Department of Nephrology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning City, 530021, Guangxi Province, China.
BMC Nephrol. 2024 Sep 3;25(1):289. doi: 10.1186/s12882-024-03723-7.
The purpose of this study was to investigate the correlation between podocyte related biomarker cofilin-1 and renal function, and explore the value of cofilin-1 in predicting the risk of renal adverse prognosis in IgA nephropathy (IgAN).
Patients with primary IgAN diagnosed by initial renal biopsy performed in our hospital from January 2019 to February 2022 were included. This study was a prospective cohort study. All IgAN patients were detected the expression of cofilin-1 and other related biomarkers (RhoA, NGAL) in urine by enzyme-linked immunosorbent assay (ELISA) and follow-up at least 6 months. We also collected baseline clinicopathologial data of IgAN. The decreased renal function group was defined as baseline eGFR < 60 ml/min/1.73m. Logistic and Cox regression model were used to analyze the correlation among cofilin-1 and renal prognosis.
133 IgAN patients were included, with a male-to-female ratio of 1.25:1 and an age of 37.67 ± 13.78 years, as well as an average of eGFR was 71.63 (40.42,109.33) ml/min/1.73m. 56 patients (42.1%) had decreased renal function at baseline, with the average of eGFR was 34.07 (16.72, 49.21) ml/min/1.73 m. 12 of which developed to renal adverse prognosis. The average of follow-up time was 22.035 ± 8.992 months. The multivariate regression analysis showed that increased urinary cofilin-1 was an independent risk factor associated with baseline renal function decline and renal adverse prognosis in IgAN patients (P < 0.05). ROC curves showed great efficacy of urinary cofilin-1 levels in diagnosing baseline renal function decline and predicting renal adverse prognosis (the area under the ROC curve was 0.708 and 0.803).
Cofilin-1 as a novel biomarker of podocyte lesion is closely related to renal function decline in IgAN. Cofilin-1 has certain clinical value in predicting the risk of renal adverse prognosis. Podocyte fusion affects the renal prognosis of IgAN.
本研究旨在探讨足细胞相关生物标志物丝切蛋白-1 与肾功能的相关性，并探讨其在预测 IgA 肾病（IgAN）肾脏不良预后风险中的价值。
纳入 2019 年 1 月至 2022 年 2 月在我院行初次肾活检诊断为原发性 IgAN 的患者。本研究为前瞻性队列研究。所有 IgAN 患者均采用酶联免疫吸附试验（ELISA）检测尿液中丝切蛋白-1 及其他相关生物标志物（RhoA、NGAL）的表达，并进行至少 6 个月的随访。我们还收集了 IgAN 的基线临床病理数据。肾功能下降组定义为基线 eGFR＜60ml/min/1.73m²。采用逻辑回归和 Cox 回归模型分析丝切蛋白-1 与肾脏预后的相关性。
共纳入 133 例 IgAN 患者，其中男女性别比为 1.25:1，年龄为 37.67±13.78 岁，平均 eGFR 为 71.63（40.42，109.33）ml/min/1.73m²。56 例（42.1%）患者基线时肾功能下降，平均 eGFR 为 34.07（16.72，49.21）ml/min/1.73m²。其中 12 例发生肾脏不良预后。平均随访时间为 22.035±8.992 个月。多因素回归分析显示，尿丝切蛋白-1 升高是 IgAN 患者基线肾功能下降和肾脏不良预后的独立危险因素（P＜0.05）。ROC 曲线显示尿丝切蛋白-1 水平对诊断基线肾功能下降和预测肾脏不良预后具有很好的效果（ROC 曲线下面积分别为 0.708 和 0.803）。
作为一种新的足细胞损伤生物标志物，丝切蛋白-1 与 IgAN 患者的肾功能下降密切相关。丝切蛋白-1 在预测肾脏不良预后风险方面具有一定的临床价值。足细胞融合影响 IgAN 的肾脏预后。
