Dr. Sadi Konuk Training and Research Hospital Department of Pediatrics, Health Science University, Istanbul, Turkey.
Dr. Sadi Konuk Training and Research Hospital Department of Pediatric Nephrology, Health Science University, Istanbul, Turkey.
Adv Rheumatol. 2021 Apr 1;61(1):20. doi: 10.1186/s42358-021-00178-4.
The most important finding that affects the prognosis in Familial Mediterranean Fever is renal amyloidosis. The aim of the present study was to analyze neutrophil gelatinase-associated lipocalin levels in the urine, and to investigate whether it may be used as an early marker for renal involvement.
Forty attack-free children followed by diagnosis of Familial Mediterranean Fever with age range of 5 and 18 years, and 38 healthy children with similar ages and genders were enrolled into the study. Hemogram, sedimentation, C-reactive protein, urine analysis, creatinine in the spot urine, microalbumin and urinary neutrophil gelatinase-associated lipocalin levels were analyzed and evaluated statistically in the patients and controls.
There was not any statistically significant difference between the patient and control groups for age, gender, height and body weight. Although there was not any clinical sign of attack in the patient group, sedimentation, C-reactive protein and fibrinogen levels were significantly higher than the control group (p = 0.002, p = 0.023, and p = 0.006, respectively). Similarly, urinary neutrophil gelatinase-associated lipocalin level and urinary creatinine ratio were significantly higher in the patient group (p = 0.0001, p = 0.011, respectively). We found a positive correlation between uNGAL level and uNGAL/uCr ratio and number of attacks per year in FMF patients (r = 0.743, p = 0.001 and r = 0.516, p = 0.001; respectively).
Detection of significantly higher levels of urinary neutrophil gelatinase-associated lipocalin level and urinary neutrophil gelatinase-associated lipocalin level to creatinine ratio were suggested as urinary neutrophil gelatinase-associated lipocalin level as a non-invasive marker for renal involvement better than microalbumin.
家族性地中海热中对预后影响最大的发现是肾淀粉样变性。本研究的目的是分析尿中性粒细胞明胶酶相关脂质运载蛋白水平，并探讨其是否可用作肾受累的早期标志物。
40 例无发作的家族性地中海热患儿（年龄 5-18 岁）和 38 例年龄和性别相匹配的健康儿童纳入本研究。对患者和对照组进行血常规、沉降率、C 反应蛋白、尿分析、尿肌酐、微量白蛋白和尿中性粒细胞明胶酶相关脂质运载蛋白水平检测，并进行统计学分析。
患者组和对照组在年龄、性别、身高和体重方面无统计学差异。尽管患者组无任何发作的临床迹象，但沉降率、C 反应蛋白和纤维蛋白原水平明显高于对照组（p=0.002、p=0.023 和 p=0.006）。同样，患者组尿中性粒细胞明胶酶相关脂质运载蛋白水平和尿肌酐比值明显升高（p=0.0001、p=0.011）。我们发现 FMF 患者尿中 NGAL 水平与 uNGAL/uCr 比值和每年发作次数呈正相关（r=0.743，p=0.001 和 r=0.516，p=0.001）。
尿中性粒细胞明胶酶相关脂质运载蛋白水平和尿中性粒细胞明胶酶相关脂质运载蛋白水平与肌酐比值明显升高提示尿中性粒细胞明胶酶相关脂质运载蛋白水平作为肾受累的非侵入性标志物优于微量白蛋白。
