The Expression Of AOPPs And Its Correlation With The Degree Of Renal Interstitial Fibrosis In Patients With IgA Nephropathy

Objective The purpose of this study is to detect the indexes which can reflect the level of oxidative stress and the degree of renal interstitial fibrosis in serum of patients with Ig A nephropathy(Ig AN); and to explore the correlation between oxidative stress and renal interstitial fibrosis.Methods(1)78 patients diagnosed as primary Ig AN through renal biopsy in renal department of General Hospital of Ningxia Medical University from 2013 January to 2014 December were enrolled as research subjects; At the same time, 30 cases of normal people who take the health examination in our hospital medical center were enrolled as control sugjects;(2)Collecting patients' general clinical data and results of correlated laboratory examinations. Using visible light spectrophotometer methods to detect serum malondialdehyde(MDA), superoxide dismutase(SOD), catalase(CAT) and glutathione peroxidase(GSH-Px) levels, and using enzyme linked immunosorbent assay(ELISA) to detect serum advanced oxidation protein products(AOPPs), transforming growth factor beta 1(TGF-?1), monocyte chemotactic protein 1(MCP-1), transforming growth factor alpha(TGF-?), interleukin 6(IL-6) and hypoxia inducible factor 1 alpha(HIF-1?) levels;(3)Serum oxidatives stress markers and renal interstitial fibrosis indexes were compared between groups, and to further explore the correlation between oxidative stress and interstitial fibrosis in Ig AN patients.Results(1)78 Ig AN patients were further divided into T0 group, T1 group and T2 group according to the degree of renal tubular atrophy/ renal interstitial fibrosis(T0/T1/T2) based on the 2009 Oxford pathological classification of Ig AN. 30 patients(16 men and 14 women) in T0 group with a mean age of 32.67±8.61 years. 26 patients(17 men and 9 women) in T1 group with a mean age of 31.88±9.77 years. 22 patients(10 men and 12 women) in T2 group with a mean age of 32.27±13.64 years. 30 cases(15 men and 15 women) in control group with a mean age of 38.80±10.29 years. There were no significant different in age and gender between groups(P>0.05). There were significant different in MAP between groups(P<0.05).(2)Compared with the control group, HB, TP, ALB, e GFR were lower and Scr, UA, 24 urine protein were higher in Ig AN patients(P<0.05). With the increase of degree of renal interstitial fibrosis, HB, TP, ALB, e GFR decreased gradually and Scr, UA and 24 hour urine protein increased gradually.(3) Compared with the control group, serum AOPPs, MDA were higher and SOD, CAT, GSH-Px were lower in Ig AN patients( P<0.05).With the increase of degree of renal interstitial fibrosis, AOPPs, MDA increased gradually and SOD, CAT, GSH-Px decreased gradually.(4) AOPPs, MDA, SOD, CAT and GSH-Px were related with the traditional risk factors of Ig AN.(5) Compared with the control group, serum TGF-?1?MCP-1?TGF-??IL-6?HIF-1? were higher in Ig AN patients( P<0.05).With the increase of degree of renal interstitial fibrosis, TGF-?1 increased in T0 and T1 groups, then decreased in T2 group and MCP-1?TGF-??IL-6?HIF-1? increased gradually in Ig AN patients.(6) In Ig AN patients, TGF-?1?MCP-1?TGF-??IL-6?HIF-1? were positively related to Scr and UA, and were negatively related to TP?Alb and e GFR(P<0.05);(7)In Ig AN patients, serum AOPPs and MDA were positively related to TGF-?1? MCP-1? TGF-??IL-6? HIF-1?, and SOD?CAT?GSH-Px were negatively related to TGF-?1? MCP-1? TGF-??IL-6? HIF-1?respectly(P<0.05);(8)Multiple stepwise regression model analysis showed the degree of renal interstitial fibrosis was positively correlated with AOPPs(?=0.285,P=0.001),and negatively correlated with CAT(?=-0.346,P=0.000) and GSH-Px(?=-0.303,P=0.000).Conclusions The level of oxidative stress was increased in Ig AN patients, and it may cause or aggravate the degree of renal interstitial fibrosis. Oxidative stress was related with the traditional factors of Ig AN.