糖尿病肾病患者外周血lncRNA ANRIL的表达与左心室肥厚的关系

The expressions of peripheral blood lncRNA ANRIL and association with left ventricular hypertrophy in patients with diabetic kidney disease

目的探讨外周血长链非编码RNA ANRIL(lncRNA ANRIL)在糖尿病肾病(DKD)患者中的表达水平与左心室肥厚(LVH)的关系。方法选取2020年1月至2021年12月在本院收治的66例DKD患者(DKD组),同期选取本院健康体检者20例作为健康对照组,采用qRT-PCR法检测两组受试者外周血lncRNA ANRIL的表达。根据左心室质量指数(LVMI)将DKD组患者分为非LVH组(23例)和LVH组(43例),比较两组患者的外周血lncRNA ANRIL差异,采用logistic回归分析影响DKD患者LVH的危险因素,采用受试者工作特征(ROC)曲线评估外周血lncRNA ANRIL对DKD患者LVH的预测价值。结果DKD组患者的收缩压、舒张压、血肌酐(Scr)、血尿素氮(BUN)、胱抑素C(Cys C)高于健康对照组,而血红蛋白(Hb)、白蛋白(ALB)、估算肾小球滤过率(eGFR)低于健康对照组(均P<0.05)。LVH组患者的尿微量白蛋白肌酐比(ACR)、Scr、BUN、Cys C、尿β2微球蛋白(β2-MG)、LVMI均高于非LVH组;而Hb、ALB、eGFR均低于非LVH组(均P<0.05)。DKD组患者外周血lncRNA ANRIL表达水平高于健康对照组(P<0.001)。外周血lncRNA ANRIL表达水平与BUN、Scr等呈正相关,与eGFR呈负相关(均P<0.05)。LVH组外周血lncRNA ANRIL表达水平高于非LVH组(P<0.05)。LVMI与收缩压、舒张压、ACR等呈正相关,与Hb、ALB、eGFR呈负相关(均P<0.05)。外周血LncRNA ANRIL是影响DKD患者LVH的独立危险因素(OR=1.535,95%CI:1.058~2.225,P=0.024),而ALB是DKD患者LVH的保护因素(OR=0.853,95%CI:0.737~0.987,P=0.033)。外周血lncRNA ANRIL预测DKD患者LVH的曲线下面积是0.795,灵敏度为81.4%,特异度为73.9%。结论外周血lncRNA ANRIL可作为DKD肾脏损害的生物标志物,且可作为评估DKD患者LVH的预测指标。

Objective To examine the expressions of long noncoding RNA ANRIL(lncRNA ANRIL)in peripheral blood with diabetic kidney disease(DKD)patients,and to explore the correlation between ANRIL and left ventricular hypertrophy(LVH).Methods From January 2020 to December 2021,66 DKD patients(DKD group)and 20 normal healthy people(control group)were collected.Expressions of lncRNA ANRIL in peripheral blood of all participants were measured by RT-qPCR.DKD patients were divided into non-LVH group(23 cases)and LVH group(43 group)according to left ventricular mass index(LVMI).The differences of ANRIL expressions were examined in the two groups.The logistic regression was explored to analyze the risk factor of LVH in DKD patients.Receiver operating characteristic(ROC)curve was used to evaluate the value of lncRNA ANRIL in predicting LVH in DKD patients.Results The systolic blood pressure(SBP),diastolic blood pressure(DBP),serum creatinine(Scr),blood urea nitrogen(BUN)and cystatin C(Cys C)in DKD patients were higher than those in control group,while hemoglobin(Hb),albumin(ALB)and estimated glomerular filtration rate(eGFR)were lower than those of control group(all P<0.05).The urinary albumin/creatinine ratio(ACR),Scr,BUN,Cys-C,urinaryβ2-microglobulin(β2-MG)and LVMI in LVH group were higher than those in non-LVH group,and Hb,ALB,eGFR were lower than those in non-LVH group,the difference was statistically significant(all P<0.05).The circulating expressions of lncRNA ANRIL in DKD patients were significantly higher than that in control group(P<0.05).lncRNA ANRIL was positively correlated with Scr,BUN and negatively correlated with eGFR(all P<0.05).lncRNA ANRIL expressions in LVH patients were dramatically higher than non-LVH group(P<0.05).ANRIL was positively correlated with LVMI(P<0.05),and ANRIL was an independent risk factor for LVH in DKD patients(OR=1.535,95%CI:1.058-2.225,P=0.024).ALB was a protective factor for LVH in DKD patients(OR=0.85,95%CI:0.737-0.987,P=0.033).The area under the curve of lncRNA ANRIL in predicting LVH in DKD patients was 0.795,the sensitivity was 81.4%and the specificity was 73.9%.Conclusions lncRNA ANRIL in peripheral blood can be used as a biomarker of kidney damage in DKD and as a predictor of LVH assessment in DKD patients.