Granulin’s Role In Diagnosis And Activity Evaluation Of Lupus Nephritis

Objective: To detect the level of granulin(GRN)in serum and urine of Lupus Nephritis(LN)patients,analysis of the GRN correlation with disease activity of LN,research GRN whether can be used as LN diagnosis and new marker of disease activity.Methods: Collected the clinical data,serum and urine specimens of 45 patients with LN from January 2016 to November 2017 in fujian province hospital.using the method of enzyme-linked immunosorbent assay(ELISA)to measure the GRN levels in serum and urine,with the same period of 44 cases of Primary nephritis as disease control group,47 patients with physical health as healthy group.The differences in expression levels of serum and urine GRN in different groups were compared,The diagnostic efficacy of GRN on LN was analyzed by the Operating Characteristic Curve of Receiver Operating Characteristic Curve(ROC).A total of 45 patients with LN were socred with reference to the Systemic lupus erythematosus.activity index(SLEDAI),which regulates the renal systemic lupus erythematosus disease activity index(r SLEDAI)> 4 into activity LN group,separate activity group 24 cases of LN,stable LN 21 cases,by t test and chi-square test,gruen analysis between the two groups of GRN expression and the clinical manifestation,laboratory examination results,through ROC curve analysis GRN disease activity in patients with LN the determination value.By adopting pearman or Spearman correlation analysis analysis LN patients serum and urine GRN express level relation with Complement C3(C3),anti ds DNA antibodies,24 hours urinary protein and SLEDAI,r SLEDAI.Results: 1 serum GRN correlation analysis of LN patients:(1)serum GRN expression from high to low order is LN group:671.7±205.6(pg/ml),pimary nephritis group: 319.7±63.3(pg/ml)and healthy group:59.7±19.4(pg/ml),significant difference between groups(P = 0.000).(2)The ROC curve of the diagnosis LN was analyzed by he serum GRN compared with the pimary nephritis group,The area under the curve was 0.94,the sensitivity :89%,the specificity :98%;(3)In LN group serum GRN was positively correlated with 24 h urine protein,anti-ds DNA antibody and SLEDAI score,Negative correlation with C3,There was no correlation with serum creatinine and r SLEDAI.2 urine GRN correlation analysis of LN patients:(1)urine GRN expression from high to low order is LN group(315.3±89.1 pg/ml),pimary nephritis group(183.4±36.6 pg/ml),healthy group(40.0±8.8 pg/ml),each also has a significant difference between(P = 0.000).(2)The ROC curve of the diagnosis LN was analyzed by the urine GRN compared with the pimary nephritis group,The area under the curve was 0.93,the sensitivity: 86%,the specificity: 93%.(3)In LN patients the urine GRN was positively correlated with the 24-hour urine protein,anti-ds DNA antibody,SLEDAI score and r SLEDAI score.It is negatively correlated with the complement C3 level,It is no correlation with creatinine.3 Activities LN group serum and urine GRN levels are high than stable LN group,urine GRN in statistically significant difference between the two groups,There was no significant difference in serum GRN between the two groups.urine GRN ROC curve analysis of the diagnosis of LN activity: area under curve: 0.75,sensitivity: 75%,specific degrees: 91%.Conclusion: GRN is highly expressed in serum and urine of LN patients,GRN is associated with LN disease activity,and urine GRN has diagnostic value for the activity of LN,GRN is expected to be a new marker of LN.