miR-770-5p和miR-145-5p在糖尿病肾脏疾病患者中的表达变化及临床意义

张冰斐; 孙雪

doi:10.3969/j.issn.1671-2390.2024.11.002

miR-770-5p和miR-145-5p在糖尿病肾脏疾病患者中的表达变化及临床意义

张冰斐,
孙雪

Expression and clinical significance of miR-770-5p and miR-145-5p in patients with diabetic nephropathy

摘要

摘要:
目的探究微小RNA（microRNA，miRNA）-770-5p和miR-145-5p在糖尿病肾脏疾病（diabetic kidney disease，DKD）患者中的表达变化及临床意义。
方法选取2020年12月至2022年12月于国药东风总医院接受治疗的DKD患者132例作为DKD组，另选取同期在国药东风总医院接受治疗的2型糖尿病（type 2 diabetes mellitus ，T2DM）患者132例作为T2DM组，选取同期在本院健康体检者132名作为对照组。采用实时荧光定量-聚合酶链式反应（reverse transcription–qPCR，qRT-PCR）测定血清miR-770-5p、miR-145-5p表达水平；影响DKD预后的因素采用多因素Logistic回归分析；血清miR-770-5p、miR-145-5p对DKD预后的预测价值绘制受试者工作特征（receiver operating characteristic，ROC）曲线分析。
结果 DKD组患者血清miR-770-5p、miR-145-5p表达水平高于对照组（1.35 ± 0.29）比（1.01 ± 0.21）、（1.37 ± 0.29）比（1.02 ± 0.22），P＜0.05、T2DM组（1.35 ± 0.29）比（1.08 ± 0.25）、（1.37 ± 0.29）比（1.12 ± 0.24），P＜0.05，且T2DM组患者血清miR-770-5p、miR-145-5p表达水平高于对照组（1.08 ± 0.25）比（1.01 ± 0.21）、（1.12 ± 0.24）比（1.02 ± 0.22），P＜0.05。晚期DKD组患者血清miR-770-5p、miR-145-5p表达水平高于早期DKD组（1.45 ± 0.33）比（1.18 ± 0.26）、（1.47 ± 0.31）比（1.21 ± 0.26），P＜0.05，中期DKD组（1.45 ± 0.33）比（1.33 ± 0.27）、（1.47 ± 0.31）比（1.35 ± 0.29），P＜0.05，且中期DKD组血清miR-770-5p、miR-145-5p表达水平高于早期DKD组（1.33 ± 0.27）比（1.18 ± 0.26）、（1.35 ± 0.29）比（1.21 ± 0.26），P＜0.05。预后不良组血清miR-770-5p、miR-145-5p表达水平高于预后良好组（1.53 ± 0.32）比（1.28 ± 0.28）、（1.58 ± 0.34）比（1.29 ± 0.27），P＜0.05。与预后良好组患者相比，预后不良组尿素氮、白蛋白、血肌酐有显著差异（P＜0.05）。多因素Logistic结果显示，miR-770-5p、miR-145-5p、尿素氮、血肌酐是影响DKD患者预后的危险因素（OR＞1，P＜0.05），白蛋白是影响DKD患者预后的保护因素（OR＜1，P＜0.05）。血清miR-770-5p、miR-145-5p二者联合预测DKD患者预后的曲线下面积最高，优于血清miR-770-5p、miR-145-5p各自单独预测（Z_{二者联合-miR-770-5p} = 3.632、P = 0.003，Z_{二者联合-miR-145-5p} = 2.370、P = 0.018）。
结论 DKD患者血清miR-770-5p和miR-145-5p表达水平升高，与DKD病情严重程度及预后密切相关，二者联合评估DKD患者预后的价值更好。

Abstract:
Objective To explore the expressions and clinical significance of MicroRNA-770-5p （miR-770-5p） and MicroRNA-145-5p （miR-145-5p） in patients with diabetic kidney disease （DKD）.
Methods From December 2020 to December 2022, 132 DKD patients （n = 132） were designated as DKD group, another 132 type 2 diabetes patients （n = 132） as T2DM group and still another 132 health checkups at the same time as control group. Real-time fluorescent quantitative polymerase chain reaction （qRT-PCR） was applied for measuring the serum expression levels of miR-770-5p and miR-145-5p. The prognostic factors of DKD were examined by multiple Logistic regression analysis. And predictive value of serum miR-770-5p and miR-145-5p for DKD prognosis was analyzed through plotting receiver operating characteristic （ROC） curve.
Results As compared with control group, the expression levels of serum miR-770-5p and miR-145-5p spiked markedly in T2DM and DKD groups （P＜0.05）. As compared with early DKD group, the serum expression levels of miR-770-5p and miR-145-5p in middle and late DKD groups rose obviously （P＜0.05）. As compared with good prognosis group, the serum expression levels of miR-770-5p and miR-145-5p jumped greatly in poor prognosis group （P＜0.05）. As compared with good prognosis group, there were significant differences in urea nitrogen, albumin and serum creatinine in poor prognosis group （P＜0.05）. Multivariate Logistic results indicated that miR-770-5p, miR-145-5p, urea nitrogen and serum creatinine were risk factors for the prognosis （P＜0.05） while albumin was a protective factor （P＜0.05）. The area under the curve （AUC） of the combined prognostic prediction of serum miR-770-5p and miR-145-5p was the highest. It was better than individual prediction of serum miR-770-5p and miR-145-5p （Z_{combination - miR-770-5p} = 3.632, P = 0.003, Z _{combination - miR-145-5p} = 2.370, P = 0.018）.
Conclusions The serum expression levels of miR-770-5p and miR-145-5p are up-regulated in DKD patients. It is closely correlated with the severity and prognosis of DKD. The combination of the two is more valuable in evaluating the prognosis of DKD patients.

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