外周血miR-92b-5p与miR-148b-3p在2型糖尿病进展至糖尿病肾病中的表达及交互作用

Expression and interaction of peripheral blood miR-92b-5p and miR-148b-3p in the progression of type 2 diabetes to diabetic nephropathy

目的探究2型糖尿病(type 2 diabetes,T2DM)进展至糖尿病肾病(diabetic nephropathy,DN)过程中血清微小RNA(microRNA,miR)-92b-5p、miR-148b-3p水平变化和作用。方法选取我院T2DM患者400例开展前瞻性研究,其中200例非DN患者作为T2DM组,200例DN患者作为DN组。比较两组临床资料、血清miR-92b-5p、miR-148b-3p水平,并比较DN组不同分期患者血清miR-92b-5p、miR-148b-3p水平,分析DN组血清miR-92b-5p、miR-148b-3p水平与临床分期的相关性,并分析T2DM进展至DN过程中血清miR-92b-5p与miR-148b-3p的交互作用,及血清miR-92b-5p、miR-148b-3p水平预测DN的价值。结果DN组血肌酐(serum creatinine,SCr)、血清miR-148b-3p水平高于T2DM组,估算肾小球滤过率(estimated glomerular filtration rate,eGFR)及血清miR-92b-5p水平低于T2DM组(P<0.05);DN组临床期患者血清miR-148b-3p水平高于早期患者,血清miR-92b-5p水平低于早期患者(P<0.05);DN组血清miR-92b-5p水平与临床分期呈负相关,血清miR-148b-3p水平与临床分期呈正相关(P<0.05);在T2DM进展至DN过程中,miR-92b-5p低表达与miR-148b-3p高表达呈次相乘模型的正向交互作用(P<0.05);miR-92b-5p、miR-148b-3p预测T2DM进展至DN的曲线下面积(area under the curve,AUC)分别为0.840、0.812,二者联合预测的AUC最大,为0.911。结论DN患者血清miR-92b-5p水平明显降低,miR-148b-3p水平明显升高,且与DN临床分期密切相关,miR-92b-5p低表达、miR-148b-3p高表达共同促进T2DM进展至DN过程。

Objective To investigate the changes in serum microRNA(miR)-92b-5p and miR-148b-3p levels and their role in the progression of type 2 diabetes mellitus(T2DM)to diabetic nephropathy(DN).Methods A prospective study was conducted on 400 T2DM patients in our hospital,with 200 non-DN patients as the T2DM group and 200 DN patients as the DN group.The clinical data,serum miR-92b-5p and miR-148b-3p levels of the two groups were compared,and the serum miR-92b-5p and miR-148b-3p levels of patients with different stages in the DN group were compared.The correlation between serum miR-92b-5p and miR-148b-3p levels and clinical stages in the DN group,the interaction between serum miR-92b-5p and miR-148b-3p in the progression of T2DM to DN,and the value of serum miR-92b-5p and miR-148b-3p levels in predicting DN were analyzed.Results In the DN group,serum creatinine(SCr)and serum miR-148b-3p levels were higher than those in the T2DM group,and the estimated glomerular filtration rate(eGFR)and serum miR-92b-5p levels were lower than those in the T2DM group(P<0.05).Serum miR-148b-3p levels in the DN group were higher,and serum miR-92b-5p levels were lower than those in the early stage(P<0.05).Serum miR-92b-5p levels in the DN group were negatively correlated with clinical stage and serum miR-148b-3p levels were positively correlated with clinical stage(P<0.05).The positive interaction between low expression of miR-92b-5p and high expression of miR-148b-3p in the progression of T2DM to DN was a submultiplicative model(P<0.05).The area under the curve(AUC)of miR-92b-5p and miR-148b-3p in predicting T2DM progression to DN was 0.840 and 0.812,respectively,and the combined prediction of the two had the largest AUC(0.911).Conclusion Serum miR-92b-5p levels are significantly lower and miR-148b-3p levels are significantly higher in DN patients,which are closely related to the clinical stage of DN.Low expression of miR-92b-5p and high expression of miR-148b-3p contribut to the progression of T2DM to DN.