2型糖尿病肾病患者血清miR-27b-3p、miR-342-3p表达特点及临床意义  

Expression and clinical significance of serum miR-27b-3p and miR-342-3p in patients with type 2 diabetic nephropathy

作　　者：韩敬 顾津伊 聂君旭 张艳萍[3] 赵玲华[4] HAN Jing;GU Jinyi;NIE Junxu;ZHANG Yanping;ZHAO Linghua(Department of Nephrology,the Affiliated Hospital of Yunnan University(the Second People's Hospital of Yunnan/Yunnan Eye Hospital),Kunming 650032,China;Departmet of Laboratory,the Affiliated Hospital of Yunnan University(the Second People's Hospital of Yunnan/Yunnan Eye Hospital),Kunming 650032,China;Departmet of Endocrinology,the Affiliated Hospital of Yunnan University(the Second People's Hospital of Yunnan/Yunnan Eye Hospital),Kunming 650032,China;Infection Control Division,Shanxi Cancer Hospital)

机构地区：[1]云南大学附属医院(云南省第二人民医院、云南省眼科医院)肾内科,650032 [2]云南大学附属医院(云南省第二人民医院、云南省眼科医院)检验科,650032 [3]云南大学附属医院(云南省第二人民医院、云南省眼科医院)内分泌科,650032 [4]山西省肿瘤医院感染控制科

出　　处：《天津医药》2022年第10期1077-1082,共6页Tianjin Medical Journal

基　　金：云南省科技厅科技计划项目(2018FE0010)。

摘　　要：目的探讨2型糖尿病肾病(DN)患者血清miR-27b-3p、miR-342-3p表达特点及其对DN的诊断价值。方法将157例2型糖尿病患者根据尿白蛋白与肌酐比率(UACR)分为正常白蛋白尿(NA)组49例、微量白蛋白尿(MA)组41例、大量白蛋白尿(DN)组67例。收集临床资料,采用实时定量聚合酶链反应检测血清miR-27b-3p、miR-342-3p表达,全自动生化分析仪检测血尿素氮(BUN)、血肌酐(Scr),双抗体夹心酶联免疫吸附试验检测尿液Ⅳ型胶原(Ⅳ-C)、层粘连蛋白(LN)、Ⅲ型前胶原肽(PCⅢ)。分析DN发病的影响因素以及miR-27b-3p、miR-342-3p对DN的诊断价值。结果与NA组比较,DN组和MA组HbA1c、UACR、尿Ⅳ-C、尿LN、尿PCⅢ水平均增加,而miR-27b-3p、miR-342-3p表达均降低(P<0.05),DN组BUN、Scr水平增加、估算肾小球滤过率(eGFR)水平降低(P<0.05)。较高水平的尿PCⅢ是DN的危险因素,而较高水平的miR-27b-3p、miR-342-3p、eGFR是DN保护因素(P<0.05)。miR-27b-3p、miR-342-3p表达与eGFR呈正相关(r分别为0.647、0.661,P<0.05),与尿PCⅢ呈负相关(r分别为-0.739、-0.766,P<0.05)。联合eGFR、尿PCⅢ、miR-27b-3p、miR-342-3p诊断DN的AUC高于单独eGFR、尿PCⅢ、miR-27b-3p、miR-342-3p(Z分别为5.631、5.794、6.715、4.577,P<0.05)。结论血清miR-27b-3p、miR-342-3p表达降低与DN患者肾功能下降和肾脏疾病发生均有关,可作为DN辅助诊断的生物学指标。Objective To investigate the serum expression characteristics of miR-27b-3p and miR-342-3p in type 2 diabetic nephropathy(DN) patients and the diagnostic value for DN.Methods A total of 157 patients with DN were selected and divided into the normal albuminuria group(NA group,n=49),the microalbuminuria group(MA group,n=41)and the macroalbuminuria group(DN group,n=67) according to the ratio of albumin to creatinine(UACR) of urine specimens.Clinical data and the expression of serum miR-27b-3p and miR-342-3p,renal function and urinary fibrosis indicators were detected by real-time quantitative polymerase chain reaction.Blood urea nitrogen(BUN) and blood creatinine(Scr),were detected by automatic biochemical analyzer.Urine type Ⅳ collagen(Ⅳ-C),laminin(LN) and type Ⅲprocollagen peptide(PC Ⅲ) were detected by double-antibody sandwich enzyme-linked immunosorbent assay.The factors influencing the pathogenesis of DN and the diagnostic value of miR-27b-3p and miR-342-3p for DN were analyzed.Results Compared with the NA group,the levels of HbAlc,UACR,urinary Ⅳ-C,urinary LN and urinary PC Ⅲ were increased,while the expresson levels of miR-27b-3p and miR-342-3p were decreased in the DN group and the MA group(P <0.05).Levels of BUN and Scr were increased in the DN group(P <0.05),and eGFR level decreased(P <0.05).The higher level of urinary PC Ⅲ was a risk factor for DN,while the higher levels of miR-27b-3p,miR-342-3p and eGFR were protective factors of DN(P <0.05),The expressions levels of miR-27b-3p and miR-342-3p were positively correlated with eGFR(r=0.647,0,661,P<0.05) and negatively correlated with urinary PC Ⅲ(r=-0.739,P<0.05).The area under the curve for diagnosing DN by combining eGFR,urinary PC Ⅲ,miR-27b-3p and miR-342-3p was higher than that of eGFR,urinary PC Ⅲ,miR-27b-3p,miR-342-3p alone(Z=5.631,5.794,6.715,4.577,P<0.05).Conclusion The decreased expressions of serum miR-27b-3p and miR-342-3p are associated with decreased renal function and DN occurrence in patients with type 2 diabetes,which can

关 键 词：糖尿病肾病 基因表达调控 诊断 鉴别 miR-27b-3p miR-342-3p 肾纤维化 

分 类 号：R587.1[医药卫生—内分泌]