Li Jingtao,Lang Xing,Wei Jianxin,et al.Correlation between serum leucine rich alpha-2-glycoprotein 1,neutrophil gelatinase associated apolipoprotein,peroxisome proliferator activated receptor γ coactivator factor-1α and postoperative renal function in children with hydronephrosis[J].Journal of Clinical Pediatric Surgery,,():335-340.[doi:10.3760/cma.j.cn101785-202403060-007]
Correlation between serum leucine rich alpha-2-glycoprotein 1,neutrophil gelatinase associated apolipoprotein,peroxisome proliferator activated receptor γ coactivator factor-1α and postoperative renal function in children with hydronephrosis
- Keywords:
- Hydronephrosis; Differential Renal Function; Kidney Function Tests; Biomarkers; Leu-cine-rich α2 Glycoprotein 1; Neutrophil Gelatinase-associated Lipocalin; Peroxisome Proliferator Activated Receptorγcoactivator-1α; Child
- Abstract:
- Objective To explore the correlation between serum levels of leucine rich alpha-2-glycoprotein 1 (LRG1),neutrophil gelatinase associated apolipoprotein (NGAL),peroxisome proliferator activated receptor γ coactivator factor-1α (PGC-1α) and postoperative differential renal function (DRF) in children with hydronephrosis. Methods From March 2019 to June 2022,124 children with hydronephrosis undergoing pyeloureteroplasty were selected as study subjects.Based upon postoperative DRF at Month 18,they were assigned into two groups of DRF ≥45%(n=72) and DRF<45%(n=52).Enzyme-linked immunosorbent assay (ELISA) was applied for detecting the serum levels of LRG1,NGAL and PGC-1α.Pearsons correlation was utilized for examining the correlation between serum levels of LRG1,NGAL,PGC-1α and renal function.Multivariate Logistic regression was employed for analyzing the factors affecting postoperative DRF<45%.Receiver operating characteristic (ROC) curve was used for evaluateing the serum values of LRG1,NGAL and PGC-1α in postoperative DRF in children with hydronephrosis. Results As compared with DRF≥45% group,DRF<45% group had higher levels of serum LRG1,NGAL,serum creatinine (Scr),blood urea nitrogen (BUN),and β2-microglobulin (β2-MG) and lower levels of PGC-1α and preoperative DRF at affected side (P<0.05).According to Pearsons correlation analysis,LRG1 and NGAL were correlated positively with Scr,BUN and β2-MG (P<0.05).And PGC-1α was correlated negatively with β2-MG,Scr and BUN(P<0.05).Multivariate Logistic regression analysis indicated that serum LRG1,NGAL,preoperative DRF at affected side,Scr,BUN and β2-MG were risk factors affecting postoperative DRF <45% while PGC-1α was a protective factor affecting postoperative DRF<45%(P<0.05).According to ROC curve analysis,area under the curve (AUC) of serum LRG1,NGAL,PGC-1α and their combined evaluation for postoperative DRF <45% was 0.899,0.872,0.878 and 0.982 respectively.And the combination of three factors was superior to each alone (Z three combined evaluation-LRG1=3.148,Z three combined evaluation-NGAL=3.937,Z three combined evaluation-PGC-1α=3.125,P<0.05). Conclusions There are the elevations of serum levels of LRG1 and NGAL and a decline of PGC-1α in hydronephrosis children with postoperative DRF<45%.The combined detection of the three has some evaluation values for postoperative DRF..
References:
[1] Zhang LL,Xu HY,Feng YK,et al.Outcome of renal function after laparoscopic pyeloplasty in children with high-grade hydronephrosis[J].Urol Int,2023,107(7):666-671.DOI:10.1159/000529032.
[2] 李小瑜,郭云飞,黄立渠.分肾功能低于10%肾积水的治疗决策及影响因素研究进展[J].临床小儿外科杂志,2021,20(12):1183-1188.DOI:10.12260/lcxewkzz.2021.12.016. Li XY,Guo YF,Huang LQ.Treatment strategies and influencing factors of hydronephrosis with split renal function <10%[J].J Clin Ped Sur,2021,20(12):1183-1188.DOI:10.12260/lcxewkzz.2021.12.016.
