背景:病例报告假设蛋白尿,有时伴有肾小球病或肾病综合征,可能与Loiasis有关.据我们所知,尚未进行评估这种关联的研究.我们旨在研究Loaloa微丝虫负荷与蛋白尿之间的关系。
方法:我们在2022年5月16日至2022年6月11日之间进行了一项横断面研究,以评估刚果共和国农村地区Loaloa微丝血症密度与蛋白尿之间的关系。我们纳入了在研究开始时居住在目标区域的所有同意的成年人,他们在2019年的临床试验筛查中,Lloa微丝虫密度大于500微丝虫/mL。这项研究是MorLo项目的一部分,并使用该项目的研究人群中居住在Sibiti附近的18岁或以上的个体。对于每个微丝症个体,两个没有Lloa微丝密度的个体在年龄上匹配,性别,包括居住地。蛋白尿(通过试纸评估)和Lloa微丝密度之间的关联,年龄,由于微丝密度违反了平行线假设,因此使用无约束的序数回归模型评估了性别。
结果:991名参与者被纳入,其中342人(35%)为Lloa微丝血症。在微丝症患者中,微量蛋白尿(<300mg/24h)的患病率为38%(325例中的122),轻度蛋白尿(300mg至1g/24h)为51%(89个中的45个),高蛋白尿(>1g/24h)占71%(21个中的15个)。在无微丝血症的个体中,微量蛋白尿的患病率为63%(325人中的203人),轻度蛋白尿为49%(89个中的44个),高蛋白尿占29%(21个中的6个)。高蛋白尿的个体具有明显较高的Lloa微丝密度(p<0·0001):在无蛋白尿的个体中,平均每毫升微丝为1595(SD4960),2691(7982)对于那些有微量蛋白尿的人,3833(9878)对于患有轻度蛋白尿的人,13541(20118)用于高蛋白尿。每mL有5000-14999个微丝虫的个体和每mL有15000个微丝虫或更多的个体是,分别,5·39和20·49的可能性比没有微丝血症的个体高蛋白尿。
结论:蛋白尿的风险随着Lloa微丝血症而增加。需要进一步的研究来确定肾脏疾病(例如,肾小管病变,肾小球疾病,或肾病综合征)导致与loiasis相关的蛋白尿。
背景:欧洲研究理事会,MorLo项目。
■有关摘要的法语翻译,请参见补充材料部分。
Case reports have hypothesised that proteinuria, sometimes with glomerulopathy or nephrotic syndromes, might be associated with loiasis. To our knowledge, no
study has been done to assess this association. We aimed to investigate the association between Loa loa
microfilariae burden and proteinuria.
We did a cross-sectional study between May 16, 2022, and June 11, 2022, to assess the relationship between Loa loa microfilaraemia densities and proteinuria in a rural area of the Republic of Congo. We included all consenting adults living in the target area at study commencement who had L loa microfilarial densities greater than 500
microfilariae per mL during previous screening for a clinical
trial in 2019. This
study is part of the MorLo project, and used the project\'s
study population of individuals aged 18 years or older who were living near Sibiti. For each microfilaraemic individual, two individuals without L loa microfilarial densities matched on age, sex, and place of residence were included. The association between proteinuria (assessed by dipstick) and L loa microfilarial densities, age, and sex was assessed using an unconstrained ordinal regression model since the parallel-lines assumption was violated for microfilarial densities.
991 participants were included, of whom 342 (35%) were L loa microfilaraemic. The prevalence of microfilaraemia was 38% (122 of 325) among individuals with trace proteinuria (<300 mg/24 h), 51% (45 of 89) among individuals with light proteinuria (300 mg to 1 g/24 h), and 71% (15 of 21) among individuals with high proteinuria (>1 g/24 h). Individuals with high proteinuria had significantly higher L loa microfilarial densities (p<0·0001): mean microfilariae per mL were 1595 (SD 4960) among individuals with no proteinuria, 2691 (7982) for those with trace proteinuria, 3833 (9878) for those with light proteinuria, and 13 541 (20 118) for those with high proteinuria. Individuals with 5000-14 999
microfilariae per mL and individuals with 15 000
microfilariae per mL or greater were, respectively, 5·39 and 20·49 times more likely to have a high proteinuria than individuals with no microfilaraemia.
The risk of proteinuria increases with L loa microfilaraemia. Further studies are needed to identify renal disorders (eg, tubulopathies, glomerulopathies, or nephrotic syndromes) responsible for loiasis-related proteinuria.
European Research Council, MorLo project.
For the French translation of the abstract see Supplementary Materials section.