miR-770-5p和miR-145-5p在糖尿病肾脏疾病患者中的表达变化及临床意义

Expression and clinical significance of miR-770-5p and miR-145-5p in patients with diabetic nephropathy

目的探究微小RNA(microRNA,miRNA)-770-5p和miR-145-5p在糖尿病肾脏疾病(diabetic kidney disease,DKD)患者中的表达变化及临床意义。方法选取2020年12月至2022年12月于国药东风总医院接受治疗的DKD患者132例作为DKD组,另选取同期在国药东风总医院接受治疗的2型糖尿病(type 2 diabetes mellitus,T2DM)患者132例作为T2DM组,选取同期在本院健康体检者132名作为对照组。采用实时荧光定量-聚合酶链式反应(reverse transcription–qPCR,qRT-PCR)测定血清miR-770-5p、miR-145-5p表达水平;影响DKD预后的因素采用多因素Logistic回归分析;血清miR-770-5p、miR-145-5p对DKD预后的预测价值绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析。结果DKD组患者血清miR-770-5p、miR-145-5p表达水平高于对照组[(1.35±0.29)比(1.01±0.21)、(1.37±0.29)比(1.02±0.22),P<0.05]、T2DM组[(1.35±0.29)比(1.08±0.25)、(1.37±0.29)比(1.12±0.24),P<0.05],且T2DM组患者血清miR-770-5p、miR-145-5p表达水平高于对照组[(1.08±0.25)比(1.01±0.21)、(1.12±0.24)比(1.02±0.22),P<0.05]。晚期DKD组患者血清miR-770-5p、miR-145-5p表达水平高于早期DKD组[(1.45±0.33)比(1.18±0.26)、(1.47±0.31)比(1.21±0.26),P<0.05],中期DKD组[(1.45±0.33)比(1.33±0.27)、(1.47±0.31)比(1.35±0.29),P<0.05],且中期DKD组血清miR-770-5p、miR-145-5p表达水平高于早期DKD组[(1.33±0.27)比(1.18±0.26)、(1.35±0.29)比(1.21±0.26),P<0.05]。预后不良组血清miR-770-5p、miR-145-5p表达水平高于预后良好组[(1.53±0.32)比(1.28±0.28)、(1.58±0.34)比(1.29±0.27),P<0.05]。与预后良好组患者相比,预后不良组尿素氮、白蛋白、血肌酐有显著差异(P<0.05)。多因素Logistic结果显示,miR-770-5p、miR-145-5p、尿素氮、血肌酐是影响DKD患者预后的危险因素(OR>1,P<0.05),白蛋白是影响DKD患者预后的保护因素(OR<1,P<0.05)。血清miR-770-5p、miR-145-5p二者联合预测DKD患者预后的曲线下面积最高,优于血清miR-770-5p、miR-145-5p各自单独预测(Z_(二者联合-miR-770-5p)=3.632、P=0.003,Z_(二者联合-miR-145-5p)=2.370、P=0.018)。结论DKD患者血清miR-770-5p和miR-145-5p表达水平升高,与DKD病情严重程度及预后密切相关,二者联合评估DKD患者预后的价值更好。

Objective To explore the expressions and clinical significance of MicroRNA-770-5p(miR-770-5p)and MicroRNA-145-5p(miR-145-5p)in patients with diabetic kidney disease(DKD).Methods From December 2020 to December 2022,132 DKD patients(n=132)were designated as DKD group,another 132 type 2 diabetes patients(n=132)as T2DM group and still another 132 health checkups at the same time as control group.Real-time fluorescent quantitative polymerase chain reaction(qRT-PCR)was applied for measuring the serum expression levels of miR-770-5p and miR-145-5p.The prognostic factors of DKD were examined by multiple Logistic regression analysis.And predictive value of serum miR-770-5p and miR-145-5p for DKD prognosis was analyzed through plotting receiver operating characteristic(ROC)curve.Results As compared with control group,the expression levels of serum miR-770-5p and miR-145-5p spiked markedly in T2DM and DKD groups(P<0.05).As compared with early DKD group,the serum expression levels of miR-770-5p and miR-145-5p in middle and late DKD groups rose obviously(P<0.05).As compared with good prognosis group,the serum expression levels of miR-770-5p and miR-145-5p jumped greatly in poor prognosis group(P<0.05).As compared with good prognosis group,there were significant differences in urea nitrogen,albumin and serum creatinine in poor prognosis group(P<0.05).Multivariate Logistic results indicated that miR-770-5p,miR-145-5p,urea nitrogen and serum creatinine were risk factors for the prognosis(P<0.05)while albumin was a protective factor(P<0.05).The area under the curve(AUC)of the combined prognostic prediction of serum miR-770-5p and miR-145-5p was the highest.It was better than individual prediction of serum miR-770-5p and miR-145-5p(Z_(combination-miR-770-5p)=3.632,P=0.003,Z_(combination-miR-145-5p)=2.370,P=0.018).Conclusions The serum expression levels of miR-770-5p and miR-145-5p are up-regulated in DKD patients.It is closely correlated with the severity and prognosis of DKD.The combination of the two is more valuable in evaluating the prognosis of DKD patients.