The correlation between C1q,MBL,C5a and the progression of type 2 diabetes nephropathy and tubular injury
10.11958/20250671
- VernacularTitle:C1q、MBL、C5a与2型糖尿病肾脏病进程及肾小管损伤的相关性
- Author:
Li LIU
1
;
Jian HOU
1
;
Qiaoling ZHANG
1
;
Hongxiu YANG
1
;
Baojun YUAN
1
Author Information
1. 开滦总医院检验科(邮编 063100)
- Publication Type:Journal Article
- Keywords:
diabetes mellitus,type 2;
diabetic nephropathies;
complement C1q;
complement pathway,mannose-binding lectin;
complement C5a;
renal tubules
- From:
Tianjin Medical Journal
2025;53(6):603-609
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical value of complement 1q(C1q),mannose-binding lectin(MBL)and complement 5a(C5a)in the early diagnosis and disease monitoring of diabetic kidney disease(DKD),as well as their relationship with renal tubular injury.Methods A total of 232 patients with type 2 diabetes mellitus admitted to the Endocrinology Department of Kailuan General Hospital from December 2020 to December 2021 were selected in this study.Patients were divided into the simple diabetes mellitus(SDM)group(n=50)and the DKD group(n=182)based on urinary albumin/creatinine ratio(UACR)and estimated glomerular filtration rate(eGFR).The DKD group was further divided into the low-risk diabetic nephropathy(LDKD)group(n=90),the moderate-risk diabetic nephropathy(MDKD)group(n=55)and the high-risk diabetic nephropathy(HDKD)group(n=37)according to the risk of chronic kidney disease progression.Forty healthy individuals who underwent physical examinations in our hospital during the same period were selected as the healthy control group(NC group).The DKD group was divided into the Q1-Q4 groups based on the quartile levels of NAG/Ucr according to the severity of renal tubular injury from mild to severe.General biochemical indicators,as well as the levels of C1q,MBL and C5a in each group were detected.Spearman correlation analysis was used to analyze the correlation between C1q,MBL,C5a and glomerular and tubular injury indexes.Multivariate ordinal Logistic regression analysis was used to analyze the influencing factors of the progression risk of DKD and the degree of renal tubular injury.Results The levels of systolic blood pressure,diastolic blood pressure,triglycerides(TG),serum creatinine(Scr),uric acid(UA),UACR,NAG/Ucr,C1q,MBL and C5a were higher in the DKD group than those in the SDM group and the NC group.The levels of TC,LDL-C,ApoB and HbA1c were higher than those in the NC group,while the level of HDL-C was lower than that in the NC group.The levels of TC,LDL-C,HbA1c and NAG/Ucr were higher in the SDM group than those in the NC group,while the level of HDL-C was lower than that in the NC group(P＜0.05).Among different progression risk groups of DKD,the levels of C1q were higher in the HDKD group than those in the SDM group and the LDKD group.The levels of MBL and C5a were higher in the MDKD group than those in the SDM group and the LDKD group,and the level of MBL was higher in the LDKD group than that in the SDM group(P＜0.05).After grouping according to the quartile levels of NAG/Ucr,the levels of TC,ApoB,HbA1c,Scr,UACR,C1q and C5a were significantly higher in the Q4 group than those in the Q1 group.The levels of TC,ApoB,Scr,UACR,C1q and C5a were significantly higher than those in the Q2 group,and the levels of UACR and C5a were significantly higher than those in the Q3 group.The levels of HbA1c,Scr,UACR,C1q and C5a were significantly higher in the Q3 group than those in the Q1 group.The level of UACR was higher in the Q2 group than that in the Q1 group(all P＜0.05).The Spearman correlation analysis showed that C1q,MBL and C5a were positively correlated with UACR and NAG/Ucr,and negatively correlated with eGFR(all P＜0.05).The ordinal Logistic regression analysis showed that elevated levels of MBL,C5a,NAG/Ucr,Scr and systolic blood pressure were independent influencing factors of progression risk in DKD patients.Elevated levels of C5a,HbA1c and UACR were independent influencing factors of renal tubular injury in DKD patients.Conclusion C1q and C5a can be used to monitor middle and late DKD and tubular injury,and C5a is an independent risk factor for DKD progression and tubular injury.MBL can be used to screen for early DKD and is also an independent risk factor for its progression.
