血清sICAM1、TNFR1、miRNA155检测对早期1型糖尿病肾病诊断的价值研究

The Value of Serum sICAM1,TNFR1 and miRNA155 Detection in the Diagnosis of Early Type 1 Diabetic Nephropathy

目的探讨血清可溶性细胞间黏附因子1(sICAM1)、肿瘤坏死因子受体1(TNFR1)、微小RNA(miRNA)-155在1型糖尿病肾病早期诊断中的价值。方法选取我院收治的1型糖尿病(T1DM)患者101例,根据尿白蛋白排泄率(UAER)分为糖尿病(DM)组和早期糖尿病肾病(DKD)组,采用Logistic回归分析DKD的可能影响因素;建立受试者工作特征曲线(ROC),计算曲线下面积(AUC),分析血清sICAM1、TNFR1、miRNA155对早期DKD的诊断价值。结果101例T1DM患者发生DKD 37例,发生率为36.63%。早期DKD组血肌酐(Scr)、血尿素氮(BUN)、超敏C反应蛋白(hs-CRP)、sICAM1、TNFR1、miRNA155高于DM组,估算肾小球滤过率(eGFR)低于DM组(P<0.05)。Logistic结果显示,hsCRP(OR=2.140,P=0.023)、eGFR(OR=0.425,P=0.009)、sICAM1(OR=4.187,P=0.001)、TNFR1(OR=4.697,P<0.001)、miRNA155(OR=3.832,P<0.001)均是发生DKD的影响因素。ROC结果显示,血清sICAM1、TNFR1、miRNA155单独及联合诊断早期DKD的AUC分别为0.762、0.749、0.756、0.835。结论DKD患者血清sICAM1、TNFR1、miRNA155水平高于单纯DM患者,三者联合检测对早期DKD具有较高诊断价值。

Objective To investigate the value of serum soluble intercellular adhesion molecule-1(sICAM1),tumor necrosis factor receptor 1(TNFR1),and microRNA(miRNA)-155 in the early diagnosis of type 1 diabetic nephropathy.Methods A total of 101 patients with type 1 diabetes mellitus(T1DM)from January 2019 to March 2021 were selected and divided into diabetes(DM)group and early diabetic kidney disease(DKD)group according to urinary albumin excretion rate(UAER),and the possible influencing factors of DKD were analyzed by logistic regression.A receiveroperating characteristic curve(ROC)was established,the area under curve(AUC)was calculated,and the diagnostic value of serum sICAM1,TNFR1 and miRNA155 for early DKD was analyzed.Results There were 37 cases of DKD in 101 T1DM patients,with an incidence rate of 36.63%.The serum creatinine(Scr),blood urea nitrogen(BUN),high-sensitivity C-reactive protein(hs-CRP),sICAM1,TNFR1,and miRNA155 in the early DKD group were higher than those in the DM group,and estimated glomerular filtration rate(eGFR)was lower than that in the DM group(P<0.05).Logistic results showed that hsCRP(OR=2.140,P=0.023),eGFR(OR=0.425,P=0.009),sICAM1(OR=4.187,P=0.001),TNFR1(OR=4.697,P<0.001),miRNA155(OR=3.832,P<0.001)were the influencing factors of DKD.ROC results showed that the AUC of serum sICAM1,TNFR1,miRNA155 alone and in combination for the diagnosis of early DKD were 0.762,0.749,0.756,and 0.835,respectively.Conclusion The serum levels of sICAM1,TNFR1 and miRNA155 in patients with DKD are higher than those in patients with simple DM,and the combined detection of the three has a high diagnostic value for early DKD.