转化生长因子-β_(1)相关血清微小核糖核酸对糖尿病肾病早期诊断的临床价值  

Early diagnostic value of TGF-β_(1) related urinary exosome miRNAs in patients with type 2 diabetic kidney disease

作　　者：胡楠杰 李佩真 章静 Hu Nanjie;Li Peizhen;Zhang Jing(Graduate School,Zhejiang University of Traditional Chinese Medicine,Hangzhou,Zhejiang 310000,China;Huzhen Town Health Center,Jinyun,Zhejiang 321404,China;Department of Endocrinology,Jinyun County People′s Hospital,Jinyun,Zhejiang 321401,China;Internal Medicine,Jinyun County People′s Hospital,Jinyun,Zhejiang 321401,China)

机构地区：[1]浙江中医药大学研究生院,浙江杭州310000 [2]缙云县壶镇镇中心卫生院,浙江缙云321404 [3]缙云县人民医院内分泌科,浙江缙云321401 [4]缙云县人民医院内科,浙江缙云321401

出　　处：《中国药物与临床》2024年第15期979-984,I0003,共7页Chinese Remedies & Clinics

摘　　要：目的探讨转化生长因子β_(1)(TGF-β_(1))相关血清微小核糖核酸(miRNA)对糖尿病肾病(DKD)早期诊断的临床价值。方法收集2019年1月至2021年12月在缙云县壶镇镇中心卫生院及缙云县人民医院就诊的2型糖尿病(T2DM)患者260例作为研究对象。根据尿白蛋白排泄率(UAER),研究对象分为单纯T2DM组135例、早期DKD组82例、临床DKD组43例。另选取50名健康志愿者作为对照组。检测各组血清miR-27a、miR-27b、miR-29c、miR-200c水平和TGF-β_(1)水平,并进行指标间的相关关系分析。利用受试者工作特征(ROC)曲线分析血清miRNAs对DKD的早期诊断价值。结果单纯T2DM组、早期DKD组和临床DKD组患者血清miR-27a、miR-27b、miR-200c水平及TGF-β_(1)水平均高于对照组,miR-29c水平低于对照组(F=235.624、70.351、108.127、672.304,P均<0.001)。TGF-β_(1)与血清miR-27a、miR-27b、miR-200c呈正相关,与miR-29c呈负相关(r=0.668、0.429、0.618、-0.502,P均<0.001)。血清miR-27a、miR-27b、miR-29c、miR-200c对T2DM患者发生DKD的诊断曲线下面积(AUC)为0.913、0.775、0.812、0.894,miR-27a和miR-200c的敏感度和特异度均>0.7。验证队列中血清miR-27a、miR-27b、miR-29c、miR-200c对T2DM患者发生DKD的诊断AUC分别为0.901、0.787、0.802、0.896,差异有统计学意义(Z=-9.012,P<0.01)。结论血清miR-27a、miR-27b、miR-29c、miR-200c对于早期DKD都有一定的诊断价值。Objective To explore the clinical value of transforming growth factor-β_(1)(TGF-β_(1))-related serum microRNA in the early diagnosis of diabetes nephropathy(DKD).Methods A total of 260 patients of type 2 diabetes mellitus(T2DM)treated in Huzhen Town Health Center and Jinyun County People′s Hospital from January 2019 to December 2021 were collected as the study cohort.According to the urinary albumin excretion rate(UAER),the study cohort was divided into a simple T2DM group(135 cases),an early DKD group(82 cases),and a clinical DKD group(43 cases).Another 50 healthy volunteers were selected as the control group(NC).The levels of serum miR-27a,miR-27b,miR-29c,miR-200c,and TGF-β_(1) were detected in each group,and correlation analysis was conducted between the indicators.The early diagnostic value of serum miRNAs for DKD was analyzed by receiver operating characteristic(ROC)curve.Results The serum levels of miR-27a,miR-27b,miR-200c and TGF-β_(1) in the simple T2DM group,early DKD group and clinical stage DKD group were higher than those in the control group,while the level of miR-29c was lower than that in the control group(F=235.624,70.351,108.127,672.304,all P<0.001).TGF-β_(1) was positively correlated with serum miR-27a,miR-27b,and miR-200c,but negatively correlated with miR-29c(r=0.668,0.429,0.618,-0.502,all P<0.001).The areas under the diagnostic curve of serum miR-27a,miR-27b,miR-29c and miR-200c for DKD in T2DM patients were 0.913,0.775,0.812 and 0.894,and the sensitivity and specificity of miR-27a and miR-200c were both greater than 0.7.In the validation cohort,the diagnostic AUCs of serum miR-27a,miR-27b,miR-29c,and miR-200c for DKD in T2DM patients were 0.901,0.787,0.802,and 0.896 respectively,and the differences were statistically significant(Z=-9.012,P<0.01).Conclusion Serum miR-27a,miR-27b,miR-29c,and miR-200c have certain diagnostic val-ue for early diabetic nephropathy,and their mechanism of action may be related to the regulation of TGF-β_(1) sig-naling pathway.

关 键 词：糖尿病肾病 微量尿蛋白排泄率 微RNA 转化生长因子β_(1) 早期诊断 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]