Analysis Of Factors Related To Adiponectin In Serum And Urine And Adiponectin Receptor Of Kidney In Primary Glomerular Disease Patients

ObjectiveTo investigate the different expression of serum ADPN,urine ADPN and AdipoR1 of kidneys in different patients with three pathological types of kidney disease,such as,primary FSGS,IgA nephropathy(FSGS-type) and minimal change neplaropathy,and to analyze the relevant factors of them.Object and methodsWe selected 12 patients with primary FSGS,12 patients with IgA nephropathy(FSGS-type),and 20 patients with glomerular minimal change,who were admitted from May 2008 to August 2008 and diagnosed by renal biopsy in our hospital.Besides collecting their pre-operative blood and urine specimens,we made the records of their general information(Age,sex,height,weight,etc.),urine routine,urine sediment,24-Hour Urine Protein and blood biochemical indicators (serum albumin,serum creatinine,serum urea nitrogen,serum uric acid, blood lipids,etc.).ELISA analysis was performed to detect the concentrations of serum ADPN and urine ADPN.Serum cystatin C was detected by DADE BEHRING BNⅡplasma protein measurement system. Performing the kidney conventional HE,PAS,PAMS,Masson stainings, we observed the pathological changes of the kidney by light microscope, counted the percentage of glomerular sclerosis balls and segmental glomerular sclerosis balls,and measured the renal interstitial fibrosis area by Image-Pro Plus 6.0 image analysis system.Expression and location of AdipoR1 in kidneys were studied by immunohistochemistry.Results1.The concentrations of serum ADPN and urine ADPN among the three groups of subjects with primary FSGS,IgA nephropathy (FSGS-type) and glomerular minimal change were no significant difference(p＞0.05).2.AdipoR1 expression was detected in renal of all subjects, AdipoR1 is mainly expressed in tubular epithelial cells,and most obviously in medullary loop tubular epithelial cells.Mesangial cells and endothelial cells can also be seen a small amount of expression of AdipoR1,and mesenchymal cells and infiltrating lymphocytes have no expression.3.AdipoR1 expression(mean optical density) in human kidney among the three groups of subjects with primary FSGS,IgA nephropathy (FSGS-type) and glomerular minimal change has no statistical difference (P＞0.05).4.The Spearman correlation analysis of overall data has found that the concentrations of serum ADPN and urine ADPN have positive correlation with 24hUTP,Scr,BUN,serum CYSC and TC,TG,LDL separately,and negative correlation with serum ALB separately, meanwhile serum ADPN is positively correlated with urine ADPN.Renal AdipoR1 is negatively correlated with 24hUTP,serum ADPN,urine ADPN,serum CYSC,TC,TG and LDL,and positively correlated with serum ALB.Serum ADPN,urine ADPN and renal AdipoR1 were not significantly related to the percentage of glomerular sclerosis balls, segmental glomerular sclerosis balls,eGFR,and the degree of interstitial fibrosis.Multiple linear regression analysis showed that 24hUTP is the independent influencing factor of the concentrations of serum ADPN or urine ADPN,and positively correlated with serum ADPN or urine ADPN. Whereas urine ADPN is the independent influencing factor of renal AdipoR1,and negative correlated with AdipoR1.5.We divided the subjects into nephrotic syndrome and chronic nephritis groups,two-independent-samples U test analysis showed that serum ADPN and urine ADPN of nephrotic syndrome were significantly higher than that of chronic nephritis group.Spearman correlation analysis of each group found that concentrations of serum ADPN and urine ADPN were positively correlated with 24hUTP,serum ADPN was positively related to urine ADPN in each group,and serum ADPN has a positive correlation with TG concentration in patients with chronic nephritis. Renal AdipoR1 is negatively correlated with 24hUTP,serum ADPN and urine ADPN in both groups.Multiple linear regression analysis showed that 24hUTP is the independent influencing factor of the concentrations of serum ADPN or urine ADPN,and positively correlated with serum ADPN or urine ADPN.Urine ADPN is independent influencing factor of renal AdipoR1,and negative correlated with AdipoR1.Conclusion1.The concentrations of serum ADPN and urine ADPN and renal expression of adipoR1 among the patients with Primary FSGS,IgA nephropathy(FSGS-type) and glomerular minimal change have no significant difference.2.Serum and urine concentrations of ADPN are positively correlated with 24hUTP,whereas not significantly related to the percentage of glomerular sclerosis balls and segmental glomerular sclerosis balls,eGFR, and the degree of interstitial fibrosis,suggesting that adiponectin is closely related to prompted glomerular filtration barrier injury.However, the role of adiponectin in the process of glomerular sclerosis and interstitial fibrosis still merits further investigated clinically and experimentally.3.AdipoR1 is widely expressed in renal tissue,negatively correlated with the concentrations of urine ADPN,suggesting that adipoR1 may play an important role in the occurrence and development of kidney disease,and urine ADPN may downregulate the renal expression of adipoR1.4.The serum and urine concentrations of ADPN of nephrotic syndrome were higher than that of chronic nephritis group,thus we inferred that the increasing serum levels of ADPN of nephrotic syndrome group might be a compensatory response to the metabolism disorder of proteinuria,lipid and other biochemical abnormalities of renal toxicity,meanwhile also a compensation for urine ADPN lost.