The Clinical Significance Of Hepcidin And Neutrophil-gelatinase Associated Lipocalin In Lupus Nephritis

Objective:To test the level of serum and urine hepcidin(sHepc and uHepc)and neutrophil-gelatinase associated lipocalin(sNGAL and uNGAL)in systemic lupus erythematosus(SLE)patients with renal damage,and study the relationship between the Hepc or NGAL and lupus nephritis(LN),to further investigate the relationship between Hepc or NGAL and active lupus nephritis.Methods:This experiment included 38 healthy subjects and 54 cases of SLE patients,According to the renal damage,all SLE patients were divided into SLE patients without nephritis(12 cases)and LN patients(42 cases),divided into A?B?C group.A group is healthy controls,B group is SLE patient without nephritis group,C group is LN group.Use enzyme-linked immunosorbent assay(ELISA)method to measure Hepc and NGAL in plasma and urine for each groups.LN patients divided into C1 group(inactive LN)and C2 group(active LN)according to Renal-Systemic Lupus Erythematosus Disease Activity Index(R-SLEDAI).To test the level of plasma and urinary Hepc and NGAL compare C1 group with C2 group,and study the relationship between the R-SLEDAI.At the same time,the activity of LN was predicted according to the Hepc and NGAL values,and the sensitivity and specificity were analyzed by receiver operating characteristic curve(ROC curve).Results:1.There was no significant difference in the level of sHepc between group A,B and C(p>0.05).uHepc were increased in group C compared with group B or group A(p<0.001,p<0.001),uHepc were increased in group B than group A(p<0.001).2.There was no difference in expression of sNGAL between group A,B and C(p>0.05).uNGAL were increased in group C compared with group A or group B(p<0.001,p<0.001),The level of uNGAL between group A and group Bwas no different(p>0.05).3.There was no difference in the level of sHepc and sNGAL compare group C1 with group C2(p>0.05,p>0.05).Levels of uHepc and uNGAL were higher in group C2 than group C1(p<0.001,p=0.001).The levels of sHepc and sNGAL was no correlation with the SLEDAI?R-SLEDAI and extra renal SLEDAI score.uHepc and uNGAL correlated with the R-SLEDAI score(r=0.313,p=0.043;r=0.344,p=0.026).4.Cut-off in uHepc and uNGAL were 7.483ng/mL(sensitivity 90.62%,specificity 80%)and 7.587ng/mL(sensitivity 90.62%,specificity 70%).For the area under the ROC curve were 0.897 and 0.836 respectively,the combined detection of uHepc and uNGAL two index found that the area under the curve was 0.916,sensitivity and specificity were 90.62% and 80%.Two index combined detection showed that the area under the ROC curve was 0.916,the sensitivity and specificity were 90.62% and 80%,respectively.Conclusion:1.The levels of uHepc and uNGAL were increased in SLE patients with renal involvement,but there was no significant different in sHepc and sNGAL.2.uHepc and uNGAL but not sHepc and sNGAL may a index for predicting disease activity in LN.