Changes in levels of serum ACA, IL-6, and NGAL in patients with diabetic kidney disease and the clinical significance

SHEN Yiping; SHEN Xuanyu

doi:10.3969/j.issn.1002-266X.2019.04.006

Abstract：Objective To explore the expression and serum anti-cardiolipin antibodies (ACA), interleukin-6 (IL-6) and neutrophil gelatinase-associated lipocalin (NGAL) in patients with diabetic kidney disease (DKD) and its clinical significance. Methods Totally 129 patients with DKD were enrolled. According to the urinary albumin creatinine ratio (ACR), when the estimated glomerular filtration rate (eG FR) was＞ 60 mL/ (min·1. 73 m2), they were divided into the micro albuminuria group (group A, n = 34) and clinical proteinuria group (group B, n = 42); when the estimated glomerular filtration rate (eG FR) was ≤60 mL/ (min·1. 73 m2), they were taken as the chronic renal failure group (group C, n = 53); at the same time, 50 patients with simple diabetes were collected as the group D. The serum ACA (ACA-IgG, ACA-IgA, and ACA-IgM) and IL-6 level were determined by enzyme-linked immunosorbent assay. The serum NGAL level was detected by latex-enhanced immunoturbidimetric assay. The correlations between the indexes and the risk factors for DKD were analyzed by Logistic regression analysis. Results The ACR and CysC levels of the groups A, B, and C were significantly higher than those of group D (both P ＜ 0. 05). The eG FR levels were lower, and the ACR and CysC levels were higher in the groups B and C than in the group A (all P ＜ 0. 05). The eG FR level was lower and the ACR and CysC levels were higher in the group C than in the group B (all P ＜ 0. 05), and the Scr level in group C was higher than that in the groups A, B and D (all P ＜ 0. 05). The levels of serum ACA-IgA, IL-6 and NGAL in the groups A, B, and C were higher than those in the group D, and those in the groups B and C were higher than those in the group A, and the group C was higher than the group B (all P ＜ 0. 05). The ACA-IgG level in group C was higher than that in the groups A, B, and D, and the ACA-IgM levels in the groups A and B were higher than those in the groups C and D (both P ＜ 0. 05). Pearson product moment correlation analysis showed that the different types of ACA were negatively correlated with eG FR (r =-0. 392, -0. 287, -0. 331; P = 0. 037, 0. 034, and 0. 198, respectively), and positively correlated with ACR, CysC (r = 0. 376, 0. 456, 0. 407; 0. 368, 0. 398, 0. 361; P = 0. 046, 0. 009, 0. 042; 0. 034, 0. 013, 0. 071, respectively).IL-6 was negatively correlated with eG FR (r =-363, P ＜ 0. 05), and positively correlated with ACR, CysC, and Scr (r= 0. 491, 0. 467, 0. 375; all P ＜ 0. 05). NGAL was positively correlated with ACR and CysC (r = 0. 527 and 0. 502; both P ＜ 0. 05). The eG FR was the protective factor for DKD (OR = 0. 710, P ＜ 0. 05). ACR, CysC, Scr, ACA-IgA, IL-6, and NGAL were independent risk factors for DKD (OR = 1. 103, 1. 879, 1. 394, 2. 938, 1. 269, and 1. 362; all P ＜0. 05). Conclusions The serum levels of ACR, IL-6, and NGAL in the DKD patients are higher than those in the simple diabetes mellitus patients. With the aggravation of renal injury in DKD patients, the levels of ACR, IL-6, and NGAL increase, which is closely related to the onset of DKD. Early detection of them is of great value in predicting early renal injury in diabetes mellitus patients.