血清miR-21、cysC、sCD40L及sICAM-1水平与糖尿病肾病的相关性分析  

Correlation Analysis of Serum Levels of miR-21,cys C,sCD40L and sICAM-1 with Diabetes Nephropathy

作　　者：贾秋利 赵旭敏 JIA Qiu-li;ZHAO Xu-min(Department of Endocrinology,The First Hospital of Yulin,Yulin Shaanxi 719000)

机构地区：[1]榆林市第一医院内分泌科,陕西榆林719000

出　　处：《医学临床研究》2022年第8期1197-1201,共5页Journal of Clinical Research

摘　　要：【目的】探讨血清微小RNA-21(miR-21)、胱抑素C(cysC)、可溶性白细胞分化抗原CD40配体(sCD40L)及可溶性细胞间黏附因子-1(sICAM-1)水平与糖尿病肾病(DN)的相关性。【方法】选择2019年10月至2021年10月本院收治的162例2型糖尿病患者,按照尿微量白蛋白排泄率(UACR)分为A组(UACR<30mg/24h,单纯2型糖尿病)70例、B组(UACR30~300 mg/24h,早期DN)52例、C组(UACR>300mg/24h,DN)40例;另选择同期在本院体检的健康志愿者60例为D组。比较各组血清miR-21、cysC、sCD40L、sICAM-1水平及与各生化指标的相关性,采用受试者工作特征(ROC)曲线分析上述指标对早期DN的诊断效能。【结果】A组、B组、C组血清miR-21水平较D组明显降低(P<0.05),血清cysC、sCD40L、sICAM-1水平较D组明显升高(P<0.05);A组、B组、C组血清miR-21水平逐渐降低(P<0.05),血清cysC、sCD40L、sICAM-1水平逐渐升高(P<0.05)。血清miR-21、cysC、sCD40L、sICAM-1与糖化血红蛋白(HbA1c)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、UACR均呈正相关(P<0.05),与估算肾小球滤过率(eGFR)均呈负相关(P<0.05)。血清miR-21、cysC、sCD40L、sICAM-1对早期DN均有一定诊断效能,曲线下面积分别为0.801、0.774、0.873、0.789。【结论】miR-21、cysC、sCD40L、sICAM-1均参与DN发病过程,与病情严重程度有关,均可作为早期DN诊断的可靠标志物。【Objective】To investigate the relationship between serum levels of microRNA-21(miR-21),Cystatin C(cys C),soluble leukocyte differentiation antigen CD40 ligand(sCD40L)and soluble intercellular adhesion factor-1(sICAM-1)and diabetes nephropathy(DN).【Methods】A total of 162 patients with type 2 diabetes admitted to our hospital from October 2019 to October 2021 were selected.According to urinary microalbumin excretion rate(UACR),they were divided into group A(UACR<30 mg/24 h,simple type 2 diabetes)70 cases,group B(UACR 30-300 mg/24 h,early DN)52 cases,and group C(UACR>300 mg/24 h,DN)40 cases;In addition,60 healthy volunteers who underwent physical examination in our hospital in the same period were selected as Group D.The serum levels of miR-21,cys C,sCD40L,sICAM-1 and their correlations with various biochemical indexes were compared in each group.The diagnostic efficacy of the above indexes for early DN was analyzed by using the receiver operating characteristic(ROC)curve.【Results】The levels of serum miR-21 in group A,B and C were significantly lower than those in group D(P<0.05),and the levels of serum cys C,sCD40L and sICAM-1 were significantly higher than those in group D(P<0.05);The levels of serum miR-21 in group A,group B and group C gradually decreased(P<0.05),and the levels of serum cys C,sCD40L and sICAM-1 gradually increased(P<0.05).Serum miR-21,cys C,sCD40L and sICAM-1 were positively correlated with HbA1c,TG,LDL-C and UACR(P<0.05),and negatively correlated with estimated glomerular filtration rate(EGFR)(P<0.05).Serum miR-21,cys C,sCD40L and sICAM-1 had certain diagnostic efficacy for early DN,and the area under the curve was 0.801,0.774,0.873 and 0.789,respectively.【Conclusion】miR-21,cys C,sCD40L and sICAM-1 are all involved in the pathogenesis of DN and are related to the severity of the disease.They can be used as reliable markers for early diagnosis of DN.

关 键 词：糖尿病肾病 微RNAs/血液 抑素类/血液 胞间黏附分子1/血液 

分 类 号：R587.24[医药卫生—内分泌]