Department of Nephrology, Jagiellonian University Medical College, 30-688 Kraków, Poland.
Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland.
Medicina (Kaunas). 2021 Dec 10;57(12):1348. doi: 10.3390/medicina57121348.
: Urine insulin-like growth factor-binding protein 7 (IGFBP-7), tissue inhibitor of matrix metalloproteinase 2 (TIMP-2), and neutrophil gelatinase-associated lipocalin (NGAL) monomer are novel tubular kidney injury biomarkers. In multiple myeloma (MM), immunoglobulin free light chains (FLCs) play an integral role in renal impairment. This study aimed to investigate the correlation between new biomarkers and acclaimed parameters of renal failure, MM stage, and prognosis. : The examined parameters included: urinary and serum cystatin-C, IGFBP-7, and TIMP-2, and urinary NGAL monomer in 124 enrolled patients. : Urinary and serum IGFBP-7 and urinary NGAL were higher among patients with an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m, and positively correlated with urine light chains. Serum and urine IGFBP-7 and urine NGAL were greater among patients with a higher disease stage. In the whole study group, urinary concentrations of the studied markers were positively correlated with each other. In multiple linear regression, urinary IGFBP-7 and NGAL were associated with lower eGFR, independently of other urinary markers. : Urinary IGFBP-7 and NGAL monomer may be useful markers of tubular renal damage in patients with MM. Biomarker-based diagnostics may contribute to earlier treatment that may improve renal outcomes and life expectancy in MM.
尿液胰岛素样生长因子结合蛋白 7(IGFBP-7)、组织金属蛋白酶抑制剂 2(TIMP-2)和中性粒细胞明胶酶相关脂质运载蛋白(NGAL)单体是新型管状肾损伤生物标志物。在多发性骨髓瘤(MM)中,免疫球蛋白游离轻链(FLC)在肾功能损害中起着重要作用。本研究旨在探讨新生物标志物与公认的肾功能衰竭、MM 分期和预后参数之间的相关性。
在 124 名入组患者中,检查了尿和血清胱抑素-C、IGFBP-7 和 TIMP-2 以及尿 NGAL 单体。
肾小球滤过率(eGFR)<60 mL/min/1.73 m 的患者的尿和血清 IGFBP-7 和尿 NGAL 水平较高,与尿轻链呈正相关。疾病分期较高的患者的血清和尿液 IGFBP-7 和尿液 NGAL 更高。在整个研究组中,研究标志物的尿浓度彼此呈正相关。在多元线性回归中,尿 IGFBP-7 和 NGAL 与较低的 eGFR 独立相关,与其他尿液标志物无关。
尿 IGFBP-7 和 NGAL 单体可能是 MM 患者管状肾损伤的有用标志物。基于生物标志物的诊断可能有助于更早的治疗,从而改善 MM 患者的肾脏结局和预期寿命。