慢性肾脏病患者血清miR-155、FT3水平对血管钙化预测价值

Predictive value of serum miR-155 and FT 3 levels for vascular calcification in patients with chronic kidney disease

目的探究慢性肾脏病(CKD)患者血清微小RNA-155(miR-155)、游离三碘甲状腺原氨酸(FT_(3))水平对血管钙化的预测价值。方法选取2020年7月至2022年3月该院CKD患者142例,另选取同期体检健康者142例。比较CKD患者与体检健康者血清miR-155、FT_(3)水平,统计CKD患者血管钙化情况并比较发生血管钙化和未发生血管钙化患者的资料,分析CKD患者血管钙化的影响因素,构建Logistic回归模型,构建CKD患者血管钙化的列线图预测模型来进行验证,绘制血清miR-155、FT_(3)水平评估CKD患者血管钙化的决策曲线并分析净受益率。结果CKD患者miR-155水平高于体检健康者,FT_(3)水平低于体检健康者(P<0.05);142例患者中47例出现血管钙化,95例未出现血管钙化,血管钙化率为33.10%;血管钙化的CKD患者年龄≥60岁、合并糖尿病、冠心病的例数多于未血管钙化的患者,疾病分期、miR-155水平高于未钙化患者,FT_(3)水平低于未钙化患者(P<0.05);合并糖尿病、冠心病、疾病分期高、血清miR-155水平升高是CKD患者血管钙化的独立危险因素(P<0.05),FT_(3)水平升高是CKD患者血管钙化的保护因素(P<0.05);构建Logistic回归模型,采用Hosmer-Lemeshow拟合优度检验,拟合效果较好;CKD患者血管钙化的列线图预测模型一致性指数为0.873(95%CI:0.758~0.902)。结论CKD患者血清miR-155、FT_(3)异常表达均与患者血管钙化有关,具有良好的预测价值。

Objective To explore the predictive value of serum microRNA-155(miR-155)and free triiodothyronine(FT_(3))levels for vascular calcification in patients with chronic kidney disease(CKD).Methods A total of 142 patients with CKD in the hospital from July 2020 to March 2022 were selected,and 142 healthy subjects were selected during the same period.The serum miR-155 and FT_(3) levels in CKD patients and healthy subjects were compared.The vascular calcification data in CKD patients was counted and compared in CKD patients with and without vascular calcification,and the factors affecting vascular calcification were analyzed in CKD patients.The influencing factors of vascular calcification in CKD patients were analyzed,and a Logistic regression model was constructed.A column graph prediction model for vascular calcification in CKD patients was conducted and verified.The decision curve of serum miR-155 and FT_(3) levels for evaluating vascular calcification in CKD patients was drawn and the net benefit rate was analyzed.Results The level of miR-155 in CKD patients was higher than that of healthy people,and the level of FT_(3) was lower than that of healthy people(P<0.05).47 of 142 patients had vascular calcification,and 95 did not have vascular calcification,and the vascular calcification rate was 33.10%.The ones who were more than 60 years old,complicated with diabetes mellitus and coronary heart disease in calcified patients were more than those in the non-calcified patients,the disease stage and miR-155 level were higher than those in the non-calcified patients,and the FT_(3) level was lower than that in the non-calcified patients(P<0.05).Combined with diabetes,coronary heart disease,high disease stage,and elevated serum miR-155 were independent risk factors for vascular calcification in CKD patients,and elevated FT_(3) level was a protective factor for vascular calcification in CKD patients(P<0.05).Logistic regression model was constructed,using Hosmer-Lemeshow goodness of fit test,the fitting effect was good.The consistency index of the column graph prediction model for vascular calcification in CKD patients was 0.873(95%CI:0.758-0.902).Conclusion The abnormal expression of serum miR-155 and FT_(3) in CKD patients were both associated with vascular calcification in patients and have good predictive value.