| Objective: To analysis the factors related to vitamin D binding protein(VDBP)and investigate its association to remission in patients with idiopathic membranous nephropathy.Methods: Patients who pathological diagnosed with membranous nephropathy in the Department of Nephrology of The First Affiliated Hospital of Guangxi Medical University during June 1,2013 to August 31,2015.There were 58 IMN patients and 21 healthy people were included in our study.The serum VDBP levels of two groups were measured by ELISA.We collected serum 25-hydroxyvitamin D [25(OH)D] levels and calculated the bioavailable25(OH)D by VDBP and serum albumin in IMN patients.The biochemical data and pathological data and treatment were collected in IMN group.We collected clinical data at the 12 th month to assess remission status.We compared the differences between IMN group and control group and used multiple linear regression to analysis the factors affect VDBP levels in IMN patients.We separated IMN patients in remission group and non-remission group at the 12 thmonth and compared serum 25(OH)D and bioavailable 25(OH)D in two groups.Results: There were 35 males(60.3%)and 23 females(39.6%)in IMN patients of our study,the average age were 48.45±14.63 years old and average eGFR were 75.22±21.26 ml/(min﹒1.73m2).There were 29 patients(50.0%)were nephrotic syndrome and 12 patients(20.7%)were hypertension.There were 50 patients in serum 25(OH)D ≤ 37nmol/L and 8 patients in37-75nmol/L.The hemoglobin,leukocyte,uric acid,estimated glomerular filtration rate,total cholesterol,triglyceride,low density lipoprotein were significant statistical differences between IMN group and control group.The serum VDBP levels were 1018.23(611.09,1329.66)μg/ml in IMN group and 643.17(357.50,1078.17)μg/ml in control group,the levels of VDBP in IMN group were higher than control group and had statistical differences significantly.We analyzed the related factors of serum VDBP levels and found erythrocyte(r=0.265,P=0.044),estimated glomerular filtration rate(r=-0.281,P=0.032),total cholesterol(r=0.342,P=0.009)were associated with VDBP levels in IMN patients.In multiple linear regression,we found estimated glomerular filtration rate was one of the associated factor to serum VDBP levels(P=0.023).There were statistical differences in three different groups of estimated glomerular filtration rate(P=0.038).After 12 months follow-up,there were 26 IMN patients achieved remission.Among them,there were 15 patients achieved partial remission and 11 patients achieved complete remission.We compared remission group and non-remission group in 12 months follow-up and found the patients with higher level of serum 25(OH)D(Z=-1.979,P=0.048)and bioavailable25(OH)D(Z=-2.314,P=0.021)at baseline were apt to achieve remission.Conclusion: The serum VDBP levels of IMN patients were higher than the normal group.The estimated glomerular filtration rate was one of the independent factors to affect VDBP levels.The level of 25(OH)D and bioavailable 25(OH)D might related to remission in patients with IMN. |
