Detection of urinary levels of matrix metalloproteinase-7 and tumor necrosis factor-like weak inducer of apoptosis in patients with IgA nephropathy and values in predicting disease progression

Objective To explore the expressions of urinary matrix metalloproteinase-7(MMP-7) and tumor necrosis factor-like weak inducer of apoptosis(TWEAK) in patients with IgA nephropathy (IgAN) and examine its predictive value. Methods From January 2018 to March 2021, 115 IgAN patients and 50 normal subjects(control group) were selected. Based upon the progress of IgAN, 115 cases of IgAN patients were divided into two groups of IgAN progressive(n=42) and IgAN non-progressive(n=73). According to the IgAN Oxford classification criteria, they were assigned into two groups of MESTC ≥ 3(n=45) and MEST-C<3(n=70). The levels of urinary MMP-7 and TWEAK were compared between two groups. Multivariate Logistic regression was utilized for analyzing the risk factors of IgAN progression. Receiver operating characteristic(ROC) curve was plotted for examining the values of urinary MMP-7 and TWEAK levels in predicting IgAN progression. Results The levels of urinary MMP-7 (15.72±7.85 vs 6.92±0.53 ng/mL) and TWEAK were significantly higher in IgAN progressive group than those in IgAN non-progressive group(958.47±42.60) vs(206.73±15.18) ng/mL, P<0.001. The levels of urinary MMP-7(23.92±9.27) vs(18.15±8.36) ng/mLand TWEAK(1408.70±71.15) vs(1036.28±50.72) ng/mLwere significantly higher in MEST-C ≥ 3 score group than those in MEST-C<3 score group(P<0.001). Multivariate Logistic regression analysis indicated that elevated levels of MMP-7OR=2.986 95%CI(2.146,-8.513) and TWEAKOR=3.370 95%CI (2.752, -10.118)were the risk factors affecting the progression of IgAN. Receiver operating characteristic(ROC) curve indicated that the area under the curve(AUC) of MMP-7 and TWEAK in predicting IgAN progression was 0.948(95% CI 0.885-0.997) with a sensitivity of 97.5% and a specificity of 85.0%. Correlation analysis indicated that the urinary levels of MMP-7 and TWEAK were significantly positively correlated with M, E, S and T(P<0.001). Conclusion The elevated urinary levels of MMP-7 and TWEAK are the risk factors affecting the progression of IgAN. Both may be used as biological indicators for predicting the progression of IgAN.