miRNA-29c在1型糖尿病早期肾病患者中的表达及其诊断价值

Expression and diagnostic value of miRNA-29c in type 1 diabetic patients with early nephropathy

目的研究miRNA-29c在1型糖尿病(type 1 diabetes mellitus,T1DM)早期肾病患者中的表达情况,及对早期肾病的诊断价值。方法回顾性选取2019年1月至2022年3月期间于杭州市临安区第一人民医院接受治疗的168例T1DM患者作为研究对象,根据肾病发生情况分为单纯性糖尿病组(122例)及糖尿病肾病组(46例)。采用RT-PCR法检测血清miRNA-29c水平,比较两组的性别、年龄、病程、血清miRNA-29c水平等一般资料,采用Logistic回归分析T1DM患者发生早期肾病的影响因素。采用ROC曲线分析miRNA-29c对于T1DM发生早期肾病的诊断价值。结果早期肾病组的病程、血压(收缩压、舒张压)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、血尿酸高于单纯性糖尿病组,而白蛋白、总胆红素、miRNA-29c(0.82±0.22 vs 1.24±0.33)低于单纯性糖尿病组,差异有统计学意义(P<0.05)。多因素Logistic分析显示:长病程(OR=2.061,95%CI=1.090~3.896)、收缩压(OR=1.143,95%CI=1.023~1.279)、舒张压(OR=1.151,95%CI=1.022~1.298)、高HbA1c(OR=1.317,95%CI=1.049~1.653)、高血尿酸(OR=1.306,95%CI=1.028~1.659)、低miRNA-29c(OR=0.845,95%CI=0.730~0.979)是影响T1DM患者发生早期肾病的危险因素(P<0.05)。ROC曲线分析显示miRNA-29c诊断早期肾病的截断值为0.952,曲线下面积(AUC)为0.863(95%CI:0.801~0.925),敏感度、特异度分别为84.78%、80.33%。结论T1DM早期肾病患者血清miRNA-29c处于低表达状态,是T1DM患者发生早期肾病的影响因素,对于早期肾病具有良好的诊断价值。

Objective To study the expression of miRNA-29c in type 1 diabetic patients with early nephropathy and its diagnostic value for early nephropathy.Methods 168 patients with type 1 diabetes who were treated in our hospital from Jan.2019 to Mar.2022 were retrospectively selected as the research subjects.According to the occurrence of nephropathy,they were divided into simple diabetes group(122 cases)and diabetic nephropathy group(46 cases).Serum miRNA-29c levels were detected by RT-PCR.The gender,age,course of disease,and serum miRNA-29c levels were compared between the two groups.Logistic regression was used to analyze the influencing factors of early nephropathy in patients with type 1 diabetes.The ROC curve was used to analyze the diagnostic value of miRNA-29c for early nephropathy in type 1 diabetes.Results The course of disease,blood pressure(systolic blood pressure,diastolic blood pressure),HbA1c,TC and blood uric acid in early nephropathy group were higher than those in simple diabetes group,while albumin,total bilirubin and miRNA-29c were lower than those in simple diabetes group,and the difference was statistically significant(P<0.05).Multivariate Logistic analysis showed:long disease duration(OR=2.061,95%CI=1.090-3.896),systolic blood pressure(OR=1.143,95%CI=1.023-1.279),diastolic blood pressure(OR=1.151,95%CI=1.022-1.298),high HbA1c(OR=1.317,95%CI=1.049~1.653),high blood uric acid(OR=1.306,95%CI=1.028-1.659),low miRNA-29c(OR=0.845,95%CI=0.730-0.979)were the risk factors for early nephropathy in patients with type 1 diabetes(P<0.05).ROC curve analysis showed that the cut-off value of miRNA-29c for the diagnosis of early renal disease was 0.952,the area under the curve(AUC)was 0.863(95%CI:0.801-0.925),and the sensitivity and specificity were 84.78%and 80.33%,respectively.Conclusion Serum miRNA-29c in patients with early stage nephropathy of type 1 diabetes is in a low expression state,which is an influencing factor for early stage nephropathy in patients with type 1 diabetes,and has a good diagnostic value for early stage nephropathy.