Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
The First Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China.
Immun Inflamm Dis. 2021 Sep;9(3):1000-1008. doi: 10.1002/iid3.459. Epub 2021 May 25.
Previous studies have shown that increased neutrophils, as a manifestation of oxidative stress, may be involved in the progression of kidney disease. To our knowledge, little is known about the relationship between neutrophils and renal impairment in rheumatoid arthritis (RA). Therefore, we aim to investigate whether neutrophil is associated with renal impairment in RA patients.
We retrospectively investigated the renal function of 602 RA patients in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine by estimated glomerular filtration rate (eGFR) from September 2018 and September 2019. The exposure variable was neutrophils, and the main outcome was eGFR. General data (gender, age, duration, hypertension, diabetes, hobbies, and medication history), whole blood markers, lipid indexes, and inflammatory indexes were collected as much as possible. We used multivariable logistic regression analysis to evaluate the association between neutrophils and renal impairment in RA participants.
A total of 89 cases (14.8%) had renal impairment with eGFR < 60 ml/min/1.73 m , and 75 cases (84.3%) were female. Subgroup analysis showed that female (odds ratio [OR] = 0.523, 95% confidence interval [CI]: 0.318-0.867, p = .011), neutrophils greater thsn 7.5 × 10 /L (OR = 2.314, 95% CI: 1.310-4.087, p = .004), NLR > 3.53 (OR = 1.757, 95% CI: 1.104-2.799, p = .018), hemoglobin less than 120 g/L (OR = 2.413, 95% CI: 1.418-4.118, p = .001), and UA > 360 μmol/L (OR = 6.052, 95% CI: 3.708-9.878, p < .001) was related to renal damage in RA. Adjusted for several confounders, the multivariable analysis indicated that neutrophils greater than 7.5 × 10 /L (OR = 1.784, 95% CI: 1.164-3.288, p = .031) was independently associated with an increased risk of renal impairment in RA.
Our study demonstrated that neutrophils greater than 7.5 × 10 /L was associated with a high risk of renal impairment in RA, suggesting that neutrophil may be a biomarker for renal impairment in RA.
既往研究表明,作为氧化应激表现之一的中性粒细胞增多可能与肾脏病的进展有关。据我们所知,类风湿关节炎(RA)患者中性粒细胞与肾损害之间的关系知之甚少。因此,我们旨在探讨中性粒细胞是否与 RA 患者的肾损害有关。
我们回顾性调查了 2018 年 9 月至 2019 年 9 月期间广州中医药大学第一附属医院 602 例 RA 患者的肾功能(通过估算肾小球滤过率[eGFR]评估)。暴露变量为中性粒细胞,主要结局为 eGFR。尽可能收集一般资料(性别、年龄、病程、高血压、糖尿病、爱好和用药史)、全血标志物、血脂指标和炎症指标。我们使用多变量逻辑回归分析来评估 RA 患者中性粒细胞与肾损害之间的关系。
共 89 例(14.8%)出现 eGFR<60ml/min/1.73m2的肾损害,其中 75 例(84.3%)为女性。亚组分析显示,女性(比值比[OR] = 0.523,95%置信区间[CI]:0.318-0.867,p = 0.011)、中性粒细胞大于 7.5×10/L(OR = 2.314,95%CI:1.310-4.087,p = 0.004)、中性粒细胞与淋巴细胞比值(NLR)>3.53(OR = 1.757,95%CI:1.104-2.799,p = 0.018)、血红蛋白<120g/L(OR = 2.413,95%CI:1.418-4.118,p = 0.001)和尿酸(UA)>360μmol/L(OR = 6.052,95%CI:3.708-9.878,p<0.001)与 RA 患者的肾损害有关。调整了几个混杂因素后,多变量分析表明,中性粒细胞大于 7.5×10/L(OR = 1.784,95%CI:1.164-3.288,p = 0.031)与 RA 患者肾损害的风险增加独立相关。
本研究表明,中性粒细胞大于 7.5×10/L 与 RA 患者肾损害的高风险相关,提示中性粒细胞可能是 RA 患者肾损害的生物标志物。