[1]马 霞,常晓东,赵 敏.糖尿病肾病患者血清miR-488，miR-654水平表达与疾病严重程度及预后的关系研究[J].现代检验医学杂志,2025,40(02):129-134.[doi:10.3969/j.issn.1671-7414.2025.02.024]
　MA Xia,CHANG Xiaodong,ZHAO Min.Relationship between Serum miR-488, miR-654 Level Expression and Disease Severity and Prognosis in Patients with Diabetic Nephropathy[J].Journal of Modern Laboratory Medicine,2025,40(02):129-134.[doi:10.3969/j.issn.1671-7414.2025.02.024]
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糖尿病肾病患者血清miR-488，miR-654水平表达与疾病严重程度及预后的关系研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年02期
页码:
129-134
栏目:
论著
出版日期:
2025-03-15

文章信息/Info

Title:
Relationship between Serum miR-488, miR-654 Level Expression and Disease Severity and Prognosis in Patients with Diabetic Nephropathy
文章编号:
1671-7414（2025）02-129-06
作者:
马 霞; 常晓东; 赵 敏
（雅安市人民医院肾病内科，四川雅安625000）
Author(s):
MA Xia; CHANG Xiaodong; ZHAO Min
（Department of Nephrology，Ya’an People’s Hospital，Sichuan Ya’an 625000，China）
关键词:
糖尿病肾病; 微小RNA-488; 微小RNA-654; 病情严重程度
分类号:
R587.2；R392.11
DOI:
10.3969/j.issn.1671-7414.2025.02.024
文献标志码:
A
摘要:
目的 探究糖尿病肾病（DN）患者血清miR-488，miR-654 水平与疾病严重程度及预后的关系。方法 选取92 例2022 年1 月～ 2024 年1 月雅安市人民医院诊治的DN 患者（DN 组）以及60 例健康正常人（健康组）进行miR-488，miR-654 水平检测，Pearson 分析血清miR-488 与miR-654 的相关性；卡方检验分析血清miR-488，miR-654 表达水平与临床病理特征和肾脏损伤程度的关系；ROC 预测DN 患者预后情况。结果 DN 患者与健康组相比，血清miR-488（1.71±0.40 vs 1.08±0.15）表达水平明显升高，miR-654（0.66±0.19 vs 0.94±0.22）表达水平明显降低，差异具有统计学意义（t=11.666，8.340，均P ＜ 0.05）。糖尿病年限≥ 10 年、24h 尿蛋白≥ 3 g/L、血肌酐≥ 150 μmol/L、肾小球滤过率＜ 60 ml/min/1.73m2，血尿素氮≥ 7.5mmol/L 的DN 患者血清miR-488 高表达、miR-654 低表达占比显著高于血清miR-488 低表达、miR-654 高表达患者，差异具有统计学意义（χ2=5.283 ～ 25.234；4.356 ～ 8.587，均P<0.05）。Pearson 分析DN 组血清miR-488 与miR-654 呈负相关（r=-0.405，P<0.05）；血清miR-488 与24h 尿蛋白、血肌酐、血尿素氮呈正相关（r=0.376，0.435，0.406，均P<0.05），与肾小球滤过率呈负相关（r=-0.382，P<0.05）；血清miR-654 与24h 尿蛋白、血肌酐、血尿素氮呈负相关（r=-0.418，-0.367，-0.425，均P<0.05），与肾小球滤过率呈正相关（r=0.374，P<0.05）。肾小球分级Ⅳ级、间质炎症2 分、间质纤维化和肾小管萎缩（IFTA）3 分DN 患者miR-488 高表达、miR-654 低表达占比显著高于miR-488 低表达、miR-654 高表达，差异具有统计学意义（χ2=7.916 ～ 20.669，8.432 ～ 13.258，均P<0.05）。与预后不良组相比，预后良好组血清miR-488 表达水平显著降低（1.57±0.29 vs 1.89±0.17），miR-654表达水平显著升高（0.78±0.21 vs 0.51±0.19），差异具有统计学意义（t=6.202，6.369，均P<0.05）。血清miR-488，miR-654 单独及二者联合对DN 患者预后的敏感度分别为87.50%，80.00% 和90.00%，特异度分别为84.62%，86.54%和82.69%，AUC（95%CI）分别为0.838（0.748 ～ 0.927），0.824（0.731 ～ 0.916）和0.906（0.846 ～ 0.966），二者联合预测优于各自单独预测（Z =2.225，2.033，P=0.026，0.042）。结论 DN 患者肾脏损伤程度越低，血清miR-488表达水平越低，血清miR-654 越高，血清miR-488，miR-654 可用于对DN 患者病情及预后预测，联合预测优于单独预测。
Abstract:
Objective To investigate the serum levels of miR-488 and miR-654 in patients with diabetes nephropathy (DN) and their relationship with the severity and prognosis of the disease. Methods 92 DN patients who received treatment at Ya’an People’s Hospital from January 2022 to January 2024 (DN group) and 60 healthy controls (healthy group) were selected. The correlation between serum miR-488 and miR-654 was analyzed with pearson. The chi-square test was used to analyze the relationship between serum miR-488 and miR-654 