Relationship between serum NRF2,HO-1 levels and disease activity and prognosis in patients with lupus nephritis
10.3969/j.issn.1673-4130.2025.19.011
- VernacularTitle:血清NRF2、HO-1水平与狼疮性肾炎患者疾病活动度及预后的关系研究
- Author:
Linfang LI
1
;
Lingyan LI
;
Yuanhui WU
Author Information
1. 神木市医院检验科,陕西榆林 719300
- Keywords:
lupus nephritis;
nuclear factor E2-related factor 2;
heme oxygenase-1;
disease activity;
prognosis
- From:
International Journal of Laboratory Medicine
2025;46(19):2371-2377
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the relationship between serum nuclear factor E2-related factor 2(NRF2),heme oxygenase-1(HO-1)levels and disease activity and prognosis in patients with lupus nephritis(LN).Methods A total of 188 LN patients who visited the hospital from March 2020 to January 2022 were selected as the case group,and were divided into a stable group(60 cases,＜10 points)and an active group(128 cases,≥ 10 points)according to the Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)score.Another 160 healthy subjects were selected as control group.The differences of serum NRF2 and HO-1 levels between case group and control group were compared,the serum NRF2 and HO-1 levels and renal func-tion indexes[glomerular filtration rate(GFR),serum creatinine(Scr),urea nitrogen(BUN)]were compared between stable group and active group,and the correlation between serum NRF2 and HO-1 levels and disease activity and renal function in LN patients was analyzed by Pearson.After 2 years of follow-up,LN patients were divided into good prognosis group(117 cases)and poor prognosis group(71 cases)according to the oc-currence of renal-related endpoint events.Serum NRF2,HO-1 levels and other clinical data were compared be-tween two groups,and the prognostic factors of LN patients were analyzed by multivariate Logistic regression model.A nomogram prediction model was constructed and verified based on the influencing factors.Results The levels of serum NRF2 and HO-1 in case group were lower than those in control group(P＜0.05).NRF2,HO-1 and GFR levels in active group were lower than those in stable group,and Scr,BUN and SLEDAI scores were higher than those in the stable group(P＜0.05).Pearson correlation analysis showed that,serum NRF2 and HO-1 levels were negatively correlated with SLEDAI score,Scr and BUN in LN pa-tients(r＜0,P＜0.05),and positively correlated with GFR(r＞0,P＜0.05).The NRF2,HO-1 and GFR in poor prognosis group were lower than those in good prognosis group,and the proportion of CKD stage 3-4 and SLEDAI score in poor prognosis group were higher than those in good prognosis group(P＜0.05).Multi-variate Logistic regression model showed that CKD stage 3-4 and the increase of SLEDAI score were inde-pendent risk factors for poor prognosis of LN patients(P＜0.05),while the increase of NRF2,HO-1 and GFR levels were independent protective factors(P＜0.05).The nomogram prediction model based on influen-cing factors had a good predictive value for the prognosis of LN patients.Conclusion NRF2 and HO-1 are lowly expressed in the serum of LN patients,and the two are closely related to their disease activity and renal function.The high expression of NRF2 and HO-1 will reduce the risk of renal-related endpoint events in LN patients.The nomogram prediction model based on influencing factors has a good predictive value for the prognosis of LN patients.
