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.
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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 .