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血管内皮生长因子(VEGF)和新蝶呤水平在儿童激素敏感和激素耐药性肾病综合征中的变化。

Vascular Endothelial Growth Factor (VEGF) and Neopterin Levels in Children with Steroid-sensitive and Steroid-resistant Nephrotic Syndrome.

机构信息

Department of Child Health, Faculty of Medicine, Universitas Prima Indonesia, Medan, Indonesia.

Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

出版信息

Med Arch. 2021 Apr;75(2):133-137. doi: 10.5455/medarh.2021.75.133-137.

Abstract

BACKGROUND

The most common glomerular disease in children is nephrotic syndrome. Steroid-resistant nephrotic syndrome tends to have a worse disease course, which bears a significant risk of chronic kidney disease in children.

OBJECTIVE

To compare VEGF and neopterin levels between children with steroid-sensitive nephrotic syndrome (SSNS), steroid-resistant nephrotic syndrome (SRNS), and also healthy (control) children.

METHODS

This cross-sectional study was conducted at H. Adam Malik General Hospital, Indonesia from January to December 2018. There were 160 children aged 1 to 8 years with confirmed nephrotic syndrome and without end-stage renal disease and systemic diseases, divided into SSNS, SRNS, and control groups. Data regarding age, gender, urine albumin creatinine ratio (UACR), serum albumin, total cholesterol, urea, creatinine, VEGF, and neopterin levels were collected. A p-value of less than 0.05 is considered statistically significant.

RESULTS

There were no differences between groups in gender (p = 0.269) and age (p = 0.375), but there was significant difference of UACR, albumin level, total cholesterol level, and VEGF level between groups, (all p< 0.001). There was a moderate positive correlation between VEGF level and UACR (r(158) = 0.439, p< 0.001) and a moderate negative correlation between neopterin level and albumin level (r(158)= -0.312, p = 0.005).

CONCLUSION

There were no differences in serum VEGF and neopterin levels between steroid-sensitive and steroid-resistant nephrotic syndrome groups. Serum VEGF level was positively correlated with UACR while serum neopterin level was negatively correlated with serum albumin level.

摘要

背景

儿童中最常见的肾小球疾病是肾病综合征。类固醇耐药性肾病综合征往往具有更差的疾病进程,这使儿童患慢性肾脏病的风险显著增加。

目的

比较儿童类固醇敏感性肾病综合征(SSNS)、类固醇耐药性肾病综合征(SRNS)和健康对照儿童之间血管内皮生长因子(VEGF)和新蝶呤水平的差异。

方法

这是一项 2018 年 1 月至 12 月在印度尼西亚 H. Adam Malik 总医院进行的横断面研究。共纳入 160 名年龄在 1 至 8 岁、确诊为肾病综合征且无终末期肾病和系统性疾病的儿童,分为 SSNS、SRNS 和对照组。收集年龄、性别、尿白蛋白肌酐比(UACR)、血清白蛋白、总胆固醇、尿素、肌酐、VEGF 和新蝶呤水平等数据。p 值<0.05 被认为具有统计学意义。

结果

组间在性别(p = 0.269)和年龄(p = 0.375)方面无差异,但在 UACR、白蛋白水平、总胆固醇水平和 VEGF 水平方面存在显著差异(均 p<0.001)。VEGF 水平与 UACR 呈中度正相关(r(158)=0.439,p<0.001),新蝶呤水平与白蛋白水平呈中度负相关(r(158)=-0.312,p = 0.005)。

结论

儿童类固醇敏感性肾病综合征和类固醇耐药性肾病综合征组之间血清 VEGF 和新蝶呤水平无差异。血清 VEGF 水平与 UACR 呈正相关,而血清新蝶呤水平与血清白蛋白水平呈负相关。

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本文引用的文献

1
Health-related quality of life in Egyptian children with nephrotic syndrome.埃及肾病综合征患儿的健康相关生活质量。
Qual Life Res. 2020 Aug;29(8):2185-2196. doi: 10.1007/s11136-020-02438-0. Epub 2020 Feb 3.
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Management of steroid-resistant nephrotic syndrome in children and adolescents.儿童和青少年类固醇耐药性肾病综合征的管理。
Lancet Child Adolesc Health. 2018 Dec;2(12):880-890. doi: 10.1016/S2352-4642(18)30283-9. Epub 2018 Oct 18.
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Idiopathic nephrotic syndrome in children.儿童特发性肾病综合征。
Lancet. 2018 Jul 7;392(10141):61-74. doi: 10.1016/S0140-6736(18)30536-1. Epub 2018 Jun 14.
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Glomerular Diseases in Children.儿童肾小球疾病
Adv Chronic Kidney Dis. 2017 Nov;24(6):364-371. doi: 10.1053/j.ackd.2017.09.005.

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