Concentrations Of Periostin In Serum And Urine In Peadiatric Henoch-Schonlein Purpura Nephritis And Its Significance

Objective:To explore the relationship between periostin and Henoch-Schonlein purpura nephritis(HSPN),and the correlation of periostin with creatinine,urea,cystatin C,24 h urinary protein quantification and microalbumin in human urine.ROC curve is adopted to evaluate the value of periost in serum and urine in HSPN,and also to explore the relationship between serum and urinary periostin and the occurrence of HSPN,so as to provide new ideas for further searching for early laboratory evaluation indexes.Methods:60 cases with HSP who were admitted to the Department of Pediatrics,Affiliated Hospital University from July 2017 to December 2018 were recruited,including 30 cases with Henoch-Schonlein purpura without nephritis(HSP)and 30 cases with Henoch-Schonlein purpura(HSPN),and another 30 healthy children who underwent a physical examination in our hospital during the same time as the normal control group.The serum and urine levels of periostin were determined by ELISA.The levels of serum and urinary periostin in the HSPN group,the HSP group and the normal control group were compared,and the correlation between serum and urinary periostin and common clinical indicators were compared.The ROC curve was used to evaluate the value of periostin in HSPN.Results:1.The serum levels of periostin in the HSPN group,the HSP group and the normal control group were(50.02�8.88)pg/ml,(41.68�8.26)pg/ml,(36.99�8.34)pg/ml,respectively.There was significant difference among the three group(F=18.081,P<0.001).There were statistically significant differences of the HSPN group and the normal control group,the HSP group and the normal control group,the HSPN group and the HSP group(P < 0.001,P < 0.001,P < 0.05).2.The urinary levels of periostin in the HSPN group,the HSP group and the normal control group were(34.94�3.04)pg/ml,(31.75�1.91)pg/ml,(31.00�1.99)pg/ml,respectively.There was significant difference among the three group(F=23.405,P<0.001).There were significant differences of the HSPN group and the normal control group,the HSPN group and the HSP group(P < 0.001,P < 0.001).There was no significant difference of the HSP group and the normal control group(P > 0.05).3.In the HSPN group,the urinary periostin was positively correlated with the 24-hour urinary protein(r=0.810,P<0.001)and H-ALB(r= 0.735,P<0.001),but not with ure,Cr,UA and Cys C.In the HSPN group,there was a positive correlation between serum periostin and H-ALB(r=0.396,P=0.030),and there was no correlation between serum periostin and ure,Cr,UA,Cys C and 24-hour urinary protein quantification.4.The ROC curve of the prediction of HSPN by serum periostin level showed that the area under the ROC curve was 0.789,95%CI was 0.696~0.882,the sensitivity and specificity were 96.7%,56.7%,and the Youden index was 0.534,the optimal critical value was 39.166pg/ml,P<0.001.5.The ROC curve of the prediction of HSPN by the level of urinary periostin showed that the area under the ROC curve was 0.851,and the 95%CI was 0.760~0.942.The sensitivity and specificity were 76.7%,85.0%,and the Youden index was 0.617,and the optimal critical value was 33.627pg/ml,P<0.001.Conclusion:1.Urinary periostin was significantly increased in HSPN,but was not significantly increased in HSP,which was a sensitive index reflecting renal injury.2.Serum periostin protein is involved in HSP and HSPN,which is higher in HSPN.