糖尿病肾病患者尿液中miR-30、miR-125变化的临床意义及其与足细胞损伤的关系

Clinical significance of miR-30,miR-125 changes in urine of diabetic nephropathy patients and their relationship with podocyte injury

目的探讨糖尿病肾病(DKD)患者尿液中miR-30、miR-125变化的临床意义及其与足细胞损伤的关系。方法2017年3月至2019年3月间在该院确诊为糖尿病肾病的患者88例作为DKD组,同期在该院首诊为2型糖尿病且肾功能正常的单纯糖尿病患者50例作为单纯糖尿病组;在该院进行体检并明确各个组织脏器功能均基本正常的志愿者50例作为健康对照组。对比3组研究对象尿液miR-30、miR-125表达水平,外周血肾功能指标[血肌酐(Scr)、尿素氮(BUN)、β2微球蛋白(β2-M)]水平,尿足细胞损伤标志物(podocalyxin、nephrin、podocin)的差异,采用Pearson检验评估DKD患者尿液中miR-30、miR-125表达水平与病情严重程度的相关关系。结果DKD组患者尿液中miR-30、miR-125的表达量均低于单纯糖尿病组、健康对照组;外周血中Scr、BUN、β2-M的水平均高于单纯糖尿病组、健康对照组;尿podocalyxin、nephrin、podocin的水平均高于单纯糖尿病组、健康对照组,差异有统计学意义(P<0.05),单纯糖尿病组、健康对照组间上述指标水平的差异无统计学意义(P>0.05)。相关性分析发现,DKD患者尿miR-30、miR-125表达量与肾功能指标、尿足细胞损伤标志物水平呈负相关性(P<0.05)。结论DKD患者尿miR-30、miR-125表达量异常降低,可间接反映肾功能及足细胞损伤程度。

Objective To investigate the clinical significance of miR-30,miR-125 changes in urine of diabetic nephropathy(DKD)patients and their relationship with podocyte injury.Methods A total of 88 cases of DKD patients diagnosed in our hospital from March 2017 to March 2019 were chosen as DKD group,50 cases of type 2 diabetes patients with normal renal function were chosen as simple diabetes group,50 cases of healthy volunteers were chosen as healthy control group.The expression levels of urinary miR-30,miR-125,peripheral blood kidney indexes[serum creatinine(Scr),urea nitrogen(BUN),β2 microglobulin(β2-M)],urinary podocyte damage markers(podocalyxin,nephrin and podocin)were compared between three groups.The levels of miR-30 and miR-125 in urine of DKD patients was evaluated by Pearson test.The expression level was correlated with the severity of the disease.Results The expression levels of miR-30 and miR-125 in urine of DKD group were lower than those in simple diabetes group and healthy control group;the levels of Scr,BUN andβ2-M in peripheral blood were all higher than those in simple diabetes group and healthy control group;the levels of urinary podocalyxin,nephrin and podocin were all higher than those of simple diabetes group and healthy control group(P<0.05),there were no statistically significant difference between simple diabetes group and normal control group(P>0.05).The correlation analysis showed that the expression levels of urinary miR-30 and miR-125 in DKD patients were negatively correlated with renal function and the level of urinary podocyte damage markers(P<0.05).Conclusion The abnormal abnormal decrease of urinary miR-30 and miR-125 in DKD patients can indirectly reflect the degree of renal function and podocyte injury.