通讯作者: 张丽梅, 3580955757@qq.com

DOI：10.12201/bmr.202603.00110

Serum Human Epididymis Protein 4 and Its Correlation with Lupus Nephritis: A Prospective Cohort Study

• 摘要：目的:探究基线血清人附睾蛋白4水平预测狼疮性肾炎的临床价值。方法:选取2022年12月~2025年12月曲靖市第一人民医院新诊断的120例初发且无肾脏受累的系统性红斑狼疮患者作为研究对象,所有对象均行血清采集并以电化学发光免疫分析法检测人附睾蛋白4水平,对患者进行随访,主要终点事件为临床诊断狼疮性肾炎,以ROC曲线评估人附睾蛋白4的预测效能,Cox比例风险回归模型分析狼疮性肾炎发生的独立危险因素。结果:入选研究的120例患者中,共计22例患者发展为狼疮性肾炎,发生率为18.33%。相对于未进展组,进展组22例患者的基线特征表现出更高的疾病活动度,该组患者的SLEDAI评分、抗dsDNA抗体阳性率更高,补体C3、C4水平则显著降低(P＜0.05)。进展组在反映全身炎症与营养状态上的的水平更差,血沉、血清白蛋白明显降低(P＜0.05)。生物标志物比较,进展组血清HE4水平高于未进展组(P＜0.05)。相关性分析显示,基线血清HE4水平与SLEDAI评分、抗dsDNA抗体滴度、血沉等疾病活动指标呈正相关,与补体C3、C4及血清白蛋白水平呈负相关(P<0.05)。血清HE4预测LN的AUC为0.828(95%CI:0.751~0.905),最佳截断值53.6 pmol/L。由HE4、补体C3及SLEDAI评分构成的联合模型预测效能最优(AUC=0.875,95% CI:0.808~0.942)。结论:血清人附睾蛋白4升高是初发系统性红斑狼疮患者发生狼疮性肾炎的独立预测因子,通过监测相关水平能够有助于早期识别狼疮性肾炎的高危患者。

  关键词： 系统性红斑狼疮; 人附睾蛋白4; 狼疮性肾炎; 临床预测

   

  Abstract: 【】Objective:Investigating the Clinical Value of Baseline Serum Human Epididymis Protein 4 Levels in Predicting Lupus NephritisMethods:A total of 120 newly diagnosed, incident systemic lupus erythematosus (SLE) patients without renal involvement were recruited from Qujing First People’s Hospital between December 2022 and December 2025. Serum samples were collected from all subjects, and human epididymis protein 4 (HE4) levels were measured by electrochemiluminescence immunoassay. Patients were prospectively followed, with the primary endpoint being clinical diagnosis of lupus nephritis (LN). Receiver operating characteristic (ROC) curve analysis was employed to evaluate the predictive performance of HE4. Cox proportional hazards regression models were used to identify independent risk factors for the development of LN.Results:Among the 120 patients enrolled in the study, 22 progressed to lupus nephritis (LN), with an incidence rate of 18.33%. Compared to the non-progressor group, the 22 patients in the progressor group exhibited higher baseline disease activity, characterized by significantly higher SLEDAI scores and anti-dsDNA antibody positivity rates, alongside significantly lower complement C3 and C4 levels (P < 0.05). The progressor group also showed poorer systemic inflammatory and nutritional status, with significantly elevated erythrocyte sedimentation rate (ESR) and reduced serum albumin levels (P < 0.05). Regarding biomarkers, serum HE4 levels were significantly higher in the progressor group than in the non-progressor group (P < 0.05). Correlation analysis revealed that baseline serum HE4 levels were positively correlated with disease activity indicators such as SLEDAI score, anti-dsDNA antibody titer, and ESR, and negatively correlated with complement C3, C4, and serum albumin levels (P < 0.05). The area under the curve (AUC) for serum HE4 in predicting LN was 0.828 (95% CI: 0.751–0.905), with an optimal cut-off value of 53.6 pmol/L. The combined model incorporating HE4, complement C3, and SLEDAI score demonstrated the best predictive performance, with an AUC of 0.875 (95% CI: 0.808–0.942).Conclusion:Elevated serum human epididymis protein 4 (HE4) is an independent predictor of lupus nephritis (LN) development in patients with incident systemic lupus erythematosus (SLE). Monitoring HE4 levels may facilitate the early identification of high-risk patients for LN.

  Key words: Systemic Lupus Erythematosus; Human Epididymis Protein 4; Lupus Nephritis; Clinical Prediction

  提交时间：2026-03-25

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• 序号	提交日期	编号	操作
  1	2026-01-12	10.12201/bmr.202603.00110V1	下载

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