Clinical Value of ABCB1 and PAI-1 Gene Polymorphisms in Predicting Glucocorticoid-induced Adverse Reactions in Nephrotic Syndrome Patients  

作　　者：Ya-ling ZHAI Shuai-gang SUN Wen-hui ZHANG Hui-juan TIAN Zhan-zheng ZHAO 

机构地区：[1]Department of Nephrology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000,China [2]The Renal Research Institution of Zhengzhou University,Zhengzhou,450000,China

出　　处：《Current Medical Science》2024年第5期923-931,共9页当代医学科学（英文）

基　　金：supported by the General Project of Henan Natural Science Foundation(No.232300420034);the National Natural Science Foundation of China for the Youth(No.81600555);the General Project of China Postdoctoral Science Foundation(No.2018M640684)。

摘　　要：Objective Glucocorticoid(GC)-induced adverse reactions(ARs)have been extensively studied due to their potential impact on patients’health.This study aimed to examine the potential correlation between two polymorphisms[adenosine triphosphate-binding cassette B1(ABCB1)C3435T and plasminogen activator inhibitor-1(PAI-1)4G/5G]and various GC-induced ARs in nephrotic syndrome(NS)patients.Methods In this study,513 NS patients who underwent GC treatment were enrolled.Then,the patients were divided into two groups based on ABCB1 C3435T and PAI-14G/5G genotyping,and intergroup comparisons of clinicopathological data and GC-induced ARs were performed.Univariate and multivariate logistic analyses were subsequently conducted to identify potential risk factors for GC-induced ARs,and a nomogram was subsequently established and validated via the area under the ROC curve(AUC),calibration curve and decision curve analysis(DCA).Results We identified ABCB1 C3435T as an independent risk factor for the development of steroid-associated avascular necrosis of the femoral head(SANFH)(OR:2.191,95%CI:1.258–3.813,P=0.006)but not as a risk factor for the occurrence of steroid diabetes mellitus(S-DM).On the other hand,PAI-14G/5G was identified as an independent risk factor for the development of both SANFH(OR:2.198,95%CI:1.267–3.812,P=0.005)and S-DM(OR:2.080,95%CI:1.166–3.711,P=0.013).Notably,no significant correlation was found between the two gene polymorphisms and other GC-induced ARs.In addition,two nomograms were established and validated to demonstrate strong calibration capability and clinical utility.Conclusion Assessing ABCB1 C3435T and PAI-14G/5G before steroid treatment in NS patients could be useful for identifying patients at a high risk of developing SANFH and S-DM.

关 键 词：adenosine triphosphate-binding cassette B1 nephrotic syndrome plasminogen activator inhibitor-1 steroid-associated avascular necrosis of the femoral head steroid diabetes 

分 类 号：R692[医药卫生—泌尿科学]