Correlation Between Serum IgA/C3 With Clinical And Pathological Features Of IgA Nephropathy

Objective:To explore the correlation between serum IgA/C3 ratio and clinical indexes and pathology in patients with IgA nephropathy(IgA nephropathy,IgAN),and to provide a theoretical basis for the assessment and intervention of IgA nephropathy patients.Methods:A cross-sectional study was conducted on 230 patients with IgA nephropathy in the affiliated Hospital of Chengde Medical College from January 1,2014 to October 1,2020.The level of serum IgA,complement C3 collected immediately after renal biopsy was detected,and the IgA/C3 ratio was calculated.The patients were divided into 2 groups,low serum IgA/C3 group and high serum IgA/C3 group,115 cases in each group,and the general clinical data and pathological results between the two groups were compared.Results:1 according to the level of IgA/C3,we found that there was no difference in age,BMI,blood pressure,blood lipid,serum protein,uric acid and 24-hour urinary protein between the two groups.Compared with the low serum IgA/C3 group,the high serum IgA/C3 group had higher levels of blood urea nitrogen,serum creatinine and IgA,and lower levels of hemoglobin,complement C3 and complement C4.The glomerular filtration rate was even worse(P < 0.05).2 The patients were divided into 2 groups according to the median serum IgA/C3 of 2.96,and the pathological typing of the 2 groups was compared,when the pathological results were classified by Lee grade,there were 48 cases of low serum IgA/C3 level < III grade lesions(41.74%),67 cases of ≥ III grade lesions(58.26%),33 cases of high serum IgA/C3 level <III grade lesions(28.70%),and 82 cases of ≥ III grade lesions(71.30%).We found that there was a significant difference in these disease rates between the two groups(P< 0.05),and the pathological damage was more severe in the high IgA/C3 group.See Table 2 for details.3 when renal biopsy specimens were scored by Oxford classification,We found that 177(76.96%)of the total number of patients had M1 lesions,only 4 cases(1.74%)had E1 lesions,78 cases(33.91%)had S1 lesions,50cases(21.74%)had T1 lesions,42 cases(18.26%)had T2 lesions,58 cases(25.22%)had C1 lesions,and 9 cases(3.91%)had C2 lesions.But there was no significant difference between the two groups(P > 0.05).4 We analyzed the correlation between serum IgA/C3 level and clinical indexes.The results showed that serum IgA/C3 level was positively correlated with age,total protein,serum potassium,blood urea nitrogen and serum creatinine,and negatively correlated with e GFR,hemoglobin and total cholesterol,but not with 24-hour urinary protein(P < 0.05).Conclusion:1 In patients with IgA nephropathy,the high level of serum IgA/C3 group had higher blood urea nitrogen,serum creatinine and lower hemoglobin.Serum IgA/C3 affects the level of renal function to some extent,and presumably it can be used as an indicator of severity.2 Higher serum IgA/C3 values were associated with higher age,total protein,blood urea nitrogen,and blood creatinine levels and,conversely,lower GEFR,hemoglobin,and total cholesterol levels.3 When Lee’s classification was applied,the pathological damage was higher in the group of IgAN patients with high serum IgA/C3 levels.