血清miR-181b在糖尿病肾病患者中的表达及与预后的相关性

Correlation Between Serum miR-181b Expression and its Relation with Prognosis in Patients with Diabetic Nephropathy

目的:探究血清miR-181b在糖尿病肾病患者(DN)中的表达及与预后的相关性。方法:选择2016年01月~2017年10月我院收治的164例DN患者作为DN组,另选同期100例我院收治的2型糖尿病(DM)无肾损伤患者作为DM组和102例体检正常者作为对照组,测定两组血清miR-181b水平并进行比较,收集患者临床资料并随访2年,分析血清miR-181b表达与肾损伤程度及与DN患者发生终末期肾病(ESRD)的相关性。结果:DN组、DM组血清miR-181b水平均高于对照组,且DN组高于DM组(P<0.05);血清miR-181b水平在DN患者不同24 h尿蛋白、尿素氮、血肌酐、肾小球滤过率、空腹血糖、肾小球分级、IFTA评分、间质炎症评分的DN患者差异具有统计学意义(P<0.05);Spearman相关性分析显示,血清miR-181b与肾小球分级、IFTA、间质炎症评分均呈正相关(r=0.653、0.601、0.579,P<0.05);164例患者中共有30例在随访期间发生ESRD,其血清miR-181b水平高于未发生ESRD患者(P<0.05);绘制ROC曲线,发现血清miR-181b预测DN患者随访期间发生ESRD的曲线下面积为AUC为0.933,其敏感度和特异度分为87.14%、84.04%。结论:血清miR-181b在DN患者中表达异常升高,且与肾损伤严重程度呈正相关,对预测DN患者预后具有一定临床应用价值。

Objective:To investigate the correlation between serum miR-181b expression and its relation withprognosis in patients with diabetic nephropathy(DN).Methods:A total of 164 patients with DN admitted to our hospital from January 2016 to October 2017 were enrolled as the DN group.Another 100 patients with type 2 diabetesmellitus rather than renal injury admitted to our hospital were used as the DM group and 102 normal subjects as the control group.Serum miR-181b levels were measured and compared.Clinical data were collected and followed up for 2 years.The relationship between serum miR-181b expression and renal injury and end-stage renal disease(ESRD)in patients with DN was analyzed.Results:Serum miR-181b levels in DN group and DM group were higher than those in control group,and DN group was higher than DM group(P<0.05);the serum miR-181b in DN patients with different 24 h urine protein,urea Nitrogen,serum creatinine,glomerular filtration rate,fasting blood glucose,glomerular grading,IFTA score,and interstitial inflammation score wassignificantlydifferent(P<0.05).Spearman correlation analysis showed that serum miR-181b was positively correlated with glomerular grading,IFTA,and interstitial inflammation scores(r=0.653、0.601、0.579,P<0.05).Thirty of 164 patients had ESRD during follow-up,and serum miR-181b levels were higher than those of patients without ESRD(P<0.05).The ROC curve was drawn and serum miR-181b could predict the area under the ROC curve(AUC)in DN patients with ESRD during follow-up,of which the AUC was 0.933,and the sensitivity and specificity were 87.14%and 84.04%,respectively.Conclusion:The expression of serum miR-181b is abnormally elevated in patients with DN,and positively correlated with the severity of renal injury,which has a certain clinical value inpredicting the prognosis of patients with DN.