2型糖尿病患者血清微小RNA-130b、白细胞介素-17A水平变化及临床意义

Changes and Clinical Significance of Serum micRNA-130b and Interleukin-17A in Patients with Type 2 Diabetes Mellitus

目的:探讨血清MRNA-130b(miR-130b)、白细胞介素-17(Interleukin-17,IL-17A)水平与2型糖尿病患者早期肾脏损伤的关系。方法:选择2016年1月-2016年12月武汉市第三医院收治肾病患者116例,依据尿蛋白排泄率(Urine protein excretion rate,UAER)分为正常白蛋白尿(DM组,41例),微量白蛋白尿(DN1组,37例),临床白蛋白尿(DN2组,38例),另选健康体检者(NC组)40例。采集空腹静脉血检测糖化血红蛋白(Glycated hemoglobin,HbAlc)、空腹血糖(Fasting blood glucose,FPG)、三酞甘油(Triglycerin,TG)、总胆固醇(Total cholesterol,TC)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)、高密度脂蛋胆固醇(HDL cholesterol,HDL-C)、尿素氮(Urea Nitrogen,BUN)、肌酐(Creatinine,Cr)、尿微量白蛋白肌酐比值(Urinary microalbumin-creatinine ratio,ACR)、白细胞介素17A(IL-17A)浓度,采用实时荧光定量PCR检测血清mi R-130b的表达,分析上述指标间的相关性。结果:DN1组和DN2组BUN、Cr、ACR显著高于NC组和DM组,且DN2组显著高于DN1组(均P<0.05);DM组、DN1组IL-17A显著高于NC组(均P<0.05),DN2组IL-17A显著低于其余三组(均P<0.05);其余三组的mi R-130b表达水平显著低于NC组(均P<0.05),且DM组<DN1组<DN2组(均P<0.05)。DN患者IL-17A与TG、LDL-C、BUN、Cr、ACR呈负相关(r=-0.361、-0.383、-0.396、-0.417、-0.425,均P<0.05),mi R-130b与HbAlc、TG、LDL-C、BUN、Cr、ACR呈负相关(r=-0.276、-0.335、-0.294、-0.296、-0.315、-0.289,均P<0.05)。结论:血清mi R-130b表达水平和IL-17A浓度与DN患者肾脏损伤均呈负相关,可能通过调节炎症反应和细胞信号通路等途径参与DN的进展,有望成为T2DM患者早期肾损伤的生物学标志物。

Objective:To investigate the relationship between the levels of serum mir-130 b and IL-17 A and the early renal injury in patients with type 2 diabetes mellitus.Methods:A total of 116 patients with kidney disease,who were admitted to Wuhan Third Hospital from January 2016 to December 2016,were divided into normal albuminuria(DM group,41 cases),microalbuminuria(DN1 group,37 cases),clinical albuminuria(DN2 group,38 cases)and 40 healthy people(NC group)according to the urinary protein excretion rate(UAER).The concentrations of HbAlc,FPG,TG,TC,LDL-C,HDL-C,bun,Cr,ACR and IL-17 A were determined by real-time fluorescence.The expression of mir-130 b in the serum was detected by quantitative PCR,and the correlation among the above indexes was analyzed.Results:The expression levels of bun,Cr and ACR in group DN 1 and group DN 2 were significantly higher than those in group NC and group DM,and the above indexes in group DN 2 were significantly higher than those in group DN 1(all P<0.05).The level of IL-17 A in group DM and group DN 1 was significantly higher than that in group NC(all P<0.05).The expression level of mir-130 b in other three groups was significantly lower than that in group NC(all P<0.05),and that in group DM<group DN 1<group DN 2(all P<0.05).In group DN,IL-17 A was negatively correlated with TG,LDL-C,bun,Cr and ACR(r=-0.361,-0.383,-0.396,-0.417,-0.425,all P<0.05),and mir-130 b was negatively correlated with HbAlc,TG,LDL-C,bun,Cr and ACR(r=-0.276,-0.335,-0.294,-0.296,-0.315,-0.289,all P<0.05).Conclusion:The expression level of mir-130 b and the concentration of IL-17 A in serum are negatively correlated with renal injury in the patients with DN,which may be involved in the progression of DN by regulating inflammatory response and cell signaling pathway,and may become a biological marker of early renal injury in the patients with T2 DM.