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...
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PeerJ Inc.
2025-02-01
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| 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 |
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| 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 |
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| institution | DOAJ |
| issn | 2167-8359 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | PeerJ Inc. |
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| 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 |
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