狼疮性肾炎患者血清维生素D代谢物及其受体水平与肾功能损伤的关系
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四川省科学技术厅计划项目(2021YJ0239)


The relationship between serum vitamin D metabolites and vitamin D receptor levels and kidney function injury in patients with lupus nephritis
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    摘要:

    目的 探讨维生素D(VitD)代谢物及其受体水平与狼疮性肾炎(LN)患者肾功能损伤之间的关系。方法 选取2022年4月—12月绵阳市中心医院就诊或体检的受试者277例,其中67例LN患者(LN组)、67例未并发LN的单纯系统性红斑狼疮患者(SLE组)、68例非LN引起的慢性肾脏病患者(non-LN-CKD组)和75例体检者作为健康对照组(HC组)。基于超高效液相色谱-串联质谱法检测血清VitD代谢物,比较各组血清VitD代谢物、维生素D受体(VDR)和肾功能指标水平差异,分析各组内指标间相关性及影响LN发生的独立危险因素。结果 与HC组比较,SLE组与LN组的血清25(OH)D2、25(OH)D2/25(OH)D3和VDR均增高,25(OH)D3和C3-epi降低(均P<0.05)。LN患者25(OH)D3与eGFR呈正相关(r>0, P<0.05),与Urea、Cr、CysC和NGAL呈均负相关(r<0, P<0.05);C3-epi与NGAL和VDR表达水平呈负相关(r<0, P<0.05)。高血清VDR和低血清C3-epi是发生LN独立危险因素,高血清25(OH)D3是LN发生的保护因素。结论 血清25(OH)D3和C3-epi水平降低及VDR水平增高可能是LN重要的致病因子,对LN患者肾功能受损的发生具有关键作用

    Abstract:

    Objective The purpose of this study was to investigate the relationship between VitD metabolites and their receptor levels and kidney damage in lupus nephritis (LN).Methods A total of 277 subjects who visited or underwent physical examination in Mianyang Central Hospital from April to December 2022 were selected, including 67 patients with LN (LN group), 67 patients with SLE without LN (SLE group), 68 patients with CKD caused by non-LN (non-LN-CKD group) and 75 healthy subjects (HC group). Serum VitD metabolites were detected by UPLC-MS/MS. The levels of serum VitD metabolites, VDR and kidney function indicators were compared among the groups, and the correlation between the indexes in each group and the independent risk factors affecting the occurrence of LN were analyzed. Results Compared with the HC group, the SLE group and the LN group had higher serum VDR levels, and lower serum 25(OH)D3 and C3-epi levels (all P< 0.05).In LN patients, 25(OH)D3 was positively correlated with eGFR (r>0, P<0.05) , with Urea, Cr, CysC and NGAL(r<0, P<0.05) negative correlation; C3-epi was negatively correlated with NGAL and VDR (r<0, P<0.05). High serum VDR and low serum C3-epi were independent risk factors for LN, and high serum 25(OH)D3 was a protective factor for LN. Conclusion The decrease of serum 25(OH)D3 and C3-epi levels and the increase of VDR level may be important pathogenic factors of LN, which play a key role in the occurrence of kidney injury in LN patients

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  • 在线发布日期: 2025-12-19
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