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    IL-6、IL-18、IL-33和骨桥蛋白在痛风病人肾损伤中的诊断及预警价值

    The diagnostic and early warning value of IL-6, IL-18, IL-33 and osteopontin in renal injury of gout patients

      摘要
    • 摘要:
      目的： 探讨血清白细胞介素（IL）-6、IL-18、IL-33和骨桥蛋白（OPN）在痛风合并肾损伤病人中的诊断及预警价值。
      方法： 选取痛风病人113例，按照肾小球滤过率分为痛风合并肾损伤组（合并组，肾小球滤过率＜90 mL/min）54例和痛风未合并肾损伤组（痛风组，肾小球滤过率≥90 mL/min）59例；另选取同期在本院行体检的健康人群34名作为对照组。检测3组血清IL-6、IL-33、IL-18和OPN水平，计算肾小球滤过率估计值(eGFR)，分析IL-6、IL-33、IL-18和OPN对痛风合并肾损伤的诊断价值。
      结果： 合并组和痛风组血清IL-6、IL-18、IL-33、OPN水平均高于对照组(P ＜ 0.05)；合并组IL-6、IL-18水平亦均高于痛风组(P ＜ 0.05)，IL-33水平低于痛风组(P ＜ 0.05)，eGFR均低于痛风组和对照组(P ＜ 0.05)。Spearman相关分析显示，合并组病人血清IL-33水平与血肌酐、胱抑素C、β2微球蛋白水平均呈负相关关系（P ＜ 0.05 ~ P ＜ 0.01），与eGFR呈明显正相关关系（P ＜ 0.01）；IL-18、IL-6、OPN与血肌酐、胱抑素C、β2微球蛋白均呈正相关关系（P ＜ 0.05 ~ P ＜ 0.01），与eGFR均呈负相关关系（P ＜ 0.05 ~ P ＜ 0.01）。ROC曲线分析显示，血清IL-33、L-18、IL-6分别单独诊断痛风合并肾损伤的AUC均低于三者联合检测。logistic回归分析显示，IL-33为痛风病人发生肾损伤的独立保护因素（P ＜ 0.05），CysC为痛风病人发生肾损伤的独立危险因素（P ＜ 0.05）。
      结论： 痛风合并肾损伤病人的血清IL-6、IL-18水平升高，IL-33水平降低，三者与肾损伤指标具有明显相关性，且均对痛风合并肾损伤具有一定诊断价值，三者联合的诊断价值较高。

       

      Abstract:
      Objective To investigate the diagnostic and prognostic value of serum interleukin (IL)-6, IL-18, IL-33, and osteopontin (OPN) in gout complicated with renal injury.
      Methods A total of 113 gout patients were divided into the gout complicated with renal injury group (Combined Group, GFR ＜ 90 mL/min, n = 54) and gout complicated without renal injury group (Gout Group, GFR ≥ 90 mL/min, n = 59) based on the glomerular filtration rate (GFR). Additionally, 34 healthy individuals with physical examinations at our hospital during the same period were selected as the control group. The serum levels of IL-6, IL-33, IL-18 and OPN in three groups were measured using the ELISA. The estimated glomerular filtration rate (eGFR) of patients were calculated, and the diagnostic value of IL-6, IL-33, IL-18, and OPN for gout complicated with renal injury were evaluated.
      Results The levels of serum IL-6, IL-18, IL-33 and OPN in the combined group and gout group were higher than those in control group (P ＜ 0.05). In the combined group, the levels of IL-6 and IL-18 were higher than those in gout group (P ＜ 0.05), the level of IL-33 was lower than that in gout group (P ＜ 0.05), and the eGFR was lower than that in both the gout group and control group (P ＜ 0.05).The results of Spearman correlation analysis showed that in the combined group, the serum IL-33 level was negatively correlated with the levels of serum creatinine, cystatin C and β2 microglobulin (P ＜ 0.05 to P ＜ 0.01), and significantly positively correlated with eGFR (P ＜ 0.01). The IL-18, IL-6 and OPN were positively correlated with serum creatinine, cystatin C and β2 microglobulin (P ＜ 0.05 to P ＜ 0.01), and negatively correlated with eGFR (P ＜ 0.05 to P ＜ 0.01). The results of ROC curve analysis showed that the AUC of serum IL-33, L-18, and IL-6 for diagnosing gout combined with renal injury separately was all lower than that of the combined detection of three. The results of logistic regression analysis showed that the IL-33 was the independent protective factor of renal injury, and the CysC was the independent risk factor of renal injury in gout patients (P ＜ 0.05).
      Conclusions The levels of serum IL-6 and IL-18 in patients with gout complicated with renal injury increase, while the level of IL-33 decreases. The three have a significant correlation with renal injury indicators, and all have certain diagnostic value for gout complicated with renal injury. The combined diagnostic value of the three is relatively high.

       

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