Ma Hui, Lei Chen, Zhao Bo, Feng Zhihong, Ye Lan, Wang Xuan, Zhou Xiaoling
Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, China.
Department of Geriatrics and Special Needs, General Hospital of Ningxia MedicalUniversity, Yinchuan, China.
Sci Rep. 2024 Dec 28;14(1):30996. doi: 10.1038/s41598-024-81929-3.
Metabolic syndrome, a cluster of conditions including obesity, hyperglycemia, hypertension, and dyslipidemia, is increasingly recognized for its association with kidney disease. However, the impact of metabolic syndrome on the long-term prognosis of IgA nephropathy(IgAN) remains understudied. From August 2009 to December 2018, we conducted a retrospective cohort study at the Department of Nephrology, General Hospital of Ningxia Medical University, involving 698 patients with primary IgAN identified by the initial renal biopsy. Patients were divided into five groups based on the number of metabolic syndrome components they exhibited, including metabolic syndrome with hyperuricemia: Group A (no components), Group B (one component), Group C (two components), Group D (three components), and Group E (four or more components). We compared and analyzed the effect of metabolic components on the prognosis of IgAN. The mean age was 35.83 years, and 51.86% male. The prevalence of metabolic syndrome was 25.07%. The 24-h urine protein quantification correlated positively with metabolic components (P < 0.05), while eGFR correlated negatively (P < 0.05). Kaplan--Meier analysis showed decreased renal survival with more metabolic components, especially with four or more (P < 0.001). Blood pressure was the most important factor influencing the occurrence of endpoint events in IgAN patients, according to a random forest technique analysis. The incidence of metabolic abnormalities in patients with IgA nephropathy is closely related to the severity of clinical manifestations and poor renal prognosis, with blood pressure being the most critical factor.
代谢综合征是一组包括肥胖、高血糖、高血压和血脂异常的病症，其与肾脏疾病的关联日益受到关注。然而，代谢综合征对IgA肾病（IgAN）长期预后的影响仍未得到充分研究。2009年8月至2018年12月，我们在宁夏医科大学总医院肾内科进行了一项回顾性队列研究，纳入了698例经初次肾活检确诊的原发性IgAN患者。根据患者表现出的代谢综合征组分数量，将患者分为五组，包括伴有高尿酸血症的代谢综合征：A组（无组分）、B组（一个组分）、C组（两个组分）、D组（三个组分）和E组（四个或更多组分）。我们比较并分析了代谢组分对IgAN预后的影响。平均年龄为35.83岁，男性占51.86%。代谢综合征的患病率为25.07%。24小时尿蛋白定量与代谢组分呈正相关（P＜0.05），而估算肾小球滤过率（eGFR）呈负相关（P＜0.05）。Kaplan-Meier分析显示，代谢组分越多，肾脏生存率越低，尤其是四个或更多组分时（P＜0.001）。根据随机森林技术分析，血压是影响IgAN患者终点事件发生的最重要因素。IgA肾病患者代谢异常的发生率与临床表现的严重程度及不良肾脏预后密切相关，其中血压是最关键的因素。
