured using the enzyme-linked immunosorbent assay method. The diagnostic performance of both indicators and their correlation with the disease activity of LN were systematically investigated using receiver operating characteristic (ROC) analysis and correlation analysis. The active LN population had significantly higher serum and urine PGRN levels than the other two populations. ROC analysis further demonstrated that these two indicators, particularly in combination, appear to have a strong performance in discriminating active LN patients from the rest of the LN population. In the active LN population, serum and urine PGRN levels were not only significantly correlated with SLEDAI score, rSLEDAI score, and activity index, but also had a considerable association with several key markers reflecting the disease activity of LN, including serum levels of complement component 3 and ds-DNA. Nevertheless, neither of the two indicators were correlated with the pathological classification of LN, chronicity index, serum creatinine level, and 24-h urine protein levels. Our findings demonstrate that PGRN may have great potential as a diagnostic factor for active LN and as a predictor for its disease activity.
本研究的目的是探讨颗粒蛋白前体(PGRN)是否不仅可作为准确诊断活动性狼疮性肾炎(LN)患者的有用标志物,还可用于预测该人群的疾病活动度。本研究共纳入154例LN患者,其中76例被诊断为活动性LN,78例为稳定期LN。此外,纳入71例年龄匹配的非LN患者作为对照。采用酶联免疫吸附测定法测量各研究人群的血清和尿液PGRN水平。使用受试者工作特征(ROC)分析和相关性分析系统地研究了这两个指标的诊断性能及其与LN疾病活动度的相关性。活动性LN人群的血清和尿液PGRN水平显著高于其他两组人群。ROC分析进一步表明,这两个指标,尤其是联合使用时,在区分活动性LN患者与其他LN人群方面表现出较强的性能。在活动性LN人群中,血清和尿液PGRN水平不仅与SLEDAI评分、rSLEDAI评分和活动指数显著相关,而且与反映LN疾病活动度的几个关键标志物,包括补体成分3和双链DNA的血清水平也有相当的关联。然而,这两个指标均与LN的病理分类、慢性指数、血清肌酐水平和24小时尿蛋白水平无关。我们的研究结果表明,PGRN作为活动性LN的诊断因素和疾病活动度的预测指标可能具有巨大潜力。