Correlation Study Of Single Nucleotide Polymorphism In M-type Phospholipase A2 Receptor Gene With Idiopathic Membranous Nephropathy In Chengde

Objective:To discuss the clinical characteristic of idiopathic membranous nephropathy(IMN) and the clinical value of M type phospholipase A2 receptor antibodies in Chengde,association of polymorphism of PLA2R1 and HLA-DQA1 in M-type phospholipase A2 receptor gene with IMN.Methods:145 patients of having membranous nephropathy in renal medical ward or outpatient of Chengde medical college affiliated hospital from January 2009 to December 2015 were collected as experimental group.And 226 healthy volunteers in our hospital check-up were selected as control group.Blood samples were collected to extract and purify DNA,identify and analyse two single nucleotide polymorphism susceptibility loci rs4664308 and Rs2187668 allele of the PLA2R1 gene and HLA-DQA1 gene.Clinical datas of all pepole were retrospectively collected,for example,sex,age,national, systolic pressure, diastolic pressure, 24 hours urinary protein quantitative, serum albumin, serum creatinine, uric acid, total cholesterol, IMN patients in addition to collect blood triglycerides, β2-microglobulin, Ig G, complement C3,pathological type and pathological staging, etc.To understand association of polymorphism of PLA2R1 and HLA-DQA1 in PLA2 R gene with IMN.I selected 40 patients with IMN first saw a doctor and were hospitalized after onset and detected the serum anti PLA2 R antibodies.They were divided into PLA2 R antibodies positive group and PLA2 R antibodies negative groups.To understand relationship of PLA2 R antibody positive patients with clinical manifestations of IMN.And summarize the characteristics of IMN in our hospital.Results:IMN constituent ratio among primary glomerular disease was respectively 19.2%, 19.2%, 30.3%, 31.3%, 30.8%, 42.2%, 54.2% from 2009 to 2015.The proportion difference was statistically significant each year(χ2=69.835,P=0.000).Compared 2009 with 2014,the difference was statistically significant(χ2=20.085,P=0.000);Compared 2009 with 2015,the difference was statistically significant(χ2=42.472,P=0.000).The ratio of male and female was 1.5:1.0.Under the age of 20 patients with IMN,more men than women, composition ratio difference was statistically significant(χ2=7.333,P=0.007).20-40 years old patients with IMN,more men than women,composition ratio difference was statistically significant(χ2=8.100,P=0.000).40-60 years old patients with IMN,more men than women,composition ratio difference was statistically significant(χ2=8.205,P=0.007).More than 60 years patients with IMN,more men than women,composition ratio difference was statistically significant(χ2=21.186,P=0.000).The IMN men patients with all age groups were higher than female patients,difference was statistically significant(P<0.05).IMN is given priority to with 40-60 patients, 53.0% of patients with IMN.compared IMN patients with PLA2 R antibody positive with patients with PLA2 R antibodies negative, systolic blood pressure was higher,(122.0, 122.0) mm Hg ratio(106.0, 106.0)mm Hg, the difference was statistically significant(χ2=3.594,P=0.000);diastolic blood pressure was higher,(83.6±9.8)mm Hg ratio(74.5±10.5)mm Hg,the difference was statistically significant(t=2.550,P=0.015);serum creatinine was higher,(61.3,79.6)umol/L ratio(47.7,63.8)umol/L,the difference was statistically significant(t=2.03,P=0.042). The serum albumin was lower,(21.4±3.8)g/L ratio(25.5±6.5)g/L,difference was statistically significant(χ2=2.878,P=0.004).compared IMN group with control group,the gender was matched,the serum creatinine level was higher,difference was statistically significant(χ2=2.892,P=0.004);the uric acid was higher,difference was statistically significant(t=8.465,P=0.000);the serum total serum total cholesterol levels was higher,the difference was statistically significant(t=8.465,P=0.000);24 hours urinary protein quantitative was higher,the difference was statistically significant(t=5.061,P=0.000);the serum albumin was lower,the difference was statistically significant(χ2=5.001,P=0.000).systolic pressure、diastolic pressure between the two groups,there was no statistically significant difference(P>0.05).AA genotype patients at PLA2R1 compared with AG/GG genotype patients, age、gender、the number of the han、manchu、the Mongolian people、the hui people、systolic pressure、diastolic pressure、serum creatinine、uric acid、serum albumin、serum total cholesterol、24-hour urine protein quantitative and pathologic stage,there was no statistically significant difference(P>0.05).AA/AG genotype patients at PLA2R1 compared with GG genotype patients, age、gender 、the number of the han、 manchu、the Mongolian people、the hui people、systolic pressure、diastolic pressure、serum creatinine、uric acid、serum albumin、serum total cholesterol、24-hour urine protein quantitative and pathologic stage,there was no statistically significant difference(P>0.05).the difference of genotype and allele frequency distribution at PLA2R1 between IMN group and control group had statistical significance(χ2=33.34,P=0.000;χ2=37.94,P=0.000).Compared AA genotype with AG/GG genotype, IMN group was higher than the control group(2=31.157, P=0.000).For A allele frequencies, IMN group was higher than the control group(χ2=37.935,P=0.000).the difference of genotype at HLA-DQA1 between IMN group and control group had statistical significanc(χ2=9.967,P=0.007). A allele frequency distribution at HLA-DQA1 between two groups had no statistical significance(χ2=3.14,P=0.076). Compared AA/AG genotype frequency with GG genotype frequency, IMN group was higher than the control group(χ2=5.139,P=0.023).Conclusions:The incidence of IMN in primary glomerular disease each year was gradually increased in Chengde. men patients aged 40-60 years were more common for IMN.The serum anti PLA2 R antibody can reflect IMN patients’ s condition.The polymorphism of PLA2R1 and HLA-DQA1 in PLA2 R gene are closely associated with the susceptibility of IMN.AA genotype at PLA2R1 and AA/AG genotype at HLA-DQA1 in PLA2 R gene were risk factors for IMN.