| Objective:To Analyze the expression of PEBP4 in patients with primary IgAN and its correlation with clinical indicators and pathological grades by detecting the levels of phosphatidylethanolamine binding protein 4(PEBP4)in serum and renal tissues of patients with primary IgA nephropathy(IgAN).So as to explore the value of PEBP4 in assessing the severity of primary IgAN disease.Methods:This study included 40 patients who were diagnosed as primary IgAN by renal biopsy in the Affiliated Hospital of North Sichuan Medical College and did not start hormone and immunosuppressant from July 2019 to July 2020.At the same time,33 patients who done the health checkup in the Medical Examination Center of the Affiliated Hospital of North Sichuan Medical University werw served as the control group.Fasting blood samples of patients were collected before treatment,and enzyme-linked immunosorbent assay(Elisa)was adopted to detect the serum PEBP4 levels in IgAN group and healthy control group.In addition,the general data and other clinical indicators of the two groups were collected,including serum creatinine,urea nitrogen,albumin,hemoglobin,blood lipid,the quantity of 24-hour urinary protein,estimated glomerular fltration rate(eGFR),serumcystain C(cysC),etc.The pathological data of IgAN patients such as the Lee’s pathology hierarchical and the Oxford classification score were collected,meanwhile,the renal biopsy specimens of IgAN patients were collected for immunohistochemical(IH)staining of PEBP4.The differences of clinical indicators and serum PEBP4 in different groups were analyzed,and the correlation between PEBP4 level in serum,renal tissue and clinical pathological indicators was analyzed.Multiple linear regression(MLR)analysis was adopted to analyze the factors influencing the expression of serum PEBP4 in patients with primary IgAN,while ROC curve was employed to analyze the diagnostic efficacy of serum PEBP4 in IgAN and lesions of renal tubular atrophy/renal interstitial fibrosis,and the SPSS 23 and GraphPad Prism 8.0 software was adopted for data analysis and drawing with taking P<0.05 as the standard of statistically difference.Results:1.The level of serum PEBP4 in patients with primary IgAN was higher than that in the healthy control group(P<0.05).Moreover,the serum PEBP4 level of IgAN patients with impaired renal function was higher than that in IgAN patients with normal renal function,and the serum PEBP4 level of in IgAN patients with normal renal function was higher than that in healthy control group(P<0.05).2.Correlation analysis showed that serum PEBP4 in patients with primary IgAN was negatively correlated with eGFR(r=-0.459),and was positively correlated with creatinine(r=0.331),urea(r=0.407),uric acid(r=0.41),and serum cysC(r=0.45)(P<0.05).Renal PEBP4 score was positively correlated with serum PEBP4,uric acid,Lee’s pathology grades and renal tubular atrophy/renal interstitial fibrosis(T grade)of Oxford classification.(P<0.05).3.Multiple linear regression analysis showed that serum PEBP4 was correlated with T grade(P<0.05).4.With the increase of Lee’s pathology grades in patients with primary IgAN,serum PEBP4 and renal PEBP4 scores gradually increased(P<0.05).5.ROC curve analysis showed that the area under the curve of serum PEBP4 to diagnose IgAN was 0.964,the sensitivity was 95%,the specificity was 90.9%,and the cut-off value was 230.685ng/ml.While,the area under the curve of serum PEBP4 for the diagnosis of T grade of Oxford classification was 0.79,and the sensitivity was 72.7%,the specificity is 75.9%,and the cut-off value is 614.875ng/ml.Conclusion:The expression level of PEBP4 in serum and kidney of patients with primary IgAN is increased.Serum PEBP4 reflects the impairment of renal function in patients with primary IgAN.The expression trend of PEBP4 in serum and renal tissue is consistent.Which plays an auxiliary role in evaluating the degree of pathological damage and renal tubular atrophy/renal interstitial fibrosis in patients with primary IgAN. |
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