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法布里病患者确诊年龄与肾病严重程度之间的直接相关性。

Direct Correlation between Age at Diagnosis and Severity of Nephropathy in Fabry Disease Patients.

作者信息

Jaurretche Sebastián P A, Antongiovanni Norberto, Perretta Fernando

机构信息

Biophysics and Human Physiology Department, School of Medicine, Instituto Universitario Italiano de Rosario, Argentina.

Los Manantiales, Neurosciences Center, Grupo GAMMA Rosario, Argentina.

出版信息

Indian J Nephrol. 2019 Nov-Dec;29(6):398-401. doi: 10.4103/ijn.IJN_167_18.

Abstract

INTRODUCTION

Nephropathy is one of the major complications of Fabry disease and mainly includes reduced glomerular filtration rate and proteinuria. Affected patients show different degrees of annual loss of renal function according to the magnitude of proteinuria and decrease in estimated glomerular filtration rate (eGFR) at the baseline.

OBJETIVE

To analyze the relationship between age at diagnosis and severity of nephropathy in a Fabry disease population.

METHODS

Cross-sectional design with retrospective data collection.

RESULTS

Seventy-two patients were studied with mean age of 26.26 ± 16.48 years and 30 men (41.6%). Twenty-seven paediatric patients and 45 adults were included. Thirteen genotypes were found: E398X, L415P, c886A>G, L106R, c.680G>A, A292T, c. 448.delG, R363H, C382Y, R301Q, D109G, del 3 and 4 exons, W81X, all pathogenic mutations of GLA gene. The mean eGFR in paediatric population was 115.81 ± 20.87 ml/min/1.73 m and in adults was 80.63 ± 42.22 ml/min/1.73 m. The Pearson's bilateral correlation coefficient test (value = -0.462) between the age at diagnosis and eGFR indicates inverse correlation between both variables with a strong statistical significance ( = < 0.01). Spearman's bilateral correlation coefficient (value = +0.385) between the variables at diagnosis and the degree of proteinuria indicates direct correlation between both variables with a strong statistical significance ( = <0.01).

CONCLUSIONS

Diagnosis of Fabry disease patients at a younger age could be a key to improve the nephropathy prognosis and allow early and effective interventions.

摘要

引言

肾病是法布里病的主要并发症之一,主要包括肾小球滤过率降低和蛋白尿。根据蛋白尿的程度以及基线时估计肾小球滤过率(eGFR)的下降情况,受影响的患者每年会出现不同程度的肾功能丧失。

目的

分析法布里病患者的诊断年龄与肾病严重程度之间的关系。

方法

采用横断面设计并进行回顾性数据收集。

结果

对72例患者进行了研究,平均年龄为26.26±16.48岁,其中男性30例(41.6%)。纳入了27例儿科患者和45例成人患者。共发现13种基因型:E398X、L415P、c886A>G、L106R、c.680G>A、A292T、c.448.delG、R363H、C382Y、R301Q、D109G、缺失3和4外显子、W81X,均为GLA基因的致病性突变。儿科人群的平均eGFR为115.81±20.87 ml/min/1.73 m²,成人为80.63±42.22 ml/min/1.73 m²。诊断年龄与eGFR之间的Pearson双侧相关系数检验(值=-0.462)表明这两个变量之间呈负相关,具有很强的统计学意义(P<0.01)。诊断时的变量与蛋白尿程度之间的Spearman双侧相关系数(值=+0.385)表明这两个变量之间呈正相关,具有很强的统计学意义(P<0.01)。

结论

法布里病患者在较年轻时确诊可能是改善肾病预后并实现早期有效干预的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/532e/6883858/aafa18a97e61/IJN-29-398-g001.jpg

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