原发性IgA肾病患者血清25-羟基维生素D水平与临床指标及肾脏病理的相关性研究  

The Correlation Between Serum 25-Hydroxyvitamin D Levels and Clinical Indicators,Renal Pathology in Patients with Primary IgA Nephropathy

作　　者：李少辉 杨瑞霞[2] 韩梅 LI Shaohui;YANG Ruixia;HAN Mei(Department of Laboratory Medicine,Nanjing Meishan Hospital,Nanjing 210039,China;Department of Laboratory Medicine,Jiangsu Province Hospital,Nanjing 210029,China)

机构地区：[1]南京梅山医院检验科,江苏南京210039 [2]江苏省人民医院检验学部,江苏南京210029

出　　处：《标记免疫分析与临床》2025年第2期363-368,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨血清25-羟基维生素D[25(OH)D]水平与原发性IgA肾病患者临床指标及肾脏病理的相关性。方法回顾性收集2019年6月至2024年6月在江苏省人民医院就诊的196例原发性IgA肾病患者的25(OH)D、肾功能相关指标结果、一般临床资料及肾活检病理结果,分析不同25(OH)D水平和IgA肾病患者肾功能相关指标及肾活检病理结果的相关性。结果196例IgA肾病患者,维生素D缺乏者120例(61.22%),维生素D不足者76例(38.78%)。维生素D缺乏组的尿蛋白、尿微量白蛋白、24h尿蛋白、24h尿微量白蛋白、尿轻链LAM水平均显著高于维生素D不足组,差异有统计学意义(P<0.05);维生素D缺乏组的肾小球滤过率水平显著低于维生素D不足组,差异有统计学意义(P<0.05)。Spearman相关性分析显示,25(OH)D与尿蛋白(r=-0.309)、尿微量白蛋白(r=-0.304)、24h尿蛋白(r=-0.308)、24h尿微量白蛋白(r=-0.308)、尿轻链LAM(r=-0.425)呈负相关,与肾小球滤过率(r=0.159)呈弱正相关,差异有统计学意义(P<0.05)。以25(OH)D为应变量,其他各项指标为自变量,进行多元线性回归分析,尿素、肌酐、24h尿肌酐、肾小球滤过率、尿轻链LAM、尿轻链KAP与25(OH)D独立相关,β分别为0.318、-0.323、0.157、-0.241、-0.934、0.899。结论25(OH)D水平与IgA肾病患者的临床指标及病理严重程度密切相关。提示临床医生应关注其维生素D水平,必要时为患者补充维生素D。Objective To investigate the correlation between serum 25-hydroxyvitamin D[25(OH)D]levels and clinical indicator,renal pathology in patients with primary IgA nephropathy.Methods A total of 196 primary IgA nephropathy in Jiangsu Province Hospital from June,2019 to June,2024 were selected retrospectively for the study.Their serum 25(OH)D levels,renal function related indicators,general clinical data,and renal biopsy pathology were collected and their correlations were analyzed.Results Among 196 patients with IgA nephropathy,the number of people with vitamin D deficiency was 120(61.22%),and the number of people with vitamin D insufficient was 76(38.78%).The levels of urinary protein,urinary microalbumin,24-hour urinary protein,24-hour urinary microalbumin,and urinary light chain LAM in the vitamin D deficiency group were significantly higher than those in the vitamin D insufficient group(P<0.05).The glomerular filtration rate level in the vitamin D deficiency group was significantly lower than that in the vitamin D insufficient group(P<0.05).Spearman correlation analysis showed that 25(OH)D was negatively correlated with urinary protein(r=-0.309),urinary microalbumin(r=-0.304),24-hour urinary protein(r=-0.308),24-hour urinary microalbumin(r=-0.308),and urinary light chain LAM(r=-0.425),while weakly positively correlated with glomerular filtration rate(r=0.159)(P<0.05).Taking 25(OH)D as the dependent variable and other indexes as independent variables,multiple linear regression analysis was performed.Urea,creatinine,24-hour urine creatinine,glomerular filtration rate,urinary light chain LAM,and urinary light chain KAP were independently correlated with 25(OH)D(βvalues were 0.318,-0.323,0.157,-0.241,-0.934,and 0.899 respectively).Conclusion The levels of 25(OH)D are closely related to clinical indicators and pathological severity in patients with IgA nephropathy.Clinicians should pay attentions to patients’vitamin D levels,supplementing vitamin D to patients as necessary.

关 键 词：IGA肾病 25-羟基维生素D 维生素D缺乏 临床指标 肾脏病理 

分 类 号：R692[医药卫生—泌尿科学] R591.44[医药卫生—外科学]