血清miR-21在糖尿病肾病中的诊断价值  

Diagnostic value of serum miR-21 for diabetic nephropathy

作　　者：朱柄铭[1] 陈文璟[1] 苏运钦[1] 温旺荣[1] 

机构地区：[1]暨南大学附属第一医院临床医学检验中心,广东广州510632

出　　处：《中国病理生理杂志》2013年第12期2160-2166,共7页Chinese Journal of Pathophysiology

基　　金：广东省科技计划(No.2011B031800315)

摘　　要：目的：评价血清miR-21对糖尿病肾病的诊断价值,探讨糖尿病肾病诊断的分子标志物.方法：对25例糖尿病肾病患者、25例Ⅱ型糖尿病患者A[尿微量白蛋白（UmAlb）＜14.29 mg/L]、25例Ⅱ型糖尿病患者B（UmAlb＞14.29 mg/L）、25例糖尿病肾病引发的尿毒症患者及25例正常对照组的血清标本进行总RNA提取,并进行miR-21的实时荧光定量PCR检测,分析血清miR-21相对表达量与相关临床指标的关系,评估血清miR-21对糖尿病肾病的诊断效能.结果：miR-21在糖尿病肾病患者血清中的相对表达量显著低于正常对照组、糖尿病A组及B组,同时显著高于尿毒症组（均P＜0.01）,糖尿病肾病患者血清miR-21水平与胱抑素C、UmAlb、UmAlb/尿肌酐呈显著负相关（P〈0.01,P〈0.05,P〈0.05）.经logistic回归及ROC曲线分析,血清miR-21在糖尿病肾病患者与正常对照组、糖尿病A组、糖尿病B组、糖尿病A组＋正常对照组、糖尿病B组＋正常对照组和糖尿病A组＋糖尿病B组中诊断糖尿病肾病的曲线下面积（AUC）为0.848（95%CI：0.737～0.959）、0.896（95%CI：0.812～0.980）、0.782（95%CI：0.641～0.922）、0.838（95%CI：0.743～0.933）、0.796（95%CI：0.675～0.917）和0.808（95%CI：0.704～0.911）,敏感性和特异性分别为80.0%和72.0%、72.0%和88.0%、72.0%和84.0%、76.0%和77.0%、76.0%和82.0%、70.0%和86.0%;在4组人群中诊断糖尿病肾病的AUC为0.845（95%CI：0.752～0.939）,敏感性和特异性分别为76.0%和77.3%.结论：血清miR-21可作为糖尿病肾病的分子诊断标志物.AIM： To evaluate the diagnostic value of serum miR-21 as a molecular biomarker in the patients with diabetic nephropathy （DN）. METHODS： Twenty-five patients with DN, 50 patients with type II diabetes [ divided into DMA group and DMB group base on urinary microalbumin （UmAlb）, 25 in each group], 25 patients with diabetic ne- phropathy-induced uremia （UM） and 25 normal controls （NC） were included in the study. Total RNA was extracted from the serum samples for determining the miR-21 level using real-time PCR. The relationship between miR-21 level and clini- cal parameters of the patients with diabetic nephropathy was analyzed. RESULTS： The relative expression level of serum miR-21 was significantly lower in DN group than that in DMA group, DMB group and NC group, and was significantly higher than that in UM group （all P 〈 0. 01 ）. The serum miR-21 level showed significant negative correlation with cystatin C, UmAlb, UmAlb/urinary creatinine in DN patients （P 〈 0.01, P 〈 0.05, P 〈 0.05 ）. For discriminating the DN patients from NC, DMA, DMB, DMA ＋ NC, DMB ＋ NC and DMA ＋ DMB, the areas under the receiver operating characteristic curve （AUC-ROC） for serum miR-21 were 0. 848 （95% CI： 0. 737 ~0. 959）, 0. 896 （95% CI： 0. 812 -0. 980）, 0. 782 （95% CI：0.641-0.922）, 0.838 （95% CI： 0. 743 - 0. 933 ） , 0.796 （95% CI： 0.675 ~0.917） and 0.808 （95% CI： 0. 704 - 0. 911 ）, and the sensitivity and specificity were 80. 0% and 72.0%, 72. 0% and 88. 0% , 72. 0% and 84. 0%, 76. 0% and 77.0%, 76.0% and 82. 0%, 70. 0% and 86. 0%, respectively. For discriminating the DN patients from DMA ＋ DMB ＋ NC, the AUC-ROC was 0. 845 （95% CI： 0. 752-0. 939）, and the sensitivity and specificity were 76.0% and 77.3%, respectively. CONCLUSION： Serum miR-21 can serve as a molecular diagnostic marker for diagno- sis of diabetic nephropathy.

关 键 词：MIR-21 糖尿病肾病 诊断 

分 类 号：R446.9[医药卫生—诊断学] R587.1[医药卫生—临床医学]