The ratio of TG/CysC is a significant indicator of nephritis in children with IgA vasculitis.

The incidence of IgA vasculitis (IgAV) in children is relatively high. Cases with severe kidney involvement can lead to death. This study aimed to assess whether the ratio of triglyceride and cystatin C (TG/CysC) represented a risk factor for nephritis in children with IgAV. A total of 451 children were recruited in this study, including 64 children with IgAV and 387 with IgAV with nephritis (IgAVN), according to renal puncture results. Triglycerides, creatinine, urea, uric acid, cystatin C, immunoglobulin A, complement C3, and complement C4 were measured. Compared with the IgAV group, the children with IgAVN had higher triglycerides, creatinine, urea, uric acid and TG/CysC and lower cystatin C and complement C4 (p<0.05). Stepwise multiple logistic regression models showed that TG/CysC (odds ratio: OR = 3.246) was an independent indicator of the presence of nephritis in children with IgAV as well as age (OR = 1.233), creatinine (OR = 1.052), and complement C4 (OR = 0.007). Furthermore, after adjustment for confounding variables, the prevalence of nephritis in children with IgAV was significantly higher according to increased serum TG/CysC levels. The adjusted ORs for nephritis according to TG/CysC tertiles were 1.00 (as references), 2.202 (1.117-4.342), and 14.188 (4.576-43.992). When the TG/CysC ratio was set as 1.94, the diagnostic sensitivity was 53%, and the specificity was 90.6%. Our data suggested that high levels of TG/CysC in children with IgAV was an increased risk for developing nephritis.