Meng Xiaomei, Yu Xiao, Lei Peipei
Department of Endocrinology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China.
Endokrynol Pol. 2023 Aug 14. doi: 10.5603/EP.a2023.0057.
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.
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.
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.
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.
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。
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。
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。
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。