Diaz-Rizo Valeria, Bonilla-Lara David, Gonzalez-Lopez Laura, Sanchez-Mosco Dalia, Fajardo-Robledo Nicte S, Perez-Guerrero Edsaul E, Rodriguez-Jimenez N Alejandra, Saldaña-Cruz A Miriam, Vazquez-Villegas M Luisa, Gomez-Bañuelos Eduardo, Vazquez-Del Mercado Monica, Cardona-Muñoz E German, Cardona-Muller David, Trujillo Xochitl, Huerta Miguel, Salazar-Paramo Mario, Gamez-Nava Jorge I
Unidad de Investigacion Biomedica 02, Hospital de Especialidades, Centro Medico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, Mexico.
Programa de Posgrado de Ciencias Medicas, Universidad de Colima, Colima, Mexico.
PLoS One. 2017 Sep 12;12(9):e0184056. doi: 10.1371/journal.pone.0184056. eCollection 2017.
There are controversial results about the role of serum leptin and adiponectin levels as biomarkers of the severity of proteinuria in lupus nephritis.
The aim of this study was to evaluate the relationship between serum leptin and adiponectin levels with severity of proteinuria secondary to lupus nephritis (LN).
In a cross-sectional study, 103 women with systemic lupus erythematosus (SLE) were evaluated for kidney involvement. We compared 30 SLE patients with LN, all of them with proteinuria, versus 73 SLE patients without renal involvement (no LN). A comprehensive set of clinical and laboratory variables was assessed, including serum levels of leptin and adiponectin by ELISA. Multivariate analyses were used to adjust for potential confounders associated with proteinuria in LN.
We found higher adiponectin levels in the LN group compared with the no LN group (20.4 ± 10.3 vs 15.6 ± 7.8 μg/mL; p = 0.02), whereas no differences were observed in leptin levels (33.3 ± 31.4 vs 22.5 ± 25.5 ng/mL; p = 0.07). Severity of proteinuria correlated with an increase in adiponectin levels (r = 0.31; p = 0.001), but no correlation was observed with leptin. Adiponectin levels were not related to anti-dsDNA or anti-nucleosome antibodies. In the logistic regression, adiponectin levels were associated with a high risk of proteinuria in SLE (OR = 1.06; 95% CI 1.01-1.12; p = 0.02). Instead, leptin was not associated with LN.
These findings indicate that adiponectin levels are useful markers associated with proteinuria in LN. Further longitudinal studies are required to identify if these levels are predictive of renal relapse.
关于血清瘦素和脂联素水平作为狼疮性肾炎蛋白尿严重程度生物标志物的作用，存在有争议的结果。
本研究旨在评估血清瘦素和脂联素水平与狼疮性肾炎（LN）继发蛋白尿严重程度之间的关系。
在一项横断面研究中，对103名系统性红斑狼疮（SLE）女性患者的肾脏受累情况进行了评估。我们将30例伴有蛋白尿的LN患者与73例无肾脏受累（无LN）的SLE患者进行了比较。评估了一系列全面的临床和实验室变量，包括通过酶联免疫吸附测定法检测血清瘦素和脂联素水平。采用多变量分析来调整与LN中蛋白尿相关的潜在混杂因素。
我们发现LN组的脂联素水平高于无LN组（20.4±10.3对15.6±7.8μg/mL；p = 0.02），而瘦素水平未观察到差异（33.3±31.4对22.5±25.5 ng/mL；p = 0.07）。蛋白尿的严重程度与脂联素水平的升高相关（r = 0.31；p = 0.001），但与瘦素未观察到相关性。脂联素水平与抗双链DNA或抗核小体抗体无关。在逻辑回归中，脂联素水平与SLE中蛋白尿的高风险相关（比值比=1.06；95%置信区间1.01 - 1.12；p = 0.02）。相反，瘦素与LN无关。
这些发现表明脂联素水平是与LN中蛋白尿相关的有用标志物。需要进一步的纵向研究来确定这些水平是否可预测肾脏复发。
