Role of red cell distribution width, tumor necrosis factor-alpha, and interleukin-6 in immunoglobulin a vasculitis nephritis among Tibetan children in high-altitude areas.

BACKGROUND

Purpose to investigate the role of red cell distribution width (RDW), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) in the pathogenesis of Immunoglobulin A vasculitis (IgAV) in Tibetan children at high altitude.

METHODS

A total of 360 children were enrolled: 103 in the IgAV group, 138 in the NIgAV group, and 119 in the control group.

RESULTS

There were no significant differences in race, gender, and age among the three groups (P > 0.05). Yet, RDW, TNF-α, and IL-6 were higher in the NIgAV and IgAV groups than in the control group (P < 0.05). In addition, RDW, TNF-α, and IL-6 were higher in the IgAV group than in the NIgAV group (P < 0.05). The increased RDW, TNF-α, and IL-6 were associated with renal injury in children with IgAV. Spearman correlation analysis showed that RDW, TNF-α, and IL-6 were positively correlated (r = 0.157, p = 0.003; R = 0.357, P < 0.001). The receiver operating characteristic curve showed that RDW, IL-6, and all combinations had high predictive values for IgAV (P < 0.05) compared with TNF-α, with RDW having the highest predictive value (Youden's index: 0.355).

CONCLUSIONS

TNF-α, IL-6, and particularly RDW were identified as risk factors for IgAV in Tibetan children, and there was no regional difference between Tibetan and Han children at high altitudes .