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IgA肾病患者血清IgA1异常糖基化与氧化应激关系的研究

Relationship between abnormal glycosylation of serum IgA1 and oxidative stress in patients with primary IgA nephropathy

摘要目的 探讨IgA肾病(IgAN)患者血清IgA1异常糖基化与氧化应激的关系.方法 选取2012年1月至2013年12月行肾穿刺活检确诊为IgAN患者52例,其中Lee分级Ⅰ~Ⅲ级且估算肾小球滤过率(eGFR)≥60cm/min41例(IgAN-A组),Lee分级≥Ⅲ级且eGFR<60ml/min11例(IgAN-B组).另外选择69例健康体检者作为对照组.采用蚕豆凝集素亲和酶联免疫吸附法检测血清O糖链N-乙酰半乳糖胺低糖基化IgA1(Gd-IgA1),采用液相色谱法检测血清终末氧化蛋白产物(AOPPs).结果 IgAN-B组尿蛋白及血尿素氮、肌酐和尿酸明显高于IgAN-A组[(3613±2247)mg/d比(1457±1342)mg/d、(8.30±2.92)mmol/L比(5.46±1.55)mmol/L、(155.09±57.97)μmol/L比(77.50±22.55)μmol/L和(466.73±120.97)μmol/L比(361.70±94.40)μmol/L],白蛋白和eGFR明显低于 IgAN-A 组[(36.45±4.71)g/L 比(39.37±3.97)g/L 和(50.71±26.50)ml/min 比(94.67±23.48)ml/min],差异有统计学意义(P<0.05).IgAN-A组与IgAN-B组IgG、IgA、IgM、C3和C4比较差异无统计学意义(P>0.05).IgAN组血清Gd-IgA1和AOPPs明显高于对照组[0.44±0.17比0.15±0.06和(120.3±48.5)μmol/L比(45.7±19.2)μmol/L],差异有统计学意义(P<0.05);IgAN-B组血清Gd-IgA1和AOPPs明显高于IgAN-A组[0.59±0.23比0.35±0.12和(159.4±50.2)μmol/L比(90.9±41.7)μmol/L],差异有统计学意义(P<0.05).IgAN组患者血清Gd-IgA1和AOPPs水平呈正相关(r=0.603,P<0.05).结论 IgAN患者血清异常糖基化可导致氧化应激水平的升高,且IgAN患者血清Gd-IgA1和AOPPs水平与IgAN的进展相关,提示Gd-IgA1联合AOPPs可能成为IgAN的治疗和预后判断新的生物学标志物.

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abstractsObjective To study the relationship between abnormal glycosylation of serum IgA1 and oxidative stress in patients with primary IgA nephropathy (IgAN).Methods Fifty-two primary IgAN patients diagnosed by renal biopsy from January 2012 to December 2013 were selected.In the patients,Lee gradeⅠ-Ⅲand estimated glomerular filtration rate(eGFR)≥60 ml/min 41 cases(IgAN-A group),Lee grade≥Ⅲand eGFR<60 ml/min 11 cases(IgAN-B group).Sixty-nine health examination volunteers were selected as control group.The serum galactose-deficient IgA1(Gd-IgA1)was detected by enzyme-linked immunosorbent assay for vicia lectin, the advanced oxidation protein products (AOPPs) was detected by liquid chromatography.Results The urinary protein,urea nitrogen,creatinine and uric acid in IgAN-B group were significantly higher than those in IgAN-A group:(3 613 ± 2 247)mg/d vs.(1 457 ± 1 342)mg/d,(8.30 ± 2.92)mmol/L vs.(5.46 ± 1.55)mmol/L,(155.09 ± 57.97)μmol/L vs.(77.50 ± 22.55)μmol/L and(466.73 ± 120.97)μmol/L vs.(361.70 ± 94.40)μmol/L,the albumin and eGFR were significantly lower than those in IgAN-A group:(36.45 ± 4.71)g/L vs.(39.37 ± 3.97)g/L and (50.71 ± 26.50) ml/min vs.(94.67 ± 23.48) ml/min, there were statistical differences (P<0.05).There were no statistical differences in IgG, IgA, IgM, C3and C4between IgAN-A group and IgAN-B group(P>0.05).The serum Gd-IgA1 and AOPPs in IgAN group were significantly higher than those in control group:0.44 ± 0.17 vs.0.15 ± 0.06 and(120.3 ± 48.5)μmol/L vs.(45.7 ± 19.2)μmol/L,there were statistical differences (P<0.05).The serum Gd- IgA1 and AOPPs in IgAN- B group were significantly higher than those in IgAN-A group:0.59 ± 0.23 vs.0.35 ± 0.12 and(159.4 ± 50.2)μmol/L vs.(90.9 ± 41.7) μmol/L, there were statistical differences (P<0.05).There was a positive correlation between Gd-IgA1 and AOPPs in IgAN group (r = 0.603, P<0.05).Conclusions Gd-IgA1 may up-regulate oxidative stress.The serum levels of Gd-IgA1 and AOPPs are related to histopathological change of IgAN, which suggests that Gd-IgA1 combined with AOPPs may become a new biomarker for prognosis of IgAN.

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栏目名称 论著
DOI 10.3760/cma.j.issn.1673-4904.2018.01.002
发布时间 2018-01-23
基金项目
大连市卫生和计划生育委员会项目(2013)Dalian Municipal Health and Family Planning Committee Project
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