Single-center Study of Serum Anti-PLA2R Antibodies in Adults with Idiopathic Membranous Nephropathy with Clinically Significant Cut-off Value

Abstract

Abstract: Objective To explore the clinically significant cut-off value of serum anti-PLA2R antibody (sPLA2R-Ab) in adult idiopathic membranous nephropathy (IMN) in Baoding City. Methods A total of 285 patients who underwent renal needle biopsy and sPLA2R-Ab detection in Baoding First Central Hospital from January 2018 to December 2021 were included. The patients were divided into IMN group, secondary membranous nephropathy (SMN) group and other groups. The level of sPLA2R-Ab was compared between the groups; the correlation between sPLA2R-Ab level and other clinical indicators in IMN patients was analyzed; logistic regression was applied to identify the risk factors of IMN; the diagnostic value of sPLA2R-Ab for IMN was analyzed by ROC curve, and Youden index was calculated to obtain the optimal cut-off value of sPLA2R-Ab for IMN diagnosis. Results The level of sPLA2R-Ab in IMN group was significantly higher than that in SMN group and other groups(P<0.05). In IMN group, sPLA2R-Ab was negatively correlated with total protein and albumin(P<0.001), it was positively correlated with 24h urinary protein, serum creatinine and cholesterol(P<0.05). ROC curve showed that the cut-off value of sPLA2R-Ab in the diagnosis of IMN patients was 3.315RU/mL, the corresponding Youden index was the highest (0.651), the sensitivity was 79.4%, the specificity was 85.7%, the AUC was 0.829, P<0.001. Conclusion sPLA2R-Ab is associated with the activity of IMN disease. The cut-off value of SPLA2R-AB for differentiating IMN from non-IMN patients is 3.315RU/mL, which can improve the early diagnosis rate of IMN.

Key words: idiopathic membranous nephropathy, scrum phospholipase A2 receptor antibady, renal needle biopsy, cut-off value

摘要： 目的探索保定市成人特发性膜性肾病（IMN）血清抗PLA2R抗体（sPLA2R-Ab）有临床意义的界值。方法纳入保定市第一中心医院2018年1月~2021年12月期间接受肾穿刺活检术并行sPLA2R-Ab检测的285例患者。根据肾穿刺活检的病理结果,分为IMN组、继发性膜性肾病（SMN）组和其他组,比较组间sPLA2R-Ab水平差异;分析IMN患者的sPLA2R-Ab水平与其他临床指标的相关性;采用Logistic回归鉴别发生IMN的危险因素;ROC曲线分析sPLA2R-Ab对IMN的诊断价值,并通过计算约登指数得出诊断IMN的sPLA2R-Ab最佳临界值。结果 IMN组的sPLA2R-Ab水平显著高于SMN组及其他组（P<0.05）;IMN组的sPLA2R-Ab与总蛋白、白蛋白呈负相关（P<0.001）,与24h尿蛋白定量、血肌酐、胆固醇正相关（P<0.05）。ROC曲线显示,sPLA2R-Ab诊断IMN患者的有临床意义的界值是3.315 RU/mL,相对应的Youden指数最高（0.651）,敏感性为79.4%、特异性为85.7%,曲线下面积AUC为0.829（95%CI 0.776-0.882）,P<0.001。结论 sPLA2R-Ab与IMN疾病的活动有关,鉴别IMN和非IMN患者的sPLA2R-Ab有临床意义的界值是3.315 RU/mL,这一新的界值可以提高IMN的早期诊断率。

关键词: 特发性膜性肾病, 抗磷脂酶A2受体抗体, 肾穿刺活检术, 临界值

CLC Number:

R692

ZHANG Ying-ying, GUO Yan-cong, LI Xiao-dong. Single-center Study of Serum Anti-PLA2R Antibodies in Adults with Idiopathic Membranous Nephropathy with Clinically Significant Cut-off Value[J]. Journal of Chengde Medical University, 2023, 40(2): 111-116.

张莹莹, 郭彦聪, 李晓东. 成人特发性膜性肾病血清抗PLA2R抗体有临床意义界值的单中心研究[J]. 承德医学院学报, 2023, 40(2): 111-116.

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