Fouad Mohamed, Salem Ibrahim, Elhefnawy Khaled, Raafat Nermin, Faisal Amal
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Department of Medical Biochemistry, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Indian J Nephrol. 2020 Jan-Feb;30(1):21-25. doi: 10.4103/ijn.IJN_80_19. Epub 2019 Dec 27.
Diabetic nephropathy (DN) is the most common cause of chronic kidney disease worldwide. A major challenge is to identify early diabetic nephropathy. microRNAs (miRNAs) are short noncoding RNA sequences and regulate a wide range of biological processes as cell differentiation, proliferation, cell metabolism and apoptosis. miRNAs may have a role in molecular mechanisms linked to cellular pathways of DN. The aim of this study was to investigate the level of microRNA-21 as a potential marker of early nephropathy in type 1 diabetes mellitus (T1DM).
A total number of 340 participants were included and classified into 3 groups; Group I included 100 healthy participants, Group II included 120 patients with T1DM with <5 years duration, and Group III included 120 patients with T1DM with >5 years duration. All participants were submitted to detail clinical examination, laboratory investigations, urinary albumin/creatinine ratio (ACR), estimated glomerular filtration rate (eGFR) as well as plasma microRNA-21 assays.
Blood pressure and ACR were significantly higher in group III than groups I and II. Further, microRNA-21 was significantly higher in group III than groups I and II, and more in group II than group I. microRNA-21 starts to rise in group II before microalbuminuria. miRNA-21 at a level of 0.01 had a greater sensitivity 94.1% and specificity 100% for identifying DN than ACR at level 45 mg/gm with sensitivity 88.2% and specificity 89%.
Plasma microRNA-21 can serve as an early marker for diagnosis and identifying diabetic nephropathy in T1DM.
糖尿病肾病（DN）是全球慢性肾脏病最常见的病因。一个主要挑战是识别早期糖尿病肾病。微小RNA（miRNA）是短的非编码RNA序列，可调节广泛的生物学过程，如细胞分化、增殖、细胞代谢和凋亡。miRNA可能在与DN细胞途径相关的分子机制中发挥作用。本研究的目的是调查微小RNA-21作为1型糖尿病（T1DM）早期肾病潜在标志物的水平。
共纳入340名参与者并分为3组；第一组包括100名健康参与者，第二组包括120名病程<5年的T1DM患者，第三组包括120名病程>5年的T1DM患者。所有参与者均接受详细的临床检查、实验室检查、尿白蛋白/肌酐比值（ACR）、估计肾小球滤过率（eGFR）以及血浆微小RNA-21检测。
第三组的血压和ACR显著高于第一组和第二组。此外，第三组的微小RNA-21显著高于第一组和第二组，第二组高于第一组。在微量白蛋白尿出现之前，第二组的微小RNA-21就开始升高。对于识别DN，微小RNA-21水平为0.01时的敏感性为94.1%，特异性为100%，而ACR水平为45mg/gm时的敏感性为88.2%，特异性为89%。
血浆微小RNA-21可作为诊断和识别T1DM患者糖尿病肾病的早期标志物。
