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Apolipoprotein M Serum Levels Correlate with IgA Vasculitis and IgA Vasculitis Nephritis
1Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
Insights
Serum apolipoprotein M (apoM) is elevated in IgA vasculitis (lgAV) patients and decreases with nephritis severity. Lower apoM levels predict kidney involvement, indicating apoM is a protective factor against nephritis in lgAV.
Area of Science:
- Pediatric Nephrology
- Immunology
- Rheumatology
Background:
- IgA vasculitis (lgAV) is the most common vasculitis in children.
- Disease prognosis is linked to patient age and nephritis severity.
- Apolipoprotein M (apoM) role in lgAV is not well understood.
Purpose of the Study:
- Investigate serum apoM levels in pediatric lgAV patients.
- Evaluate the association between apoM and lgAV disease severity, particularly nephritis.
- Determine if apoM can serve as a predictive biomarker for nephritis in lgAV.
Main Methods:
- Included 109 lgAV patients and 76 healthy controls, matched for age and sex.
- Measured serum apoM levels using enzyme-linked immunosorbent assay (ELISA).
- Assessed lipids, other apolipoproteins, kidney function markers, immunoglobulins, and complement levels.
Main Results:
- Serum apoM levels were significantly higher in lgAV patients than in controls.
- ApoM levels were lower in patients with nephritis compared to those without.
- Higher apoM levels correlated with less severe nephritis (Classes I/II vs. III/IV) and negatively with ISKDC scores.
- Serum apoM < 24.81 mg/L independently predicted nephritis in lgAV patients.
Conclusions:
- Serum apoM is elevated in lgAV patients and inversely correlates with nephritis severity.
- ApoM acts as a protective factor against nephritis in lgAV.
- Serum apoM levels may serve as a valuable biomarker for predicting kidney involvement in lgAV.
Objective:
IgA vasculitis (lgAV) is the most frequent vessel vasculitis in children, and the prognosis is related to the children's age and degree of nephritis. This study is aimed at investigating serum apolipoprotein M (apoM) levels in patients with lgAV patients and at evaluating the association between apoM and disease severity.
Methods:
A total of 109 lgAV patients and 76 age- and sex-matched healthy controls were included. The age and gender of the study participants were matched. ApoM levels were measured by an enzyme-linked immunosorbent assay. Additionally, the serum levels of lipids, apolipoproteins, kidney biochemical profiles, immunoglobulins (IgA, IgG, IgM, and IgE), and the complements (C3 and C4) were assessed using an automatic biochemical analyzer.
Results:
ApoM was increased significantly in lgAV patients compared to healthy controls. ApoM, meanwhile, was lower in patients with nephritis than in those without nephritis. The apoM levels were higher in classes I and II IgA vasculitis nephritis (lgAVN) patients than in classes III and IV. Besides, the apoM serum level < 24.81 mg/L was an independent predictive factor for lgAVN and can be independently associated with the presence of nephritis in lgAV patients. Meanwhile, the serum apoM concentration negatively correlated with the ISKDC grading score in lgAVN patients.
Conclusions:
Serum apoM was elevated in lgAV patients and decreased gradually with the ISKDC grading score. ApoM (OR = 0.32, 95%CI = 0.12-0.85, p = 0.023) was identified as a protective factor for nephritis in all lgAV patients.
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