血清长链非编码RNA Rpph1表达对2型糖尿病患者蛋白尿进展的预测价值研究

Predictive value of serum lncRNA Rpph1 expression in progression of albuminuria for patients with type 2 diabetes mellitus

目的探讨血清长链非编码RNA(lncRNA)Rpph1表达对2型糖尿病患者蛋白尿进展的预测价值。方法选取2016年1月—2018年1月在浙江省立同德医院内分泌科因控制血糖重复住院治疗的2型糖尿病患者268例。根据首次、再次入院时24 h尿蛋白定量水平将患者分为蛋白尿进展组62例和蛋白尿非进展组206例。比较两组首次入院的临床资料;采用多因素Logistic回归分析2型糖尿病患者蛋白尿进展的影响因素;采用受试者工作特征(ROC)曲线分析血清lncRNA Rpph1表达对2型糖尿病患者蛋白尿进展的早期预测价值。结果两组患者的糖尿病病程、合并高血压、使用二甲双胍及Scr、血尿酸、lncRNA Rpph1水平比较,差异有统计学意义(P<0.05)。合并高血压[OR=3.271(95%CI:1.864,3.872)]、使用二甲双胍[OR=2.192(95%CI:1.253,2.413)]及Scr水平[OR=1.873(95%CI:1.211,2.063)]、血尿酸水平[OR=2.321(95%CI:1.432,2.784)]、lncRNA Rpph1相对表达量[OR=2.621(95%CI:1.732,3.064)]是2型糖尿病患者蛋白尿进展的独立危险因素(P<0.05)。ROC曲线显示,首次入院血清lncRNA Rpph1相对表达量预测蛋白尿进展发生的最佳截断值为0.564,AUC为0.800(95%CI:0.742,0.858),敏感性为67.48%(95%CI:0.517,0.784),特异性为82.26%(95%CI:0.684,0.935)。结论血清lncRNA Rpph1相对表达量较高是2型糖尿病患者蛋白尿进展的独立危险因素之一,其对蛋白尿进展具有一定的预测价值。

Objective To investigate the predictive value of serum lncRNA Rpph1 expression in short-term progression of albuminuria in type 2 diabetes mellitus patients. Methods A total of 268 cases of type 2 diabetes patients repeatedly hospitalized for blood glucose control in the department of endocrinology of our hospital from January 2016 to January 2018 were chosen as research subject, they were divided into albuminuria advanced group(n = 62), albuminuria non-advanced group of albuminuria(n = 206) according to the quantitative level of urinary albumin at 24 hours after the first and second admission. Comparing the difference of clinical data of two groups at first admission, influencing factors of albuminuria progression in type 2 diabetes patients were analyzed with multifactor logistics regression, early prediction value of serum lncRNA Rpph1 expression in type 2 diabetes patients was analyzed with ROC curve. Results There were significant difference in diabetes course, hypertension, metformin treatment, Scr, serum uric acid, and lncRNA Rpph1 levels between albuminuria advanced group and albuminuria non-advanced group(P < 0.05). Hypertension [OR = 3.271(95% CI: 1.864, 3.872)], metformin therapy [OR = 2.192(95% CI: 1.253, 2.413) ], Scr [OR = 1.873(95% CI: 1.211, 2.063) ], serum uric acid [OR = 2.321(95% CI: 1.432,2.784) ], and lncRNA Rpph1 [OR = 2.621(95% CI: 1.732, 3.064) ] levels were all independent risk factors for the progression of albuminuria in patients with type 2 diabetes(P < 0.05). ROC curve showed that optimal cut-off value of serum lncRNA Rpph1 expression level for the prediction of the progression of albuminuria at the first admission was 0.564, AUC was 0.800(95% CI: 0.742, 0.858), and corresponding sensitivity and specificity were 67.48%(95% CI: 0.517, 0.784) and 82.26%(95% CI: 0.684, 0.935). Conclusion High expression level of serum lncRNA Rpph1 in type 2 diabetes mellitus patients is one of the independent risk factors for the subsequent progression of albuminuria, and its specific expression level has a certain early prediction value for the progression of albuminuria.