expression levels, clinical pathological features, and degree of renal injury. ROC was used to predict the prognosis of DN patients Results Compared with healthy individuals, the expression level of serum miR-488（1.71±0.40 vs 1.08±0.15）was increased in DN patients, while the expression level of miR-654（0.66±0.19 vs 0.94±0.22）was reduced，and the differences were statistically significant (t=11.666，8.340，all P<0.05). In DN patients with diabetes ≥ 10 years, 24h urinary protein ≥ 3 g/L, serum creatinine (Scr) ≥ 150 μmol/L, glomerular filtration rate<60 ml/ min/1.73m2, and blood urea nitrogen(BUN) ≥ 7.5 mmol/L, the proportions of high expression of serum miR-488 and low expression of miR-654 were higher than the proportions of low expression of serum miR-488 and high expression of miR-654， and the differences were statistically significant (χ2=5.283 ～ 25.234；4.356 ～ 8.587，all P<0.05). Pearson analyze the correlation between serum miR-488 and miR-654 in the DN group were negatively correlated (r=-0.405)，serum miR-488 was positively correlated with 24h urinary protein, Scr and BUN (r=0.376, 0.435，0.406) and negatively correlated with glomerular filtration rate (r=-0.382). Serum miR-654 was negatively correlated with 24-hour urine protein, Scr and BUN (r=-0.418, -0.367, -0.425) and positively correlated with glomerular filtration rate (r=0.374). The proportions of high expression of miR- 488 and low expression of miR-654 in DN patients with glomerular grade IV, 2 points of interstitial inflammation, and 3 points of interstitial fibrosis and tubular atrophy (IFTA) were higher than proportions of low expression of miR-488 and high expression of miR-654，and the differences was statistically significant (χ2=7.916 ～ 20.669，8.432 ～ 13.258，all P<0.05). Compared with the poor prognosis group, the serum miR-488 expression level in the good prognosis group was obviously reduced(1.57±0.29 vs 1.89±0.17), while the miR-654 expression level was obviously increased (0.78±0.21 vs 0.51±0.19), and the differences were statisticolly significant (t=6.202, 6.369, all P<0.05). The sensitivity of serum miR-488, miR-654 and their combination for prognosis of DN patients were 87.50%, 80.00% and 90.00%, respectively. The specificity were 84.62%, 86.54% and 82.69%, respectively. The AUC (95%CI) were 0.838(0.748 ～ 0.927), 0.824(0.731 ～ 0.916) and 0.906(0.846 ～ 0.966), respectively, the joint prediction of the two was better than their individual predictions (Z=2.225, 2.033，P=0.026, 0.042). Conclusion The lower the degree of renal injury in DN patients, the lower the serum miR-488, and the higher the serum miR-654, serum miR-488 and miR- 654 can be used to predict the condition and prognosis of DN patients, and combined prediction is better than individual prediction.

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备注/Memo

备注/Memo:
基金项目：四川省卫生健康委员会科研课题（19PJ095）。
作者简介：马霞（1987-），女，本科，主治医师，研究方向：肾脏内科相关疾病，E-mail：dzz973119@163.com。
更新日期/Last Update: 2025-03-15