机构地区:[1]江苏省连云港市第一人民医院内分泌科,222002 [2]苏州大学附属第一医院内分泌科
出 处:《临床内科杂志》2022年第5期314-317,共4页Journal of Clinical Internal Medicine
基 金:江苏省卫生健康委员会科研项目(Z2018021);连云港市卫生计生委科技项目(zd1802)
摘 要:目的探讨血小板反应蛋白(TSP)-1 mRNA与微小RNA(miR)-194与2型糖尿病肾病的关系。方法纳入2型糖尿病(T2DM)患者167例为T2DM组,随机选择健康体检者163例为健康对照组。再根据尿微量白蛋白/肌酐比值(UACR)将167例T2DM患者分为正常白蛋白尿组(UACR<30 mg/g,56例)、微量白蛋白尿组(30 mg/g≤UACR<300 mg/g,55例)及大量白蛋白尿组(UACR≥300 mg/g,56例)。收集所有受试者的一般资料、实验室检查结果、miR-194及TSP-1 mRNA水平并分组进行比较。采用Pearson或Spearman相关分析探讨影响miR-194及TSP-1 mRNA表达水平的相关因素,采用多元线性逐步回归分析探讨影响miR-194及TSP-1 mRNA表达水平的独立因素。采用受试者工作特征(ROC)曲线探讨TSP-1 mRNA和miR-194对2型糖尿病肾病的诊断价值。结果T2DM组患者收缩压、舒张压、空腹血浆葡萄糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)、血尿酸(SUA)、miR-194及TSP-1 mRNA水平均高于健康对照组,BMI、高密度脂蛋白胆固醇(HDL-C)水平均低于健康对照组(P<0.05)。TSP-1 mRNA及miR-194表达水平在正常白蛋白尿组、微量白蛋白尿组及大量白蛋白尿组患者中比较差异均有统计学意义(P<0.05)。Pearson或Spearman相关分析结果显示,T2DM患者TSP-1 mRNA与胱抑素C(Cys-C)、UACR呈正相关,miR-194与UACR呈正相关(P<0.05)。多元线性逐步回归分析结果显示,Cys-C、UACR是T2DM患者TSP-1 mRNA的独立影响因素,UACR是miR-194的独立影响因素(P<0.05)。ROC曲线分析结果显示,TSP-1 mRNA及miR-194诊断2型糖尿病肾病的ROC曲线下面积(AUC)分别为0.756(95%CI 0.620~0.893,P<0.01)和0.584(95%CI 0.421~0.748,P<0.01)。结论血清TSP-1 mRNA及miR-194在T2DM患者中表达明显升高,在不同程度尿微量白蛋白患者中的表达存在差异,是早期2型糖尿病肾病的危险因素,对其具有一定的诊断评估价值。Objective To investigate the relationship between microRNA(miR)-194 and TSP-1 mRNA in type 2 diabetic nephropathy.Methods A total of 167 T2 DM patients were included in the T2 DM group,and 163 healthy people who underwent physical examination were randomly selected as the healthy control group.According to the urinary microalbumin/creatinine ratio(UACR),167 T2 DM patients were divided into normal albuminuria group(UACR<30 mg/g,56 cases),microalbuminuria group(30 mg/g≤UACR<300 mg/g,55 cases)and macroalbuminuria group(UACR≥300 mg/g,56 cases).General information,laboratory test results,miR-194 and TSP-1 mRNA levels of all subjects were collected and compared in groups.Pearson or Spearman correlation analysis was used to investigate the related factors affecting the expression levels of miR-194 and TSP-1 mRNA.Multiple linear stepwise regression analysis was used to investigate the independent factors affecting the expression levels of miR-194 and TSP-1 mRNA.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of TSP-1 mRNA and miR-194 in type 2 diabetic nephropathy.Results Systolic blood pressure,diastolic blood pressure,fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1 c),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),blood uric acid(SUA),miR-194 and TSP-1 mRNA levels in T2 DM group were higher than those in healthy control group.BMI and high density lipoprotein cholesterol(HDL-C)levels were lower than those in healthy control group(P<0.05).There were statistically significant differences in the expression levels of miR-194 and TSP-1 mRNA in normal albuminuria group,microalbuminuria group and macroalbuminuria group(P<0.05).Pearson or Spearman correlation analysis showed that TSP-1 mRNA was positively correlated with Cystatin C(Cys-C)and UACR,miR-194 was positively correlated with UACR(P<0.05).Multiple linear stepwise regression analysis showed that Cys-C and UACR were the independent influencing factors of TSP-1 mRNA,and UACR were the ind
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