The influences of serum TXNIP,CTRP9 and ANGPTL4 levels in children with Ig A nephropathy on renal function and oxidative stress

Yang Yuehong

Qiu Sanling

Guo Xiuting

Wang Hui

Yang Yuanyuan

Wang Bin

Department of Nephrology,Shanxi Children's Hospital/Shanxi Maternal and Child Health Hospital

Abstract:Objective To explore the expression levels of thioredoxin interacting protein(TXNIP), complement C1q tumor necrosis factor-related protein 9(CTRP9), and angiopoietin-like protein 4(ANGPTL4) in the serum of children with Ig A nephropathy(IgAN), and their relationships with renal function and oxidative stress. Methods From May 2022 to June2025, 93 children with Ig AN admitted to the Department of Nephrology of Shanxi Children' s Hospital(Shanxi Maternal and Child Health Hospital) were selected as the Ig AN group. Additionally, 85 healthy children who underwent physical examinations at the hospital during the same period were selected as the control group. Serum levels of TXNIP, CTRP9, and ANGPTL4 were measured by ELISA. The diagnostic value of serum TXNIP, CTRP9, and ANGPTL4 for Ig AN was explored.The relationships between serum TXNIP, CTRP9, ANGPTL4 and renal function and oxidative stress indicators in children with Ig AN, as well as their impact on Ig AN, were analyzed. Results Compared with the control group, serum TXNIP and ANGPTL4 levels were significantly increased, while serum CTRP9 level was significantly decreased in the Ig AN group(t =7.460, 7.616, 7.180, all P<0.001). Serum creatinine(SCr), blood urea nitrogen(BUN), and 24-hour urine protein(24h UPro) levels were significantly higher, while estimated glomerular filtration rate(e GFR) was significantly lower in the Ig AN group compared to the control group(t/P =17.773/<0.001, 17.818/<0.001, 42.980/<0.001, 16.552/<0.001). Compared with the control group, malondialdehyde(MDA) level was significantly increased and superoxide dismutase(SOD) level was significantly decreased in the Ig AN group(t/P =12.386/<0.001, 11.966/0.020). Serum TXNIP and ANGPTL4 levels in children with Ig AN were positively correlated with SCr, BUN, 24h UPro, and MDA, and negatively correlated with e GFR and SOD(r/P = 0.529/<0.001, 0.436/0.003,0.512/<0.001, 0.418/0.005, 0.508/<0.001, 0.503/<0.001, 0.517/<0.001, 0.534/<0.001,-0.602/<0.001,-0.568/<0.001,-0.582/<0.001,-0.523/<0.001). Serum CTRP9 level was negatively correlated with SCr, BUN, 24h UPro, and MDA, and positively correlated with e GFR and SOD(r/P =-0.516/0.001,-0.419/0.002,-0.558/<0.001, 0.579/<0.001, 0.512/<0.001,-0.495/0.001). The AUC values for diagnosing Ig AN using serum TXNIP, CTRP9, ANGPTL4, and their combination were 0.812, 0.772, 0.803, and0.910, respectively. The combined use of these three indicators significantly outperformed their individual use for diagnosing Ig AN(Z = 3.881, 4.007, 3.845; all P<0.001). The risk of Ig AN in children with high expression of serum TXNIP and ANGPTL4 was approximately 2.7 times that of those with low expression, while the risk of Ig AN in children with low expression of serum CTRP9 was approximately 3.5 times that of those with high expression. Conclusion Serum TXNIP and ANGPTL4 levels are significantly elevated, while serum CTRP9 level is significantly decreased in children with Ig AN. These changes are closely related to renal function and oxidative stress, and significantly impact renal function and oxidative stress in patients. Moreover, combined detection of these three biomarkers can improve the diagnostic efficiency for Ig AN.

Keyword:IgA nephropathyThioredoxin interacting proteinComplement C1q tumor necrosis factor-related protein 9Angiopoietin-like protein 4Renal functionOxidative stress

Fund:Scientific Research Project Plan Task Book for Science and Technology Innovation Projects of Higher Education Institutions in Shanxi Province (2024L122)