| 摘要: |
| ［摘要］ 目的 分析糖尿病肾病（DKD）患者血清miR-181a-5p、miR-132-5p水平及其与肾损伤、预后的关联性。方法 招募2021年4月至2024年4月南京中医药大学连云港附属医院收治的DKD患者121例作为DKD组，单纯糖尿病患者119例作为单纯糖尿病组，健康体检者116名作为对照组。根据DKD患者实际情况开展治疗干预，严格控制血糖、糖化血红蛋白（HbA1c）、血压、血脂。对DKD患者进行1年随访，以随访期间患者出现血清肌酐（Scr）水平倍增或肾小球滤过率下降50%判定为预后不良。检测研究对象血清miR-181a-5p、miR-132-5p水平并进行比较。分析DKD患者血清miR-181a-5p、miR-132-5p水平与肾小球分级、间质炎症评分、间质性纤维化和小管萎缩（IFTA）评分的相关性。通过多因素logistic回归分析影响DKD患者预后不良的因素，通过受试者工作特征（ROC）曲线分析血清miR-181a-5p、miR-132-5p水平预测DKD患者预后不良的效能。结果 DKD组血清miR-181a-5p、miR-132-5p水平低于对照组和单纯糖尿病组，单纯糖尿病组血清miR-181a-5p、miR-132-5p水平低于对照组，差异有统计学意义（P<0.05）。血清miR-181a-5p、miR-132-5p水平与肾小球分级、间质炎症评分及IFTA评分呈负相关（P<0.05）。DKD患者预后良好96例，预后不良25例。多因素logistic回归分析结果显示，血清miR-181a-5p［OR（95%CI）=0.816（0.710～0.938）］、miR-132-5p［OR（95%CI）=0.753（0.632～0.897）］升高是抑制DKD患者预后不良发生的独立保护因素（P<0.05）。ROC曲线分析结果显示，血清miR-181a-5p、miR-132-5p水平均可有效预测DKD患者预后不良（P<0.05），且两指标联合的预测效能优于单一指标（Z=2.278，P=0.036；Z=2.612，P=0.025），灵敏度为91.74%，特异度为99.67%。结论 DKD患者血清miR-181a-5p、miR-132-5p水平显著降低，与肾脏损伤程度及预后密切相关，两指标联合检测可更好预测DKD患者预后。 |
| 关键词: 糖尿病肾病 miR-181a-5p miR-132-5p 肾损伤 预后 |
| DOI：10.3969/j.issn.1674-3806.2026.06.15 |
| 分类号:R 587.2 |
| 基金项目:南京医科大学康达学院科研发展基金项目（编号:KD2025KYJJ154）；连云港市卫生健康面上科技项目（编号：202115） |
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| Analysis on serum levels of miR-181a-5p and miR-132-5p in diabetic kidney disease patients and their correlations with kidney injury and prognosis |
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WANG Li1, ZHAO Xiaohui2, ZHANG Huaming1, HOU Sinan2
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1.Department of Nephropathy, Lianyungang Affiliated Hospital of Nanjing University of Chinese Medicine, Lianyungang 222000, China; 2.Department of Laboratory Medicine, Lianyungang Affiliated Hospital of Nanjing University of Chinese Medicine, Lianyungang 222000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the serum levels of microRNA-181a-5p(miR-181a-5p) and microRNA-132-5p(miR-132-5p) in diabetic kidney disease(DKD) patients and their correlations with kidney injury and prognosis. Methods A total of 121 patients with DKD who were admitted to Lianyungang Affiliated Hospital of Nanjing University of Chinese Medicine from April 2021 to April 2024 were recruited as the DKD group, and 119 patients with diabetes only were recruited as the diabetes-only group, and 116 healthy individuals undergoing physical examination were recruited as the control group. Treatment interventions were performed according to the actual situation of the DKD patients, and their blood glucose, glycated hemoglobin A1c(HbA1c), blood pressure and blood lipid were strictly controlled. The DKD patients were followed up for 1 year. Poor prognosis was considered if the patients′ serum creatinine(Scr) level doubled or the glomerular filtration rate decreased by 50% during the follow-up period. The levels of serum miR-181a-5p and miR-132-5p of the research subjects were detected and compared. The correlations of serum miR-181a-5p and miR-132-5p levels with glomerular grades, interstitial inflammation scores, interstitial fibrosis and tubular atrophy(IFTA) scores in the DKD patients were analyzed. Multivariate logistic regression was used to analyze the factors influencing the poor prognosis of the DKD patients. The efficacy of serum miR-181a-5p and miR-132-5p levels in predicting poor prognosis of the DKD patients was analyzed by using receiver operating characteristic(ROC) curve. Results The levels of serum miR-181a-5p and miR-132-5p in the DKD group were lower than those in the control group and the diabetes-only group. The levels of serum miR-181a-5p and miR-132-5p in the diabetes-only group were lower than those in the control group, and the differences were statistically significant(P<0.05). The levels of serum miR-181a-5p and miR-132-5p were negatively correlated with glomerular grades, interstitial inflammation scores and IFTA scores(P<0.05). Ninety-six patients with DKD had a favorable prognosis, while 25 patients with DKD had an unfavorable prognosis. The results of multivariate logistic regression analysis showed that elevated serum miR-181a-5p［OR(95%CI)=0.816(0.710-0.938)］ and elevated miR-132-5p［OR(95%CI)=0.753(0.632-0.897)］ were independent protective factors for inhibiting poor prognosis in the DKD patients(P<0.05). The results of ROC curve analysis showed that the levels of serum miR-181a-5p and miR-132-5p could effectively predict the poor prognosis of the DKD patients(P<0.05), and the predictive efficacy of the combination of the two indicators was better than that of a single indicator(Z=2.278, P=0.036; Z=2.612, P=0.025), with a sensitivity of 91.74% and a specificity of 99.67%. Conclusion The levels of serum miR-181a-5p and miR-132-5p in DKD patients are significantly decreased, which is closely related to the degree of kidney injury and prognosis. The combined detection of the two indicators can better predict the prognosis of the DKD patients. |
| Key words: Diabetic kidney disease(DKD) MicroRNA-181a-5p(miR-181a-5p) MicroRNA-132-5p(miR-132-5p) Kidney injury Prognosis |
