Department of Nephrology, 74559First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
Department of Rheumatology, 74559First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221108967. doi: 10.1177/10760296221108967.
Podoplanin (PDPN) promotes platelet aggregation and activation by interacting with C-type lectin-like receptor 2(CLEC-2) on platelets. The interaction between the upregulated PDPN and platelet CLEC-2 stimulates venous thrombosis. PDPN was identified as a risk factor for coagulation and thrombosis in inflammatory processes. Hypercoagulability is defined as the tendency to develop thrombosis according to fibrinogen and/or D dimer levels. Nephrotic syndrome is also considered to be a hypercoagulable state. The aim of this study is to investigate the association of soluble PDPN/CLEC-2 with hypercoagulability in nephrotic syndrome. Thirty-five patients with nephrotic syndrome and twenty-seven healthy volunteers were enrolled. PDPN, CLEC-2 and GPVI concentrations were tested by enzyme-linked immunosorbent assay (ELISA). Patients with nephrotic syndrome showed higher serum levels of PDPN and GPVI in comparison to healthy controls ( < .001, = .001). PDPN levels in patients with nephrotic syndrome were significantly correlated with GPVI (r = 0.311; = .025), hypoalbuminemia (r = -0.735; < .001), hypercholesterolemia (r = 0.665; < .001), hypertriglyceridemia (r = 0.618; < .001), fibrinogen (r = 0.606; < .001) and D-dimer (r = 0.524; < .001). Area under the curve (AUC) for the prediction of hypercoagulability in nephrotic syndrome using PDPN was 0.886 (95% CI 0.804-0.967, < .001). Cut-off value for the risk probability was 5.88 ng/ml. The sensitivity of PDPN in predicting hypercoagulability was 0.806, and the specificity was 0.846. When serum PDPN was >5.88 ng/ml, the risk of hypercoagulability was significantly increased in nephrotic syndrome (OR = 22.79, 95% CI 5.92-87.69, < .001). In conclusion, soluble PDPN levels were correlated with hypercoagulability in nephrotic syndrome. PDPN has the better predictive value of hypercoagulability in nephrotic syndrome as well as was a reliable indicator of hypercoagulable state.
Podoplanin (PDPN) 通过与血小板上的 C 型凝集素样受体 2（CLEC-2）相互作用促进血小板聚集和激活。上调的 PDPN 与血小板 CLEC-2 的相互作用刺激静脉血栓形成。PDPN 被确定为炎症过程中凝血和血栓形成的危险因素。高凝状态定义为根据纤维蛋白原和/或 D 二聚体水平发生血栓形成的趋势。肾病综合征也被认为是一种高凝状态。本研究旨在探讨可溶性 PDPN/CLEC-2 与肾病综合征高凝状态的关系。纳入 35 例肾病综合征患者和 27 名健康志愿者。通过酶联免疫吸附试验（ELISA）检测 PDPN、CLEC-2 和 GPVI 浓度。与健康对照组相比，肾病综合征患者血清 PDPN 和 GPVI 水平升高（ < .001， = .001）。肾病综合征患者的 PDPN 水平与 GPVI 显著相关（r = 0.311； = .025）、低白蛋白血症（r = -0.735； < .001）、高胆固醇血症（r = 0.665； < .001）、高三酰甘油血症（r = 0.618； < .001）、纤维蛋白原（r = 0.606； < .001）和 D-二聚体（r = 0.524； < .001）。使用 PDPN 预测肾病综合征高凝状态的曲线下面积（AUC）为 0.886（95%CI 0.804-0.967， < .001）。风险概率的截断值为 5.88ng/ml。PDPN 预测高凝状态的敏感性为 0.806，特异性为 0.846。当血清 PDPN 水平>5.88ng/ml 时，肾病综合征高凝状态的风险显著增加（OR = 22.79，95%CI 5.92-87.69， < .001）。结论：可溶性 PDPN 水平与肾病综合征高凝状态相关。PDPN 对肾病综合征高凝状态具有更好的预测价值，是高凝状态的可靠指标。
