血清miR-141在糖尿病肾损伤患者中的表达及与远期预后的关系

Expression of Serum miR-141 in Patients with Diabetic Renal Injury and Its Relationship with Long-term Prognosis

目的:分析血清miR-141在糖尿病肾损伤患者中的表达及与远期预后的关系。方法:选取2017年1月-2019年6月于本院就诊的72例糖尿病肾损伤患者作为观察组,选取同期于本院进行健康体检的48例健康体检者作为对照组,比较两组血清miR-141表达水平在不同临床病理参数情况下的表达水平,并分析观察组不同肾脏损伤程度与血清miR-141表达水平的相关性,对观察组血清miR-141表达水平与远期预后情况进行评价。结果:观察组收缩压、舒张压、血肌酐表达水平以及血清miR-141表达水平均明显高于对照组,血红蛋白与白蛋白表达水平均明显低于对照组,差异均有统计学意义(P<0.05)。糖尿病病史≥10年、尿蛋白≥3.0 g/L、血肌酐表达水平≥150μmol/L以及血尿素氮表达水平≥7.5 mmol/L的患者血清miR-141表达水平均明显高于未超过其标准的患者,eGFR≥60 mL/(min·1.73 m^2)患者血清miR-141表达水平明显低于未超过其标准患者,差异均有统计学意义(P<0.05)。观察组不同肾小球分级、IFTA分数以及间质炎症分数血清miR-141表达水平比较,差异均有统计学意义(P<0.05)。肾小球分级Ⅳ级、IFTA 3分以及间质炎症2分高表达占比均明显高于低表达,差异均有统计学意义(P<0.05)。观察组27例患者在随访期间出现终末期肾病,其中血清miR-141低表达水平中占6例,血清miR-141高表达水平中占21例,血清miR-141高表达水平随访期间出现终末期肾病的风险比低表达高3.5倍。结论:糖尿病肾损伤患者血清miR-141表达水平明显高于正常人,且其表达水平与糖尿病肾损伤患者的肾损伤水平以及预后具有相关性;血清miR-141表达水平越高,糖尿病肾损伤患者肾损伤程度越严重,其预后程度越差,在临床上具有一定预后价值。

Objective:To analyze the correlation between serum miR-141 expression and long-term prognosis in patients with diabetic renal injury.Method:From January 2017 to June 2019,72 patients with diabetic renal injury treated in our hospital were selected as the observation group,and 48 healthy subjects who came in the hospital for physical examination at the same time were selected as the control group.The expression levels of serum miR-141 under different clinical pathological parameters were compared between two groups.The correlation between the degree of renal injury and the expression level of serum miR-141 in the observation group was analyzed.The serum miR-141 expression level and long-term prognosis in the observation group were evaluated.Result:The systolic blood pressure,diastolic blood pressure,serum creatinine expression and serum miR-141 expression in the observation group were significantly higher than those in the control group(P<0.05).The hemoglobin expression level and albumin expression level in the observation group were significantly lower than those in the control group(P<0.05).The expression level of serum miR-141 in patients with a history of diabetes≥10 years,proteinuria≥3.0 g/L,serum creatinine expression levels≥150μmol/L,and blood urea nitrogen expression levels above 7.5 mmol/L were significantly higher than those in patients without exceeding the standard(P<0.05).The expression level of serum miR-141 in patients with eGFR≥60 mL/(min·1.73 m^2)was significantly lower than that in patients who did not exceed the standard(P<0.05).There were significant differences in serum miR-141 expression levels between the different glomerular grades,IFTA scores,and interstitial inflammation scores(P<0.05).The glomerular gradeⅣ,IFTA 3 points and interstitial inflammation 2 points in high expression were significantly higher than those in low expression(P<0.05).There were 27 patients in the observation group who had end-stage renal disease during the follow-up period,included 6 cases of low expression of serum miR-141 and 21 cases of high expression of serum miR-141,and the risk of end-stage renal disease of high expression of serum miR-141 during follow-up was 3.5 times higher than that of low expression.Conclusion:The expression level of serum miR-141 in patients with diabetic renal injury is significantly higher than that in normal subjects,and its expression level is correlated with the level of renal injury and prognosis in patients with diabetic renal injury.The higher the expression level of serum miR-141,the more serious the degree of renal injury in patients with diabetic kidney injury,and the worse the prognosis,which has some clinical prognostic value.