2型糖尿病肾病患者血清miR-27b-3p、miR-342-3p 表达特点及临床意义.

Objective To investigate the serum expression characteristics of miR-27b-3p and miR-342-3p in type 2 diabetic nephropathy (DN) patients and the diagnostic value for DN. Methods A total of 157 patients with DN were selected and divided into the normal albuminuria group (NA group, n=49), the microalbuminuria group (MA group, n=41) and the macroalbuminuria group (DN group, n=67) according to the ratio of albumin to creatinine (UACR) of urine specimens. Clinical data and the expression of serum miR-27b-3p and miR-342-3p, renal function and urinary fibrosis indicators were detected by real-time quantitative polymerase chain reaction. Blood urea nitrogen (BUN) and blood creatinine (Scr), were detected by automatic biochemical analyzer. Urine type Ⅳ collagen (Ⅳ-C), laminin (LN) and type Ⅲ procollagen peptide (PCⅢ) were detected by double-antibody sandwich enzyme-linked immunosorbent assay. The factors influencing the pathogenesis of DN and the diagnostic value of miR-27b-3p and miR-342-3p for DN were analyzed. Results Compared with the NA group, the levels of HbA1c, UACR, urinary Ⅳ-C, urinary LN and urinary PCⅢ were increased, while the expresson levels of miR-27b-3p and miR-342-3p were decreased in the DN group and the MA group (P＜0.05). Levels of BUN and Scr were increased in the DN group (P＜0.05), and eGFR level decreased (P＜0.05). The higher level of urinary PCⅢ was a risk factor for DN, while the higher levels of miR-27b-3p, miR-342-3p and eGFR were protective factors of DN (P＜0.05). The expressions levels of miR-27b-3p and miR-342-3p were positively correlated with eGFR (r = 0.647, 0.661, P＜0.05) and negatively correlated with urinary PCⅢ (r=-0.739, P＜0.05). The area under the curve for diagnosing DN by combining eGFR, urinary PCⅢ, miR-27b-3p and miR-342-3p was higher than that of eGFR, urinary PCⅢ, miR-27b-3p, miR-342-3p alone (Z=5.631, 5.794, 6.715, 4.577, P＜0.05). Conclusion The decreased expressions of serum miR-27b-3p and miR-342-3p are associated with decreased renal function and DN occurrence in patients with type 2 diabetes, which can be used as biological indicators for the auxiliary diagnosis of DN. [ABSTRACT FROM AUTHOR]

探讨 2 型糖尿病肾病(DN)患者血清 miR-27b-3p, miR-342-3p 表达特点及其对 DN 的诊断价值. 方法 将 157 例 2 型糖尿病患者根据尿白蛋白与肌酐比率(UACR)分为正常白蛋白尿(NA)组 49 例, 微量白蛋白 尿(MA)组41例, 大量白蛋白尿(DN)组67例.收集临床资料, 采用实时定量聚合酶链反应检测血清miR-27b-3p, miR-342-3p表达, 全自动生化分析仪检测血尿素氮(BUN), 血肌酐(Scr), 双抗体夹心酶联免疫吸附试验检测尿液Ⅳ 型胶原(Ⅳ-C), 层粘连蛋白(LN), Ⅲ型前胶原肽(PCⅢ).分析DN发病的影响因素以及miR-27b-3p, miR-342-3p对 DN 的诊断价值.结果 与 NA 组比较, DN 组和MA 组 HbA1c, UACR, 尿Ⅳ-C, 尿 LN, 尿PCⅢ水平均增加, 而 miR27b-3p, miR-342-3p 表达均降低(P＜0.05), DN 组 BUN, Scr 水平增加, 估算肾小球滤过率(eGFR)水平降低(P＜ 0.05).较高水平的尿PCⅢ是DN的危险因素, 而较高水平的miR-27b-3p, miR-342-3p, eGFR是DN保护因素(P＜ 0.05).miR-27b-3p, miR-342-3p表达与eGFR呈正相关(r分别为0.647, 0.661, P＜0.05), 与尿PCⅢ呈负相关(r分别 为-0.739, -0.766, P＜0.05).联合eGFR, 尿PCⅢ, miR-27b-3p, miR-342-3p诊断DN的AUC高于单独eGFR, 尿PCⅢ, miR-27b-3p, miR-342-3p(Z 分别为 5.631, 5.794, 6.715, 4.577, P＜0.05).结论 血清 miR-27b-3p, miR-342-3p 表 达降低与DN患者肾功能下降和肾脏疾病发生均有关, 可作为DN辅助诊断的生物学指标. [ABSTRACT FROM AUTHOR]