Hypertriglyceridemia Is Associated with More Severe Histological Glomerulosclerosis in IgA Nephropathy

Abstract

IgA nephropathy (IgAN) is a globally well-known primary glomerular nephropathy. Hypertriglyceridemia (HTG) is one factor contributing to atherosclerosis and is a common complication of renal failure. HTG is a significant risk factor for decreased renal function in patients with IgAN. We evaluated the association of HTG with the histopathological features of IgAN patients. A total of 480 patients diagnosed with IgAN via kidney biopsy from eight university hospitals affiliated with the College of Medicine of the Catholic University of Korea were included in the final cohort. Pathological features were evaluated by eight expert pathologists with hospital consensus. HTG was defined as a serum triglyceride (TG) level of ≥150 mg/dL. In the study population analysis, the HTG group was older, with more males; higher body mass index (BMI), low-density lipoprotein cholesterol (LDL-C) and spot urine protein ratio; and lower estimated glomerular filtration rate (eGFR). In the lipid profile analysis, eGFR was negatively correlated with TGs/ high-density lipoprotein cholesterol (HDL) and triglyceride-glucose index (TyG). Proteinuria positively correlated with TGs/HDL, non-HDL/HDL, LDL/HDL, TyG, TGs and LDL. The percentages of global sclerosis (GS), segmental sclerosis (SS) and capsular adhesion (CA), and the scores for mesangial matrix expansion (MME) and mesangial cell proliferation (MCP), were more elevated in the HTG group compared to the normal TG group. Multivariable linear regression analysis showed that the percentages of global sclerosis, segmental sclerosis and capsular adhesion, as well as the scores for mesangial matrix expansion and mesangial cell proliferation, were positively associated with TG level. In binary logistic regression, the HTG group showed a higher risk for global sclerosis and segmental sclerosis. In conclusion, HTG is a significant risk factor for glomerulosclerosis in IgAN.

Correlation of Body Mass Index with Clinicopathologic Parameters in Patients with Idiopathic Membranous Nephropathy

“…33 C3 deposits were first detected from IMN in 1984. 16,17 Patients with glomerular C3 deposits have proteinuria with a more severe symptom, which supports the relationship between complement activation and severity of IMN. 17 The greater deposition of C3 predicts a poor prognosis of glomerular disease.…”

“…The simplified GMTIV score is similar to the MEST score used in the estimation of IgAN severity, according to the presence of mesangial (M), endocapillary (E), glomerular sclerosis (S), and tubular atrophy (T). 16,17 The prevalence of obesity has increased dramatically. This worldwide obesity epidemic has produced more medical attention.…”

“…The presence and degree of five histological indicators, GS, MCP, TA, IF, and VWT, were assessed separately or in combination. [15][16][17][18]…”

Triglyceride–Glucose Index May Predict Renal Survival in Patients with IgA Nephropathy

“…IR can induce glucose metabolism imbalance, causing excessive glycosylation, which can promote smooth muscle cell proliferation, collagen crosslinking, and collagen deposition, as well as triggering inflammation and oxidative stress [ 25 ]. In addition to its role in hyperglycaemia, IR plays an important role in hyperlipidaemia, which induces oxidative stress and apoptosis, causing the initiation of atherosclerosis and podocyte injury via fibrosis, inflammation and apoptosis [ 26 , 27 ]. Moreover, mounting evidence has revealed that IR can induce an increased production of glycosylated products and free radicals, leading to nitric oxide (NO) inactivation.…”