The association between serum lipids at diagnosis and renal outcome in microscopic polyangiitis patients

Objectives Microscopic polyangiitis (MPA) is a subgroup of ANCA-associated vasculitis (AAV), which is characterized by vascular endothelial cell damage caused by abnormally activated neutrophils. Dyslipidemia is associated with vascular endothelial cell injury, and the relationship between blood lip...

Full description

Saved in:
Bibliographic Details
Main Authors: Zigui Zheng, Yujia Wang, Jingzhi Xie, Zhimin Chen, Bingjing Jiang, Yanfang Xu
Format: Article
Language:English
Published: PeerJ Inc. 2025-02-01
Series:PeerJ
Subjects:
Online Access:https://peerj.com/articles/18839.pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850068243330367488
author Zigui Zheng
Yujia Wang
Jingzhi Xie
Zhimin Chen
Bingjing Jiang
Yanfang Xu
author_facet Zigui Zheng
Yujia Wang
Jingzhi Xie
Zhimin Chen
Bingjing Jiang
Yanfang Xu
author_sort Zigui Zheng
collection DOAJ
description Objectives Microscopic polyangiitis (MPA) is a subgroup of ANCA-associated vasculitis (AAV), which is characterized by vascular endothelial cell damage caused by abnormally activated neutrophils. Dyslipidemia is associated with vascular endothelial cell injury, and the relationship between blood lipid levels and renal prognosis in MPA patients is not clear. We aim to investigate the correlation between blood lipid levels at diagnosis and renal prognosis in MPA patients. Methods Firstly, we retrospectively included 110 patients diagnosed with MPA and the primary endpoint was the occurrence of end stage renal disease (ESRD). The association between blood lipids at diagnosis and renal outcome was evaluated with Cox regression analysis and survival analysis. Secondly, we explored the potential underlying mechanism of poor renal prognosis in patients with high triglycerides (TG) levels at diagnosis using data independent acquisition (DIA) quantitative proteomics. Results During a median follow-up period of 23 months, 44 out of 110 patients (40%) developed ESRD. High serum TG at diagnosis was associated with ESRD development after adjusting for several confounding factors including age, gender, body mass index (BMI), hypertension, diabetes mellitus, estimated glomerular filtration rate (eGFR) and Birmingham Vasculitis Activity Score (BVAS). Serum very low-density lipoprotein (VLDL) demonstrated a marginal trend towards association with ESRD development. MPA patients with TG >1.45 mmol/L or VLDL > 0.66 mmol/L had significantly higher risk of ESRD development than those with TG ≤ 1.45 mmol/L or VLDL ≤ 0.66 mmol/L. DIA quantitative proteomics analysis suggested that patients with elevated TG levels and severe MPA had an upregulation of profibrotic pathways, inflammatory signaling, and complement and coagulation cascades, in contrast to those with lower TG levels and milder disease severity. Conclusions In MPA patients, high TG or VLDL at diagnosis is associated with an increased risk of ESRD development. The potential mechanisms may be associated with the upregulation of profibrotic and inflammatory signaling pathways, and the activation of complement and coagulation cascades.
format Article
id doaj-art-6ebcd5ff1fc34186b3eca6720c4042e1
institution DOAJ
issn 2167-8359
language English
publishDate 2025-02-01
publisher PeerJ Inc.
record_format Article
series PeerJ
spelling doaj-art-6ebcd5ff1fc34186b3eca6720c4042e12025-08-20T02:48:07ZengPeerJ Inc.PeerJ2167-83592025-02-0113e1883910.7717/peerj.18839The association between serum lipids at diagnosis and renal outcome in microscopic polyangiitis patientsZigui Zheng0Yujia Wang1Jingzhi Xie2Zhimin Chen3Bingjing Jiang4Yanfang Xu5Department of Nephrology, Blood Purification Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Nephrology, Blood Purification Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Nephrology, Blood Purification Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Nephrology, Blood Purification Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Nephrology, Blood Purification Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Nephrology, Blood Purification Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, ChinaObjectives Microscopic polyangiitis (MPA) is a subgroup of ANCA-associated vasculitis (AAV), which is characterized by vascular endothelial cell damage caused by abnormally activated neutrophils. Dyslipidemia is associated with vascular endothelial cell injury, and the relationship