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半乳糖凝集素-3——单肾儿童肾损伤的新参与者还是无辜旁观者?

Galectin-3-A New Player of Kidney Damage or an Innocent Bystander in Children with a Single Kidney?

作者信息

Latoch Eryk, Konończuk Katarzyna, Jander Anna, Trembecka-Dubel Elżbieta, Wasilewska Anna, Taranta-Janusz Katarzyna

机构信息

Department of Pediatric Oncology and Hematology, Medical University of Bialystok, 15-274 Białystok, Poland.

Department of Pediatrics, Immunology and Nephrology, Polish Mother's Memorial Hospital Research Institute, 93-338 Łódź, Poland.

出版信息

J Clin Med. 2021 May 8;10(9):2012. doi: 10.3390/jcm10092012.

Abstract

The aim of this study was to evaluate the galectin-3 (Gal-3) level in children with a congenital solitary functioning kidney (cSFK) and determine its association with common renal function parameters. The study consisted of 68 children (49 males) with cSFK. We demonstrated that children with cSFK had a lower level of galectin-3 than that of healthy subjects ( < 0.001). No significant differences in serum cystatin C (Cys C) levels between the cSFK children and the reference group were found. The subjects with cSFK and reduced estimated glomerular filtration rate (eGFR) had significantly higher levels of Gal-3 and Cys C compared to those with normal eGFR ( < 0.05). Children with eGFR <60 mL/min/1.73 m showed significant statistical differences between the values of area under ROC curve (AUC) for Gal-3 (AUC 0.91) and Cys C (AUC 0.96) compared to that for creatinine level (AUC 0.76). Similar analyses carried out among cSFK children with eGFR <90 mL/min/1.73 m revealed an AUC value of 0.69 for Gal-3, 0.74 for Cys C, and 0.64 for creatinine; however, no significant superiority was shown for any of them. The receiver operating characteristic (ROC) analyses for identifying the SFK children among all participants based on the serum levels of Gal-3 and Cys C did not show any diagnostic profile (AUCs for Gal-3 and Cys C were 0.22 and 0.59, respectively). A positive correlation between the Gal-3 and Cys C concentrations was found ( = 0.39, = 0.001). We demonstrated for the first time that Gal-3 might play an important role in the subtle kidney damage in children with cSFK. However, further prospective studies are required to confirm the potential applicability of Gal-3 as an early biomarker for kidney injury and possible progression to CKD.

摘要

本研究旨在评估先天性孤立功能性肾(cSFK)患儿的半乳糖凝集素-3(Gal-3)水平,并确定其与常见肾功能参数的关联。该研究纳入了68例患有cSFK的儿童(49例男性)。我们发现,cSFK患儿的半乳糖凝集素-3水平低于健康受试者(<0.001)。cSFK患儿与参照组之间的血清胱抑素C(Cys C)水平未发现显著差异。与估算肾小球滤过率(eGFR)正常的受试者相比,cSFK且eGFR降低的受试者的Gal-3和Cys C水平显著更高(<0.05)。eGFR<60 mL/min/1.73 m²的患儿中,Gal-3(AUC 0.91)和Cys C(AUC 0.96)的ROC曲线下面积(AUC)值与肌酐水平(AUC 0.76)相比存在显著统计学差异。在eGFR<90 mL/min/1.73 m²的cSFK患儿中进行的类似分析显示,Gal-3的AUC值为0.69,Cys C为0.74,肌酐为0.64;然而,它们之间均未显示出显著优势。基于Gal-3和Cys C血清水平在所有参与者中识别SFK患儿的受试者工作特征(ROC)分析未显示出任何诊断特征(Gal-3和Cys C的AUC分别为0.22和0.59)。发现Gal-3与Cys C浓度之间存在正相关(r = 0.39,P = 0.001)。我们首次证明,Gal-3可能在cSFK患儿的轻微肾损伤中起重要作用。然而,需要进一步的前瞻性研究来证实Gal-3作为肾损伤早期生物标志物的潜在适用性以及向慢性肾脏病进展的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6ae/8125852/0803004a3279/jcm-10-02012-g001a.jpg

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