2型糖尿病患者血清miR-146a与糖尿病肾病相关性研究

Correlation between serum miR-146a and diabetic nephropathy in patients with type 2 diabetes mellitus

目的 探讨2型糖尿病患者血清miR-146a及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)与糖尿病肾病的关系。方法 收集2020年12月至2022年1月嘉兴市第一医院内分泌科收治的128例2型糖尿病患者,根据尿白蛋白与尿肌酐比值(urinary albumin-to-creatinine ratio,UACR)将患者分为3组:尿白蛋白正常组(UACR<30mg/g,58例);微量尿白蛋白组(30mg/g≤UACR<300mg/g,44例);大量尿白蛋白组(UACR≥300mg/g,26例)。收集患者的基线资料,采用实时荧光定量聚合酶链反应(real-time quantitative polymerase chain reaction,RT-qPCR)检测血清miR-146a的表达水平,酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测血清TNF-α的表达水平。分析miR-146a及TNF-α与UACR的关系。结果 与尿白蛋白正常组相比,微量尿白蛋白组和大量尿白蛋白组患者的TNF-α水平均明显升高,且随尿蛋白升高递增,差异有统计学意义(P<0.05)。微量尿白蛋白组和大量尿白蛋白组患者的miR-146a水平均低于尿白蛋白正常组,差异有统计学意义(P<0.05)。Spearman相关分析显示,miR-146a与UACR呈负相关(r=–0.574,P<0.05),TNF-α与UACR呈正相关(r=0.824,P<0.05)。miR-146a预测糖尿病肾病的敏感度为77.1%,特异性为79.3%(95%CI:71.7%~87.4%,P<0.05)。结论 2型糖尿病患者血清miR-146a及TNF-α可作为预测糖尿病肾病的分子学标志物,有助于糖尿病肾病的早期诊断。

Objective To investigate the relationship between miR-146a,tumor necrosis factor-α(TNF-α) and diabetic nephropathy in patients with type 2 diabetes mellitus.Methods A total of 128 patients with type 2 diabetes mellitus admitted to the Department of Endocrinology,the First Hospital of Jiaxing from December 2020 to January 2022 were collected.According to the urinary albumin-to-creatinine ratio(UACR),the patients were divided into three groups:urinary albumin normal group(UACR30mg/g,58 cases);microalbuminuria group(30mg/g≤UACR<300mg/g,44 cases);macroalbuminuria group(UACR≥300mg/g,26 cases).The baseline data of all patients were collected,the expression level of serum miR-146a was detected by real-time quantitative polymerase chain reaction(RT-qPCR),and the expression level of serum TNF-α was detected by enzyme linked immunosorbent assay(ELISA).The relationship between miR-146a,TNF-α and UACR was analyzed.Results Compared with the urinary albumin normal group,the level of TNF-α in the microalbuminuria group and macroalbuminuria group were significantly increased,and showed an increasing trend,the differences were statistically significant(P<0.05).The level of miR-146a in the microalbuminuria group and macroalbuminuria group were lower than those in urinary albumin normal group,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that miR-146a was negatively correlated with UACR(r=–0.574,P<0.05),and TNF-α was positively correlated with UACR(r=0.824,P>0.05).The sensitivity and specificity of miR-146a in predicting diabetic nephropathy were 77.1% and 79.3%(95%CI:71.7%-87.4%,P<0.05).Conclusion Serum miR-146a and TNF-α in patients with diabetic mellitus can be used as molecular markers to predict diabetic nephropathy and contribute to the early diagnosis of diabetic nephropathy.