between blood lipid levels and renal prognosis in MPA patients is not clear. We aim to investigate the correlation between blood lipid levels at diagnosis and renal prognosis in MPA patients. Methods Firstly, we retrospectively included 110 patients diagnosed with MPA and the primary endpoint was the occurrence of end stage renal disease (ESRD). The association between blood lipids at diagnosis and renal outcome was evaluated with Cox regression analysis and survival analysis. Secondly, we explored the potential underlying mechanism of poor renal prognosis in patients with high triglycerides (TG) levels at diagnosis using data independent acquisition (DIA) quantitative proteomics. Results During a median follow-up period of 23 months, 44 out of 110 patients (40%) developed ESRD. High serum TG at diagnosis was associated with ESRD development after adjusting for several confounding factors including age, gender, body mass index (BMI), hypertension, diabetes mellitus, estimated glomerular filtration rate (eGFR) and Birmingham Vasculitis Activity Score (BVAS). Serum very low-density lipoprotein (VLDL) demonstrated a marginal trend towards association with ESRD development. MPA patients with TG >1.45 mmol/L or VLDL > 0.66 mmol/L had significantly higher risk of ESRD development than those with TG ≤ 1.45 mmol/L or VLDL ≤ 0.66 mmol/L. DIA quantitative proteomics analysis suggested that patients with elevated TG levels and severe MPA had an upregulation of profibrotic pathways, inflammatory signaling, and complement and coagulation cascades, in contrast to those with lower TG levels and milder disease severity. Conclusions In MPA patients, high TG or VLDL at diagnosis is associated with an increased risk of ESRD development. The potential mechanisms may be associated with the upregulation of profibrotic and inflammatory signaling pathways, and the activation of complement and coagulation cascades.https://peerj.com/articles/18839.pdfAntineutrophil cytoplasmic antibody-associated vasculitisBlood lipid disorderEnd stage renal disease
spellingShingle Zigui Zheng
Yujia Wang
Jingzhi Xie
Zhimin Chen
Bingjing Jiang
Yanfang Xu
The association between serum lipids at diagnosis and renal outcome in microscopic polyangiitis patients
PeerJ
Antineutrophil cytoplasmic antibody-associated vasculitis
Blood lipid disorder
End stage renal disease
title The association between serum lipids at diagnosis and renal outcome in microscopic polyangiitis patients
title_full The association between serum lipids at diagnosis and renal outcome in microscopic polyangiitis patients
title_fullStr The association between serum lipids at diagnosis and renal outcome in microscopic polyangiitis patients
title_full_unstemmed The association between serum lipids at diagnosis and renal outcome in microscopic polyangiitis patients
title_short The association between serum lipids at diagnosis and renal outcome in microscopic polyangiitis patients
title_sort association between serum lipids at diagnosis and renal outcome in microscopic polyangiitis patients
topic Antineutrophil cytoplasmic antibody-associated vasculitis
Blood lipid disorder
End stage renal disease
url https://peerj.com/articles/18839.pdf
work_keys_str_mv AT ziguizheng theassociationbetweenserumlipidsatdiagnosisandrenaloutcomeinmicroscopicpolyangiitispatients
AT yujiawang theassociationbetweenserumlipidsatdiagnosisandrenaloutcomeinmicroscopicpolyangiitispatients
AT jingzhixie theassociationbetweenserumlipidsatdiagnosisandrenaloutcomeinmicroscopicpolyangiitispatients
AT zhiminchen theassociationbetweenserumlipidsatdiagnosisandrenaloutcomeinmicroscopicpolyangiitispatients
AT bingjingjiang theassociationbetweenserumlipidsatdiagnosisandrenaloutcomeinmicroscopicpolyangiitispatients
AT yanfangxu theassociationbetweenserumlipidsatdiagnosisandrenaloutcomeinmicroscopicpolyangiitispatients
AT ziguizheng associationbetweenserumlipidsatdiagnosisandrenaloutcomeinmicroscopicpolyangiitispatients
AT yujiawang associationbetweenserumlipidsatdiagnosisandrenaloutcomeinmicroscopicpolyangiitispatients
AT jingzhixie associationbetweenserumlipidsatdiagnosisandrenaloutcomeinmicroscopicpolyangiitispatients
AT zhiminchen associationbetweenserumlipidsatdiagnosisandrenaloutcomeinmicroscopicpolyangiitispatients
AT bingjingjiang associationbetweenserumlipidsatdiagnosisandrenaloutcomeinmicroscopicpolyangiitispatients
AT yanfangxu associationbetweenserumlipidsatdiagnosisandrenaloutcomeinmicroscopicpolyangiitispatients