Study On Clinical Correlation Between Serum Uric Acid And Lupus Nephritis

Objective:By retrospectively analyzing the clinical,laboratory indicators and pathological features of first-episode patients with simple systemic lupus erythematosus(SLE)and patients with lupus nephritis(LN)with normal renal function,to explore the effect of serum uric acid on lupus nephritis in SLE patients Influence and risk factors of hyperuricemia in LN patients with normal renal function,so as to demonstrate the clinical relevance of serum uric acid and LN.Methods:A total of 181 SLE patients with normal renal function who were hospitalized for the first time in the Department of Rheumatology of the First Hospital of Jilin University and the Department of Nephrology of the Lequn Campus of the First Hospital of Jilin University between January 1,2013 and October 31,2022 were selected.According to the diagnostic criteria for SLE promulgated by the American College of Rheumatology(ACR)in 1997,97 cases were diagnosed as LN by renal biopsy.The first group of research was divided into a simple SLE group of 84 cases and a LN group of 97 cases according to whether the kidneys were involved,and analyzed the effect of blood uric acid on LN in simple SLE patients.In the second group of research,97 LN patients were divided into a normal uric acid group of 46 cases and a hyperuric acid group of 51 cases according to the blood uric acid level,and the risk factors of LN hyperuricemia were discussed.The above-mentioned patients had a complete medical history,clinical manifestations,laboratory test results and renal biopsy pathological results.Statistical methods were used to analyze the clinical manifestations,laboratory test results and pathological characteristics of the two groups of researches,to explore the effects of blood uric acid on renal involvement in SLE patients and the risk factors for hyperuricemia in LN patients with normal renal function,and then multivariate Logistic Regression analysis identified independent risk factors and plotted Receiver Operating Characteristic curve(ROC)to describe predictive power.Result:According to the inclusion and exclusion criteria,a total of 181 SLE patients with normal renal function were enrolled,including 84 cases of pure SLE and 97 cases of LN.The 97 LN patients included 46 normal uric acid patients and 51 hyperuric acid patients.1、Study1:The scores of serum uric acid,NLR,TG,TC,LDL and SLEDAI in LN group were higher,and the incidence of serositis,anemia,leukocyte urine and erythrocyte urine in LN group were higher,and the difference was statistically significant compared with SLE group(P<0.05).The values of ALB,GLO,IgG and complement C3 were lower in the LN group,and the differences were statistically significant compared with the SLE group(P<0.05).2、Study1:Univariate analysis between SLE group and LN group showed that statistically significant factors were included as independent variables in multivariate Logistic regression analysis.It was suggested that serum uric acid,SLEDAI score and LDL were independent risk factors for LN in simple SLE,and ALB was an independent protective factor for LN in simple SLE.Drawing the ROC curve of serum uric acid,ALB,LDL and SLEDAI scores showed that the area under the serum uric acid curve was 0.762,the critical value was 330.5umol/L,and the sensitivity was 65.9%.the specificity was 75.3%.The area under the LDL curve was 0.843,the critical value was2.37mmol/L,the sensitivity was 76.9%,and the specificity was 83.6%.The area under the SLEDAI score curve was 0.813,the critical value was 15.5 points,the sensitivity was 67%,and the specificity was 86.3%.The area under the ALB curve was 0.815,the critical value was 28.85g/L,the sensitivity was 68.1%,and the specificity was 90.4%.3、Study2:The HDL value in the LN high uric acid group was lower,and the difference was statistically significant compared with the normal uric acid group(P<0.05).In the LN hyperuricemia group,the incidence of serositis,increased cells in capillaries,and hyaline thrombus were higher,and the TG,urine protein quantification,SLEDAI score,AI and CI values were higher,and the difference was statistically significant compared with the normal uric acid group(P<0.05).4、Study2:Univariate analysis between LN normal uric acid group and hyperuric acid group showed that TG and AI were independent risk factors of LN hyperuricemia by multivariate Logistic regression analysis.ROC curve showed that the area under TG curve was 0.763,critical value was 1.65mmol/L,the sensitivity was67.3%,the specificity was 77.3%.The area under the AI curve was 0.689,the critical value was 8.5points,the sensitivity was 36.7%,and the specificity was 97.7%.Conclution:1、Patients with LN with normal renal function are prone to hyperuricemia,hyperlipidemia,high SLEDAI score,high NLR value,serositis,anemia,leukocyturia and hematuria,while ALB,GLO,IgG and complement C3 are low,among which serum uric acid,SLEDAI Score and LDL are independent risk factors for renal damage in patients with pure SLE;ALB is an independent protective factor for renal damage in patients with pure SLE.2、Patients with normal renal function and LN hyperuricemia are prone to high TG,high SLEDAI score,high AI value,high CI value,massive proteinuria,serositis,capillary intracellular hypercellularity and hyaline thrombus,but low HDL,among which TG and AI are independent risk factors for the occurrence of LN hyperuricemia.3、Combined with the research results of the two groups,it is suggested that serum uric acid and LN contact closely and influence each other.