IgA肾病患者血清Twist水平与疾病进展关系研究OA

Objective:To investigate the expression levels of Twist in the serum of IgA nephropathy(IgAN)pa-tients and the relationship to disease progression.Methods:We prospectively collected the clinical data and serum samples of 86 IgAN patients and serum Twist concentration of the participants were tested using enzyme-linked im-munosorbent assay(ELISA).Results:IgAN patients had significantly higher serum Twist concentration than the health controls[540.5(323.1-583.2)pg/ml versus 220.2(204.8-257.6)pg/ml,P＜0.001].Serum Twist levels were significantly different among IgAN Lee stages,we observed that the level of Twist increased significantly at IgAN Lee grade Ⅳ-Ⅴ lesions compared with IgAN Lee grade Ⅰ-Ⅱ lesions(P＜0.001).Spearman correlation ana-lyses showed that Twist levels in the serum were inversely correlated with estimated glomerular filtration rates(eGFRs)(r=-0.429,P＜0.001).In addition,positive correlations were found between serum Twist levels and serum creati-nine,blood urea nitrogen,and the proportions of tubulointerstitial fibrosis(r=0.346,P＜0.001;r=0.254,P=0.003;r=0.388,P＜0.001;respectively).There was no significant correlation between Twist expression levels and other clinicopathological factors,including the proteinuria,gender,and age.Kaplan-Meier survival curves showed that higher serum Twist level was associated with shorter renal survival duration.Cox proportional hazard regression model analyses further demonstrated that high serum Twist concentration was an independent prognostic factor for IgAN patients(HR=7.40,P＜0.001).Conclusion:Our study showed that high circulating Twist levels were asso-ciated with adverse kidney disease outcome,suggesting that Twist is a novel biomarker for CKD progression.