Correlation of peripheral blood monocyte count and serum anti-phospholipase A2 receptor antibody in patients with nephrotic syndrome

doi:10.3969/j.issn.1673-8640.2023.07.006

Abstract

Abstract:

Objective To investigate the related factors and clinical role of serum anti-phospholipase A2 receptor antibody（PLA2R-Ab）in patients with nephrotic syndrome. Methods A total of 108 patients for the first time diagnosed with nephrotic syndrome and determined positive for serum PLA2R-Ab in the First Affiliated Hospital of Soochow University from August 2019 to September 2021 were enrolled，and their clinical data and laboratory determination results，including 51 items such as biochemistry，immunity，routine blood test and blood coagulation，were collected. Linear regression analysis was used to analyze the relationship between each index and serum PLA2R-Ab level. According to serum PLA2R-Ab level，the patients were classified into low-level （≤60 RU/mL）group and high-level（>60 RU/mL）group. Logistic regression analysis was used to evaluate the influencing factors of high-level PLA2R-Ab. Results PLA2R-Ab was positively correlated with creatine kinase and fibrinogen（β values were 0.001 and 0.057，respectively），and it was negatively correlated with blood glucose，aspartate aminotransferase，potassium and monocyte count（β values were -0.084，-0.007，-0.247 and -0.662，respectively）. According to the quartiles of monocyte count，all the patients were classified into 4 groups，≤0.35×10⁹/L group（28 cases），（0.36-0.45）×10⁹/L group（26 cases），（0.46-0.55）×10⁹/L group（27 cases） and >0.55×10⁹/L group（27 cases）. There was no statistical significance in serum PLA2R-Ab levels among the 4 groups（P>0.05）. After adjusting confounding factors，such as creatine kinase，blood glucose，aspartate aminotransferase，fibrinogen and potassium，compared with monocyte count ≤0.35×10⁹/L group，lgPLA2R-Ab levels in the other 3 groups were decreased by 0.190，0.117 and 0.281（β values were -0.190，-0.117 and -0.281，P=0.008），and serum lgPLA2R-Ab levels were decreased by 1.55，1.31 and 1.91 RU/mL，respectively. Creatine kinase could increase the risk of high-level PLA2R-Ab [odds ratio（OR）=1.012，95% confidence interval（CI）1.003-1.021，P=0.007]，while monocyte count could decrease the risk of serum high-level PLA2R-Ab in patients with nephrotic syndrome（OR=0.047，95%CI 0.004-0.602，P=0.019）. Conclusions The correlation between peripheral blood monocyte count and serum PLA2R-Ab suggests that peripheral blood monocyte may be involved in the pathogenesis of nephrotic syndrome，especially membranous nephropathy.

Key words: Phospholipase A2 receptor, Monocyte count, Nephrotic syndrome, Membranous nephropathy

CLC Number:

R446.62

TANG Qingqin, QIAO Longwei, YIN Jingping, ZHANG Sheng, FENG Bin, LIANG Yuting. Correlation of peripheral blood monocyte count and serum anti-phospholipase A2 receptor antibody in patients with nephrotic syndrome[J]. Laboratory Medicine, 2023, 38(7): 647-652.

Figures/Tables 5

References 21

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自变量	单因素回归分析		多因素回归分析
自变量	β值（95%CI^①）	P值	β值（95%CI^①）	标准化系数	P值
年龄	0.006（0.002~0.011）	0.008
肌酸激酶	0.001 （0~0.002）	0.009	0.001（0~0.002）	0.212	0.017
血糖	-0.024 （-0.094~0.047）	0.508	-0.084（-0.152~-0.016）	-0.228	0.016
丙氨酸氨基转移酶	-0.005 （-0.009~-0.001）	0.009
天门冬氨酸氨基转移酶	-0.005 （-0.011~0.002）	0.150	-0.007（-0.013~-0.002）	-0.223	0.012
钠	0.037 （0.003~0.072）	0.035
钾	-0.206 （-0.366~-0.047）	0.012	-0.247（-0.396~-0.098）	-0.289	0.001
纤维蛋白原	0.034 （-0.015~0.082）	0.172	0.057（0.01~0.103）	0.222	0.018
单核细胞计数	-0.402 （-0.807~0.002）	0.051	-0.662（-1.05~-0.274）	-0.310	0.001
白细胞计数	-0.038（-0.073~-0.004）	0.029

