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miR-23a-3p表达在糖尿病肾病早期诊断中的临床价值

Clinical value of miR-23a-3p expression in early diagnosis of diabetic kidney disease.

作者信息

Meng Xiaomei, Yu Xiao, Lei Peipei

机构信息

Department of Endocrinology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China.

出版信息

Endokrynol Pol. 2023 Aug 14. doi: 10.5603/EP.a2023.0057.

Abstract

INTRODUCTION

The objective was to observe the expression of miR-23a-3p in the serum of patients with type 2 diabetic nephropathy (T2DN) and to explore its clinical significance.

MATERIALS AND METHODS

112 patients with type 2 diabetes were divided into a simple diabetes mellitus (NON) group, T2DN microalbuminuria (MIC) group, and T2DN macroalbuminuria (MAC) group, according to the urinary protein-creatinine ratio (uACR). Clinical data were collected, miR-23a-3p levels in serum were measured by quantitative reverse transcription polymerase chain reaction (qRT-PCR), and clinical parameters were measured by an automatic biochemical analyser; the influencing factors of diabetic kidney disease (DKD) and the correlation between miR-23a-3p expression and clinical parameters were analysed.

RESULTS

The expression of miR-23a-3p in the serum of the DKD group was lower than that of the normal control (CON) and NON groups. Correlation analysis showed that miR-23a-3p was positively correlated with urinary albumin (Albu), glycosylated haemoglobin (HbA1c), total cholesterol (CHOL), glycated albumin (GA-L), serum creatinine (Scr), fasting blood glucose (GLU), and uric acid (UA), negatively correlated with uACR and high-density lipoprotein cholesterol (HDL-C), but not correlated with urinary creatinine (CREA). The area under the receiver operating characteristic (ROC) curve (AUC) of miR-23a-3p for the diagnosis of DKD was 0.686 [95% confidence interval (CI): 0.599-0.773], with a sensitivity of 64.5% and a specificity of 71.2%; the AUC for differentiating NON from DKD was 0.700 (95% CI: 0.598-0.802), with a sensitivity of 61.8% and a specificity of 77.8%. Multivariate logistic regression analysis showed that serum miR-23a-3p levels were not associated with the development of DKD after adjusting for other levels of influence and were not significant for the differentiation of NON and DKD.

CONCLUSION

Serum miR-23a-3p levels are decreased in T2DN patients, and this change becomes more significant with the severity of the disease, which may be a marker for the early diagnosis and progression of T2DN.

摘要

引言

目的是观察2型糖尿病肾病(T2DN)患者血清中miR-23a-3p的表达,并探讨其临床意义。

材料与方法

根据尿蛋白-肌酐比值(uACR),将112例2型糖尿病患者分为单纯糖尿病(NON)组、T2DN微量白蛋白尿(MIC)组和T2DN大量白蛋白尿(MAC)组。收集临床资料,采用定量逆转录聚合酶链反应(qRT-PCR)检测血清中miR-23a-3p水平,用自动生化分析仪检测临床参数;分析糖尿病肾病(DKD)的影响因素以及miR-23a-3p表达与临床参数之间的相关性。

结果

DKD组血清中miR-23a-3p的表达低于正常对照组(CON)和NON组。相关性分析显示,miR-23a-3p与尿白蛋白(Albu)、糖化血红蛋白(HbA1c)、总胆固醇(CHOL)、糖化白蛋白(GA-L)、血清肌酐(Scr)、空腹血糖(GLU)和尿酸(UA)呈正相关,与uACR和高密度脂蛋白胆固醇(HDL-C)呈负相关,但与尿肌酐(CREA)无关。miR-23a-3p诊断DKD的受试者工作特征(ROC)曲线下面积(AUC)为0.686 [95%置信区间(CI):0.599 - 0.773],灵敏度为64.5%,特异度为71.2%;区分NON与DKD的AUC为0.700(95% CI:0.598 - 0.802),灵敏度为61.8%,特异度为77.8%。多因素logistic回归分析显示,在调整其他影响水平后,血清miR-23a-3p水平与DKD的发生无关,对NON和DKD的鉴别也无统计学意义。

结论

T2DN患者血清miR-23a-3p水平降低,且这种变化随疾病严重程度加重而更显著,这可能是T2DN早期诊断和病情进展的一个标志物。

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