The Role Of Adiponectin And Its Receptor In Patients With Primary Membranous Nephropathy Complicated With Hyperuricemia

Objective:To investigate the changes of adiponectin(APN),IL-1 ? in plasma and urine,adiponectin receptor 1(Adipo R1)and NLRP3 expression in renal tissue of patients with primary membranous nephropathy complicated with hyperuricemia and their relationship.Methods:48 patients with membranous nephropathy complicated with hyperuricemia(IMN+HUA group),49 patients with membranous nephropathy(IMN group),30 patients with healthy blood and urine(healthy group)and 24 cases of normal renal tissue after nephrectomy were selected.Clinically,the concentrations of APN and IL-1? in blood and urine of each group were detected by ELISA,and the changes of APN and IL-1? levels in each group were compared.At the same time,the clinical data of each group were collected to analyze the relationship between APN,IL-1? and other indicators.At the pathological point of view,the expression levels of Adipo R1 and NLRP3 in the kidney tissues of the same patients were detected by immunohistochemistry,and the expression levels of Adipo R1 and NLRP3 were compared between the groups.Results:(1)In different groups,the levels of UA,24 h protein,APN,IL-1? in blood and urine,and NLRP3 expression in renal tissue in IMN and IMN+HUA patients were higher than those in control group(P < 0.05),and there was significant difference between the two groups(P < 0.05).The expression level of Adipo R1 in renal tissue was significantly lower than that in control group(P < 0.05).The levels of UA,APN,IL-1? in blood and urine,and NLRP3 expression in renal tissue in IMN+HUA group were significantly higher than those in IMN group(P < 0.05).The difference was statistically significant(P< 0.05).The expression level of Adipo R1 in renal tissue was lower than that in IMN group(P < 0.05).(2)In different CKD stages and membranous nephrotic stages,with the increase of CKD stage,the expression levels of APN,IL-1? in plasma and urine and NLRP3 of IMN+HUA group gradually increased,and the expression level of Adipo R1 gradually decreased.The difference was statistically significant(P<0.05).With the increase of membranous nephropathy stage,the expression of APN in urine increased gradually.The expression levels of IL-1?,APN in blood and Adipo R1 and NLRP3 in renal tissue were not significantly different in plasma and urine.The difference was not statistically significant.(3)Correlation between APN,IL-1?,Adipo R1,NLRP3 and other indexes;the expression of APN,IL-1? in plasma and urine of: IMN+HUA group was positively correlated with the quantity of UA,24 h urine protein(P < 0.05).The expression of IL-1?in blood and urine was positively correlated with NLRP3 in renal tissue and APN in blood and urine,and negatively correlated with Adipo R1 in renal tissue(P < 0.05).Conclusion:1.The expression of APN-Adipo R1 pathway is significantly increased in IMN+HUA patients.It is predicted that APN-Adipo R1 signaling pathway may play an important role in IMN+HUA patients.2.It is speculated that UA may interact with theAPN-Adipo R1 pathway by activating the NLRP3-caspase-1-IL-1? pathway to induce the body's own protection.Intervention of these two pathways may play an important role in the occurrence and progression of IMN+HUA patients.