Pediatrics Department, the Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China.
Pediatrics Department, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China.
Int Immunopharmacol. 2022 Jul;108:108765. doi: 10.1016/j.intimp.2022.108765. Epub 2022 Apr 6.
IgA vasculitis is characterized by inflammation of the blood vessels, which can result in microvascular destruction and consequently renal damage. Transthyretin is a newly discovered angiogenesis regulator in promoting microvascular regeneration. This indicates that transthyretin may act as a potential predictor of IgAV as well as IgAVN.
This retrospective study included 125 patients newly diagnosed as IgAV with demographic and laboratory parameters. Of these, 78 patients had demonstrated internal organ damage and 47 patients with only skin and joint injury. Of 78 patients with organ impairment, 27 were diagnosed of renal involvement. Then we evaluated the relationship between NLR, total protein, albumin, globulin, transthyretin, B lymphocyte counts and the severity of IgAV.
For patients with internal organ or renal involvement, the level of transthyretin were lower than non-internal organ damage group (p < 0.001 for both group). Remarkably, the NLR was only higher in patients with internal organ damage group (p = 0.019). Logistic regression analysis showed that NLR and transthyretin both were risk factors for internal organ involvement (OR = 1.768, 0.973 separately), and only transthyretin is the independent risk for renal involvement (OR = 0.981, p < 0.05). The ROC analysis showed an AUC of 0.626 for NLR, 0.815 for transthyretin in predicting organ damage, 0.755 for transthyretin in patients with renal involvement (p < 0.05, to all parameters).
Transthyretin is a better predictor in predicting internal organ or renal involvement than NLR, and low plasma transthyretin concentration can increase the risk of renal involvement in IgAV patients.
IgA 血管炎的特征是血管炎症，可导致微血管破坏，进而导致肾脏损伤。转甲状腺素蛋白是一种新发现的血管生成调节剂，可促进微血管再生。这表明转甲状腺素蛋白可能作为 IgAV 以及 IgAVN 的潜在预测因子。
本回顾性研究纳入了 125 例新诊断的 IgAV 患者，包括人口统计学和实验室参数。其中，78 例患者有内脏器官损伤，47 例仅有皮肤和关节损伤。在 78 例有器官损伤的患者中，27 例被诊断为肾脏受累。然后，我们评估了 NLR、总蛋白、白蛋白、球蛋白、转甲状腺素、B 淋巴细胞计数与 IgAV 严重程度之间的关系。
对于有内脏器官或肾脏受累的患者，转甲状腺素蛋白水平低于无内脏器官损伤组（两组均 p<0.001）。值得注意的是，只有内脏器官损伤组的 NLR 更高（p=0.019）。Logistic 回归分析显示，NLR 和转甲状腺素蛋白均为内脏器官受累的危险因素（OR=1.768、0.973），只有转甲状腺素蛋白是肾脏受累的独立危险因素（OR=0.981，p<0.05）。ROC 分析显示，NLR 预测器官损伤的 AUC 为 0.626，转甲状腺素蛋白为 0.815，转甲状腺素蛋白预测肾脏受累的 AUC 为 0.755（p<0.05，所有参数）。
转甲状腺素蛋白是预测内脏器官或肾脏受累的更好指标，而血浆转甲状腺素蛋白浓度降低会增加 IgAV 患者肾脏受累的风险。
