糖尿病肾脏疾病患者血浆miR-34a表达水平及临床意义

Expression levels and clinical significance of miR-34a in the plasma of patients with diabetic kidney disease

目的 探讨DKD患者血浆miR-34a表达水平及临床意义。方法 选取2019年6月至2020年6月于我院内分泌科治疗的T2DM患者189例。根据UACR分为正常蛋白尿组(Nor,UACR<30 mg/g,n=88)、微量蛋白尿组组(Mic,30≤UACR<300 mg/g,n=60)及大量蛋白尿组(Mac,UACR≥300 mg/g,n=41),同期选取体检健康者为正常对照组(NC,n=90)。采用ELISA法检测中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子1(KIM-1),受试者工作特征(ROC)曲线分析血浆miR-34a对DKD的诊断价值。结果 NC、Nor、Mic、Mac组FPG、HbA_(1)c、Scr、BUN、NGAL、UACR、KIM-1、miR-34a依次升高(P<0.05)。Pearson相关分析显示,miR-34a与FPG、HbA_(1)c、Scr、BUN、NGAL、UACR、KIM-1呈正相关(P<0.01)。ROC曲线下面积为0.824,敏感度、特异度为75.1%、86.7%。结论 血浆miR-34a对DKD有一定诊断价值。

Objective To investigate the expression level of plasma miR-34a in patients with diabetic kidney disease(DKD) and its clinical significance.Methods 189 type 2 diabetes mellitus(T2DM) patients treated in our hospital from June 2019 to June 2020 were selected and divided into normal proteinuria group(Nor,UACR<30 mg/g,n=88),microalbuminuria group(Mic,30≤UACR<300 mg/g,n=60) and macroproteinuria group(Mac,UACR≥300 mg/g,n=41) based on the levels of UACR.,During the same period,healthy individuals who underwent physical examination were selected as the normal control group(NC,n=90).Neutrophil gelatinase-associated lipocalin(NGAL),kidney injury molecule 1(KIM-1) were measured by ELISA.The expression of miR-34a in plasma was measured by reverse transcription-polymerase chain reaction,The diagnostic value of DKD was analyzed by receiver operating characteristic(ROC) curve.Results The levels of FPG,HbA_1c,Scr,BUN,NGAL,UACR,KIM-1 and miR-34a in NC,Nor,Mic and Mac groups increased sequentially(P<0.05).Pearson correlation analysis showed that miR-34a was positively correlated with FPG,HbA_1c,Scr,BUN,NGAL,UACR and KIM-1(P<0.01).The area under ROC curve was 0.824,with the sensitivity 75.1% and specificity 86.7%,respectively.Conclusion Plasma miR-34a has certain diagnostic value for DKD.