实用医学杂志2025，Vol.41Issue(21)：3322-3329,8.DOI:10.3969/j.issn.1006-5725.2025.21.004
残余胆固醇与IgA肾病患者临床病理特征的关系
The relationship between remnant cholesterol and clinicopathological characteristics in patients with IgA nephropathy
摘要
Abstract
Objective To investigate the association between remnant cholesterol(RC)and clinicopatho-logical parameters in patients with IgA nephropathy(IgAN),and to assess the clinical significance of RC in the progression and management of IgAN.Methods A total of 366 patients with a biopsy-proven diagnosis of IgAN were consecutively enrolled in this retrospective study.Clinical and pathological data were systematically collected,and RC was calculated.Participants were stratified into two groups according to the median RC value.Baseline characteristics were compared between these groups.The association between RC and the presence of tubular atrophy/interstitial fibrosis(T1/2 lesions)in IgAN patients was evaluated using binary logistic regression,restricted cubic spline(RCS)analysis,receiver operating characteristic(ROC)curve analysis,and subgroup analyses.Results In this study,the high-RC group exhibited significantly higher levels of body weight,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),triglycerides(TG),total cholesterol(TC),non-high-density lipoprotein cholesterol(non-HDL-C),uric acid(UA),complement 3(C3),and 24-hour urinary protein,as well as lower levels of albumin(ALB),estimated glomerular filtration rate(eGFR),and high-density lipoprotein cholesterol(HDL-C),compared to the low-RC group.Patients with T1/2 lesions showed elevated levels of SBP,DBP,TC,non-HDL-C,UA,24-hour urinary protein,and RC,along with reduced levels of hemoglobin(Hb),ALB,and eGFR,relative to those with T0 lesions.Multivariate logistic regression analysis indicated that increased RC and decreased eGFR were independent risk factors for the presence of T1/2 lesions in patients with IgAN(P<0.05).RCS analysis revealed a linear association between RC and the likelihood of T1/2 lesions(non-linearity P=0.343).The area under the receiver operating characteristic curve(AUC)for a predictive model incorporating RC,Hb,UA,and eGFR was 0.833,indicating good discriminative ability.Subgroup analyses consistently demonstrated a significant associa-tion between RC and the risk of T1/2 lesions,with no statistically significant interactions observed across subgroups(all P>0.05).Conclusion RC can reflect the severity of both clinical and pathological manifestations in patients with IgAN,making RC monitoring a potentially valuable tool for assessing disease progression in clinical practice.关键词
肾小球肾炎/IgA/残余胆固醇/肾小管/间质纤维化Key words
glomerulonephritis/immunoglobulin A/remnant cholesterol/kidney tubules/intersti-tial fibrosis分类
临床医学引用本文复制引用
李硕,张云鹏,黄艳,王京,白杨,段书众..残余胆固醇与IgA肾病患者临床病理特征的关系[J].实用医学杂志,2025,41(21):3322-3329,8.基金项目
河北省医学科学研究课题(编号:20242090) （编号:20242090）
