高尿酸血症与儿童 IgA 肾病的进展有关。
Hyperuricemia is associated with the progression of IgA nephropathy in children.
机构信息
Department of Pediatric Nephrology and Rheumatology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Division of Joint Surgery, Department of Orthopaedic Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
出版信息
Pediatr Res. 2023 Sep;94(3):1057-1066. doi: 10.1038/s41390-023-02538-w. Epub 2023 Mar 13.
BACKGROUND
The objective of the study was to explore the potential biomarkers and risk factors in children with immunoglobulin A nephropathy (IgAN).
METHODS
Untargeted metabolomics analysis was performed on children with IgAN before and after treatment. Subsequently, a retrospective study involving the past 15 years and a follow-up study were performed to verify the role of hyperuricemia in IgAN children.
RESULTS
Serum metabolomics analyses showed that levels of serum xanthosine were closely related to the outcome of IgAN, and KEGG analyses showed that differential metabolites were significantly enriched in purine metabolism. Furthermore, retrospectively analyses of 252 children with IgAN showed that hyperuricemia was associated with poorer renal outcome. Logistic regression analysis showed that BMI, serum creatinine, eGFR, Lee's grade III, and crescents were risk factors of hyperuricemia in children with IgAN. Kaplan-Meier analysis revealed that kidney progression-free survival in IgAN children with hyperuricemia was lower than that without hyperuricemia, especially in females.
CONCLUSIONS
We first performed a dynamic metabolomics study to reveal that hyperuricemia is closely related to the progression of IgAN in children. Then retrospective and follow-up studies confirmed that hyperuricemia is an important risk factor for poor renal outcomes. We need to pay more attention to the hyperuricemia in children with IgAN.
IMPACT
We first performed a dynamic metabolomics study to reveal that hyperuricemia was closely related to the progression of IgAN in children. Retrospective analyses in past 15 years confirmed that IgAN children with hyperuricemia had poorer renal function and worse renal pathology. The BMI, Scr, eGFR, Lee's grade III, and crescents were risk factors of hyperuricemia in children with IgAN. The long-term follow-up study showed that hyperuricemia was an important risk factor for poor renal outcome in children with IgAN. We need to pay more attention to hyperuricemia in children with IgAN, especially in females.
背景
本研究旨在探讨儿童 IgA 肾病（IgAN）的潜在生物标志物和危险因素。
方法
对治疗前后的 IgAN 患儿进行非靶向代谢组学分析。随后，进行了一项回顾性研究和一项随访研究，以验证高尿酸血症在 IgAN 患儿中的作用。
结果
血清代谢组学分析表明，血清黄嘌呤核苷水平与 IgAN 的转归密切相关，KEGG 分析表明，差异代谢物在嘌呤代谢中显著富集。此外，对 252 例 IgAN 患儿进行的回顾性分析显示，高尿酸血症与肾脏预后不良有关。Logistic 回归分析显示，BMI、血清肌酐、eGFR、Lee 分级Ⅲ和新月体是 IgAN 患儿高尿酸血症的危险因素。Kaplan-Meier 分析显示，高尿酸血症的 IgAN 患儿肾脏无进展生存率低于无高尿酸血症的患儿，尤其是女性。
结论
我们首次进行了动态代谢组学研究，揭示了高尿酸血症与儿童 IgAN 的进展密切相关。然后，回顾性和随访研究证实，高尿酸血症是儿童 IgAN 不良肾脏结局的重要危险因素。我们需要更加关注 IgAN 患儿的高尿酸血症。
影响
我们首次进行了动态代谢组学研究，揭示了高尿酸血症与儿童 IgAN 的进展密切相关。过去 15 年的回顾性分析证实，高尿酸血症的 IgAN 患儿肾功能较差，肾脏病理较差。BMI、Scr、eGFR、Lee 分级Ⅲ和新月体是 IgAN 患儿高尿酸血症的危险因素。长期随访研究显示，高尿酸血症是儿童 IgAN 不良肾脏结局的重要危险因素。我们需要更加关注 IgAN 患儿的高尿酸血症，尤其是女性。
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