Department of Neonatology, Tianjin Central Hospital of Obstetrics and Gynecology, No. 156 Nan Kai San Ma Lu, Tianjin, 300000, China.
Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin, 300000, China.
Pediatr Nephrol. 2023 Mar;38(3):729-738. doi: 10.1007/s00467-022-05663-6. Epub 2022 Jun 27.
Preterm birth has been identified as a risk factor for development of long-term chronic kidney disease. Podocyte loss has been reported to contribute to this process in preterm animal models. However, details about podocyte loss in preterm infants and related perinatal risk factors have not been well clarified.
Forty full-term infants and 106 preterm infants were enrolled. Urine samples were collected from full-term infants within 4-7 days of birth and preterm infants at 37-40 weeks of corrected age. Levels of urine podocin mRNA, urine protein (UP), and urine microalbumin (UMA) were measured, and the relationship between these markers was evaluated. Clinical information in these infants was collected, and potential correlates that may lead to increased podocyte loss during the perinatal period were identified using linear regression analysis.
Urine podocyte loss indicated by the urine podocin mRNA to creatinine ratio (UpodCR) was higher in preterm infants than in full-term infants. UpodCR was correlated with the levels of UP and UMA. Multiple linear regression analysis also showed that lower gestational age (GA) at birth and small for gestational age (SGA) were high risk factors for urine podocyte loss.
Increasing urine podocyte loss was identified in preterm infants. Moreover, perinatal factors were associated with podocyte loss and may be a potential direction for comprehensive research and intervention in this field. A higher resolution version of the Graphical abstract is available as Supplementary information.
早产已被确定为发展为长期慢性肾脏病的危险因素。已有研究报道,足细胞丢失是早产动物模型发生这一过程的原因之一。然而,早产儿足细胞丢失及其相关围生期危险因素的详细情况尚不清楚。
本研究纳入了 40 名足月产婴儿和 106 名早产儿。足月产婴儿在出生后 4-7 天内,早产儿在校正胎龄 37-40 周时采集尿液样本。测量尿液足细胞 mRNA、尿蛋白(UP)和尿微量白蛋白(UMA)水平,并评估这些标志物之间的关系。收集这些婴儿的临床信息,并使用线性回归分析确定围生期可能导致足细胞丢失增加的潜在相关因素。
早产婴儿的尿足细胞 mRNA 与肌酐比值(UpodCR)表明尿足细胞丢失增加。UpodCR 与 UP 和 UMA 水平相关。多元线性回归分析还表明,出生时的胎龄(GA)较低和小于胎龄儿(SGA)是尿足细胞丢失的高危因素。
本研究发现早产儿尿足细胞丢失增加。此外,围生期因素与足细胞丢失有关,可能是该领域全面研究和干预的潜在方向。高分辨率版本的图表摘要可在补充信息中查看。