[3] Mao WP,Liu SH,Wang KY,et al.Cystatin C in evaluating renal function in ureteral calculi hydronephrosis in adults[J].Kidney Blood Press Res,2020,45(1):109-121.DOI:10.1159/000504441.
[4] Camilli C,Hoeh AE,De Rossi G,et al.LRG1:an emerging player in disease pathogenesis[J].J Biomed Sci,2022,29(1):6.DOI:10.1186/s12929-022-00790-6.
[5] Marakala V.Neutrophil gelatinase-associated lipocalin (NGAL) in kidney injury-a systematic review[J].Clin Chim Acta,2022,536:135-141.DOI:10.1016/j.cca.2022.08.029.
[6] Fontecha-Barriuso M,Martin-Sanchez D,Martinez-Moreno JM,et al.The role of PGC-1α and mitochondrial biogenesis in kidney diseases[J].Biomolecules,2020,10(2):347-354.DOI:10.3390/biom10020347.
[7] Akta? GE,Sarikaya A.Correction of differential renal function for asymmetric renal area ratio in unilateral hydronephrosis[J].Ann Nucl Med,2015,29(9):816-824.DOI:10.1007/s12149-015-1009-z.
[8] V?rel? S,Omling E,B?rjesson A,et al.Resolution of hydronephrosis after pyeloplasty in children[J].J Pediatr Urol,2021,17(1):102.e1-102.e7.DOI:10.1016/j.jpurol.2020.10.031.
[9] Liu TT,Luo R,Yang Y,et al.LRG1 mitigates renal interstitial fibrosis through alleviating capillary rarefaction and inhibiting inflammatory and pro-fibrotic cytokines[J].Am J Nephrol,2021,52(3):228-238.DOI:10.1159/000514167.
[10] 李亚男,张遵城,董华. 99Tcm-DTPA肾动态显像对单侧肾积水患者健侧肾代偿功能的研究[J].国际放射医学核医学杂志,2020,44(11):691-696. Li YN,Zhang ZC,Dong H.Study of 99Tcm-DTPA renal dynamic imaging on the compensatory capacity of contralateral kidney in patients with unilateral hydronephrosis[J].Int J Radiat Med Nucl Med,2020,44(11):691-696.
[11] Popova A,Vasilvolfa A,Rācenis K,et al.Leucine-rich alpha-2-glycoprotein (LRG-1) as a potential kidney injury marker in kidney transplant recipients[J].Ann Transplant,2022,27(1):936751-936762.DOI:10.12659/AOT.936751.
[12] Hong Q,Zhang L,Fu J,et al.LRG1 promotes diabetic kidney disease progression by enhancing TGF-β-Induced angiogenesis[J].J Am Soc Nephrol,2019,30(4):546-562.DOI:10.1681/ASN.2018060599.
[13] Gavrilovici C,Dusa CP,Iliescu Halitchi C,et al.The role of urinary NGAL in the management of primary vesicoureteral reflux in children[J].Int J Mol Sci,2023,24(9):7904.DOI:10.3390/ijms24097904.
[14] Brewin A,Sriprasad S,Somani B.The use of neutrophil gelatinase-associated lipocalin (NGAL) as a diagnostic and prognostic biomarker in urinary tract obstruction:a systematic review[J].Curr Urol Rep,2022,23(8):155-163.DOI:10.1007/s11934-022-01098-6.
[15] Lee G,Uddin MJ,Kim Y,et al.PGC-1α,a potential therapeutic target against kidney aging[J].Aging Cell,2019,18(5):e12994.DOI:10.1111/acel.12994.
[16] 李晶,陆芹芹,崔艳飞.血清PGC-1α水平在脓毒症致急性肾损伤诊断中的价值[J].实用医学杂志,2023,39(4):471-475.DOI:10.3969/j.issn.1006-5725.2023.04.015. Li J,Lu QQ,Cui YF.Early diagnostic value of serum level of PGC-1α for secondary acute kidney injury in septic patients[J].J Pract Med,2023,39(4):471-475.DOI:10.3969/j.issn.1006-5725.2023.04.015.
Memo
收稿日期:2024-02-14。
基金项目:2022年度河北省医学科学研究课题计划(20220547)
通讯作者:李静涛,Email:c14ncy@163.com