血浆miR-192、miR-29c水平对2型糖尿病肾病诊断的临床意义

The clinical significance of plasma mir-192 and mir-29c levels in diagnosis of type 2 diabetic nephropathy

目的探讨血浆微小RNA 192(miR 192)与微小RNA 29c(miR 29c)联合检测对2型糖尿病肾病的诊断价值。方法选取2017年12月至2018年12月本院收治的166例2型糖尿病患者为研究对象,分为糖尿病无肾损害组(DM组)与糖尿病肾病组(DN组),同时以同时期本院健康体检健康人群60例为正常对照组(NC组)。采用实时荧光定量聚合酶链反应(qRT PCR)检测各组血浆miR 192、miR 29c的表达水平;采用酶联免疫吸附法(ELISA)检测尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平;采用Pearson法分析DN患者血浆miR 192、miR 29c与NGAL的相关性;采用受试者工作特征曲线(ROC)分析血浆miR 192、miR 29c表达对DN的诊断价值;分析血浆miR 192、miR 29c联合诊断DN的诊断效能。结果与NC组比较,DM组与DN组患者尿NGAL水平、miR 29c的表达水平显著升高(P<0.05),DN组显著高于DM组(P<0.05);与NC组相比,DM组与DN组患者血浆miR 192的表达水平均显著降低(P<0.05),DN组显著低于DM组(P<0.05);miR 192与尿NGAL呈负相关(r=-0.338,P=0.002),miR 29c与尿NGAL呈正相关(r=0.516,P<0.001);miR 192诊断DN的灵敏度52.50%,特异度75.58%;miR 29c诊断DN的灵敏度50.00%,特异度86.05%;联合诊断灵敏度97.50%,特异度95.34%,准确度为96.39%;联合检测时灵敏度与准确度均高于单项检测(P<0.05)。结论血浆miR 192、miR 29c表达异常与2型糖尿病肾病发生发展密切相关,二者联合检测可提高2型糖尿病肾病诊断效能。

Objective Toexplore the diagnostic value of combined detection of plasma microRNA 192(miR 192)and microRNA 29c(miR 29c)in type 2 diabetic nephropathy.Methods 166 patients with type 2 diabetes admitted to our hospital from December 2017 to December 2018 were enrolled.According to the clinical diagnostic criteria of diabetic nephropathy,they were divided into renal damage(DM)group and diabetic nephropathy group(DN group).At the same time,60 healthy people were taken as the normal control group(NC group).Real time quantitative polymerase chain reaction(qRT PCR)was used to detect the expression levels of miR 192 and miR 29c in plasma.Urine neutrophil gelatinase associated lipocalin(NGAL)levels were measured by enzyme linked immunosorbent assay(ELISA).The correlation between plasma miR 192,miR 29c and NGAL in DN patients was analyzed by Pearson method.The diagnostic value of plasma miR 192 and miR 29c expression on DN was analyzed by receiver operating characteristic curve(ROC).The diagnostic efficacy of plasma miR 192 and miR 29c combined with diagnosis of DN was analyzed by clinical pathological diagnosis.Results Compared with the NC group,the expression levels of urinary NGAL and miR 29c in the DM group and the DN group increased significantly(P<0.05),and the DN group was significantly higher than the DM group(P<0.05).Compared with the NC group,the expression levels of plasma miR 192 in the DM group and the DN group were significantly lower(P<0.05),and the DN group was significantly lower than the DM group(P<0.05).miR 192 was negatively correlated with urinary NGAL(r=-0.338,P=0.002),and miR 29c was positively correlated with urinary NGAL(r=0.516,P<0.001).The sensitivity of miR 192 for diagnosis of DN was 52.50%and the specificity was 75.58%.The sensitivity of miR 29c for diagnosis of DN was 50.00%and the specificity was 86.05%.The combined diagnostic sensitivity was 97.50%,the specificity was 95.34%,and the accuracy was 96.39%.The sensitivity and accuracy of the joint detection were higher than the single test(P<0.05).Conclusion The abnormal expression of miR 192 and miR 29c in plasma is closely related to the occurrence and development of type 2 diabetic nephropathy.The combined detection of the two can improve the diagnostic efficiency of type 2 diabetic nephropathy.