sPLA2-IB Level Correlates with Hyperlipidemia and the Prognosis of Idiopathic Membranous Nephropathy
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40(4):683-690,2020
683
sPLA2-IB Level Correlates with Hyperlipidemia and the Prognosis of Idiopathic Membranous Nephropathy* Li-yan YANG1, Yuan-sheng WU3, Bin-bin DAI1, Song-hua LIN1, Hong CHEN4, Guo-ping LI4, Xuan TAO4, Jian-xin WAN1#, Yang-bin PAN1, 2# 1 Department of Nephrology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China 2 Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, China 3 Department of Cardiology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China 4 Department of Pathology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China Huazhong University of Science and Technology 2020
Summary: Recent studies suggested that serum secretory phospholipase A2 group IB (sPLA2-IB) was increased in idiopathic membranous nephropathy (IMN). However, the interference of high lipemia on the sPLA2-IB levels was not taken into account in these studies. The present study aimed to investigate the correlation between sPLA2-IB and lipemia, and the clinical merit of sPLA2IB in the prediction of prognosis of IMN patients. A total of 64 IMN patients, 39 immunoglobulin A nephropathy (IgAN) patients and 64 healthy controls were included in the study. The levels of serum sPLA2-IB, lipemia and proteinuria were measured. Fifty IMN patients were followed up for 6 months. Pathologic stages were made for all IgAN and IMN patients. The results showed that the levels of serum sPLA2-IB, cholesterol and low-density lipoprotein cholesterol (LDL-C) were significantly higher, and the levels of albumin and high-density lipoprotein cholesterol (HDL-C) were significantly lower in IMN patients than in healthy controls and IgAN patients. Serum sPLA2IB levels were also found to be higher in IgAN patients than in heathy controls, but the association of serum sPLA2-IB levels with proteinuria, cholesterol and albumin was only shown in IMN patients. Antibody against M-type receptor for secretory phospholipase A2 (PLA2R1) was positive in 81.3% IMN patients. Glomerular sPLA2-IB deposition, podocyte fused processes, and density deposition on thickened basement membrane were seen in IMN patients, but not in IgAN patients. IMN patients with lower sPLA2-IB and proteinuria levels were found to have better outcome after the 6-month follow-up. In IMN patients, sPLA2-IB levels were significantly increased in both serum and renal tissue. In conclusion, serum sPLA2-IB was closely correlated with proteinuria, albumin and cholesterol, and IMN patients with lower sPLA2-IB levels were more likely to achieve a better outcome. Key words: sPLA2-IB; lipemia; idiopathic membranous nephropathy; prognosis
Idiopathic membranous nephropathy (IMN) is a relatively common primary glomerular disease. About one-third of IMN patients progress to end-stage renal disease (ESRD)[1, 2]. The incidence of IMN has been on the rise and it has become the first leading pathological type in primary glomerular disease in place of immunoglobulin A nephropathy (IgAN)[3,
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