自变量	单因素回归分析		多因素回归分析
自变量	β值（95%CI^①）	P值	β值（95%CI^①）	标准化系数	P值
年龄	0.006（0.002~0.011）	0.008
肌酸激酶	0.001 （0~0.002）	0.009	0.001（0~0.002）	0.212	0.017
血糖	-0.024 （-0.094~0.047）	0.508	-0.084（-0.152~-0.016）	-0.228	0.016
丙氨酸氨基转移酶	-0.005 （-0.009~-0.001）	0.009
天门冬氨酸氨基转移酶	-0.005 （-0.011~0.002）	0.150	-0.007（-0.013~-0.002）	-0.223	0.012
钠	0.037 （0.003~0.072）	0.035
钾	-0.206 （-0.366~-0.047）	0.012	-0.247（-0.396~-0.098）	-0.289	0.001
纤维蛋白原	0.034 （-0.015~0.082）	0.172	0.057（0.01~0.103）	0.222	0.018
单核细胞计数	-0.402 （-0.807~0.002）	0.051	-0.662（-1.05~-0.274）	-0.310	0.001
白细胞计数	-0.038（-0.073~-0.004）	0.029

变量	β值（95%CI）	P值
模型1^①		0.184
≤0.35×10⁹/L组	参照
（0.36~0.45）×10⁹/L组	-0.185（-0.384~0.014）
（0.46~0.55）×10⁹/L组	-0.058（-0.255~0.139）
>0.55×10⁹/L组	-0.172（-0.370~0.025）
模型2^②		0.052
≤0.35×10⁹/L组	参照
（0.36~0.45）×10⁹/L组	-0.166（-0.358~0.026）
（0.46~0.55）×10⁹/L组	-0.074（-0.265~0.117）
>0.55×10⁹/L组	-0.219（-0.412~-0.026）
模型3^③		0.008
≤0.35×10⁹/L组	参照
（0.36~0.45）×10⁹/L组	-0.190（-0.373~-0.007）
（0.46~0.55）×10⁹/L组	-0.117（-0.301~0.066）
>0.55×10⁹/L组	-0.281（-0.468~-0.093）

变量	β值（95%CI）	P值
模型1^①		0.184
≤0.35×10⁹/L组	参照
（0.36~0.45）×10⁹/L组	-0.185（-0.384~0.014）
（0.46~0.55）×10⁹/L组	-0.058（-0.255~0.139）
>0.55×10⁹/L组	-0.172（-0.370~0.025）
模型2^②		0.052
≤0.35×10⁹/L组	参照
（0.36~0.45）×10⁹/L组	-0.166（-0.358~0.026）
（0.46~0.55）×10⁹/L组	-0.074（-0.265~0.117）
>0.55×10⁹/L组	-0.219（-0.412~-0.026）
模型3^③		0.008
≤0.35×10⁹/L组	参照
（0.36~0.45）×10⁹/L组	-0.190（-0.373~-0.007）
（0.46~0.55）×10⁹/L组	-0.117（-0.301~0.066）
>0.55×10⁹/L组	-0.281（-0.468~-0.093）

自变量	单因素分析		多因素分析
自变量	OR值（95%CI）	P值	OR值（95%CI）	P值
肌酸激酶	1.010（1.002~1.019）	0.014	1.012（1.003~1.021）	0.007
血糖	0.839（0.567~1.243）	0.382
天门冬氨酸氨基转移酶	0.977（0.943~1.012）	0.189	0.960（0.920~1.002）	0.064
血钾	0.683（0.281~1.660）	0.400
纤维蛋白原	1.127（0.853~1.488）	0.399
单核细胞计数	0.082（0.008~0.848）	0.036	0.047（0.004~0.602）	0.019