Serum 25(OH)D Level And Correlation Analyof Clinical And Renal Pathology In Idiopathic Membranous Nephropathy

Objective: Through the analysis of patients with idiopathic membranous nephropathy(IMN)in the serum 25(OH)D levels and the correlation of clinical and renal pathological,further discussion the significance of 25(OH)D in the pathogenesis of membranous nephropathy.Methods: The data of 60 cases of healthy adults and 194 IMN patients before the first renal biopsy were collected,including gender,age,nationality and 25(OH)D levels,biochemical indicators and immunological parameters.The pathological indexes and kidney pathological staging of the first renal puncture in IMN patients were recorded too.According to the level of 25(OH)D,IMN patients were divided into deficiency group and insufficient group.The SPSS19.0 statistical software was used to analyze the differences of 25(OH)D levels between healthy and IMN groups;the difference of clinical index levels between the deficiency group and insufficient group;and the correlation between 25(OH)D and Clinical and pathological indicators.Result:1.Comparison of general data and 25(OH)D between healthy and IMN groups: The level of 25(OH)D in IMN group was significantly lower than that in healthy group,and the difference was statistically significant(P<0.01).The levels of 25(OH)D in different sexes and age groups were significantly different in the healthy group(P<0.01),but there was no statistical difference in the IMN group(P>0.05).2.Comparison of clinical data of 25(OH)D deficiency and insufficient group in IMN group: Of the 194 IMN patients,the proportion of 25(OH)D deficiency and insufficient is 83% and 17%.There were significant differences in 24 h up,Ca,ALB,GLB,Hb,Cr,TC,TG,LDL,Ig G,and IgA levels between the two groups(P< 0.05).Through correlation analysis,25(OH)D was negatively associated with 24 h up,UA,Cr,TC,TG,LDL,PLT(r=-0.533,-0.168,-0.200,-0.391,-0.160,-0.289,-0.152,P<0.05),was positively correlated with Ca,ALB,GLB,Hb,IgG(r=0.382,0.552,0.245,0.174,0.372,P<0.05).Multiple stepwise regression analysis showed that 25(OH)D may be affected by 24 h up,ALB,Hb(B=-0.291,0.759,0.100,P<0.05).3.Comparison of renal pathological data between 25(OH)D deficiency and insufficient group in IMN group: GBM thickness,mesangial cell proliferation,renal tubular degeneration,renal tubular atrophy,and renal interstitial fibrosis were statistically different between the two groups(P<0.05).After controlling related clinical indicators(24-hup,ALB,Hb,Cr),25(OH)D levels were negatively correlated with GBM thickness,mesangial cell proliferation,tubular degeneration,tubular atrophy,renal interstitial fibrosis,and immunofluorescence IgG.(b=-0.233,-0.182,-0.209,-0.175,-0.185,-0.156,P < 0.05).There was a significant difference in renal pathological staging between the two groups(P<0.05).Conclutions:1.25(OH)D levels in IMN patients are generally lower than those in healthy individuals;2.25(OH)D levels may be related to the severity of clinical manifestations and renal pathological changes of IMN patients;3.25(OH)D may be related to the pathogenesis of IMN,and the lower the 25(OH)D level.