基础脂联素水平升高预示特发性肾病综合征和儿童慢性肾脏病疾病活动风险增加。

Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt -

Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt.

Minerva Pediatr (Torino). 2023 Jun;75(3):410-416. doi: 10.23736/S2724-5276.17.04927-1. Epub 2017 Jul 27.

BACKGROUND

Adiponectin, an adipocyte-derived protein, is present abundantly in circulation and has anti-atherogenic and anti-inflammatory effects, so we aimed to assess the role of adiponectin in idiopathic nephrotic syndrome and chronic kidney disease in children.

METHODS

Overall of 290 children, 95 patients with the steroid-responsive idiopathic nephrotic syndrome (50 in remission and 45 in relapse). Another 95 patients with chronic kidney disease (50 on hemodialysis and 45 on conservative therapies) and 100 apparently healthy matched children were enrolled into the study. Serum adiponectin levels, blood chemistry (protein/albumin, serum creatinine, blood urea and electrolytes levels) and 24-hour proteinuria w studied as well.

RESULTS

There was highly significant increasing differences in adiponectin level between the relapsed idiopathic nephrotic syndrome (26.93±6.79 µg/mL) compared to remission (10.96±3.33 µg/mL) and control group (4.89±1.01 µg/mL) and between remission in comparing to control group (P<0.001). Also there was significant negative correlation between adiponectin level and serum albumin level in the relapse group (r=-0.60, P≤0.05), and highly positive correlation between adiponectin level and 24-hour proteinuria in relapse (r=0.98, P≤0.001) and remission group (r=0.92, P≤0.001). Regarding children with chronic kidney disease, There were high significant increasing differences in adiponectin levels in conservative (13.88±4.27 µg/mL) and dialysis (15.09±6.14 µg/mL) groups compared to controls (6.05±5.83 µg/mL) with P<0.001. Furthermore, there was a significant positive correlation between adiponectin and serum creatinine and blood urea levels in both conservative and dialysis groups with P<0.05.

CONCLUSIONS

Adiponectin can be considered as an important useful biomarker for chronic kidney diseases in children.

背景

脂联素是一种脂肪细胞衍生的蛋白质，在循环中大量存在，具有抗动脉粥样硬化和抗炎作用，因此我们旨在评估脂联素在儿童特发性肾病综合征和慢性肾脏病中的作用。

方法

共有 290 名儿童入组，其中 95 名患者为激素反应性特发性肾病综合征（缓解期 50 例，复发期 45 例）。另 95 例慢性肾脏病患者（血液透析 50 例，保守治疗 45 例）和 100 名明显健康的匹配儿童入组。研究了血清脂联素水平、血液化学（蛋白质/白蛋白、血清肌酐、血尿素和电解质水平）和 24 小时蛋白尿。

结果

与缓解期（10.96±3.33 µg/mL）和对照组（4.89±1.01 µg/mL）相比，复发期特发性肾病综合征（26.93±6.79 µg/mL）患者的脂联素水平有显著升高差异（P<0.001），且缓解期与对照组相比，脂联素水平也有显著差异（P<0.001）。此外，在复发组中，脂联素水平与血清白蛋白水平呈显著负相关（r=-0.60，P≤0.05），与复发组（r=0.98，P≤0.001）和缓解组（r=0.92，P≤0.001）的 24 小时蛋白尿呈高度正相关。至于慢性肾脏病儿童，保守治疗（13.88±4.27 µg/mL）和透析治疗（15.09±6.14 µg/mL）组的脂联素水平明显高于对照组（6.05±5.83 µg/mL），差异有统计学意义（P<0.001）。此外，在保守治疗和透析治疗组中，脂联素与血清肌酐和血尿素水平呈显著正相关（P<0.05）。