糖尿病肾病患者外周血微小RNA-30c表达与肾间质纤维化的关系-现代医学

糖尿病肾病患者外周血微小RNA-30c表达与肾间质纤维化的关系

单位：海南医学院第一附属医院血液净化科, 海南海口 570206

分类号：R587.2

出版年·卷·期（页码）：2020·39·第七期（813-816）

摘要：

目的：观察糖尿病肾病（DN）患者外周血微小RNA-30c（miR-30c）表达变化，探讨其与肾间质纤维化的关系。方法：选取2018年2月至2019年4月我院诊疗的单纯2型糖尿病（T2DM）患者60例和DN患者60例作为研究对象，另取我院健康体检者40例作为对照。荧光定量聚合酶链反应检测miR-30c表达，酶联免疫吸附法（ELISA）测定转化生长因子-β（TGF-β），化学发光法测定透明质酸酶（HA）、Ⅲ型前胶原（PC Ⅲ）、Ⅳ型胶原（Ⅳ-C）。结果：对照组、T2DM组、轻度DN组和中重度DN组miR-30c表达的2^-ΔΔCt值分别为0.62±0.11、0.47±0.08、0.32±0.06和0.25±0.04，各组间差异具有统计学意义（F=5.42，P=0.03）。其中DN组（含轻度DN组和中重度DN组）低于对照组和T2DM组（t=6.14，P<0.001；t=6.55，P<0.001），中重度DN组低于轻度DN组（t=3.16，P=0.04）。轻度和中重度DN组TGF-β、HA、PC Ⅲ和Ⅳ-C纤维化指标高于对照组和T2DM组，中重度DN组TGF-β、HA、PC Ⅲ和Ⅳ-C高于轻度DN组，差异均有统计学意义（P<0.05）。DN患者miR-30c表达与TGF-β（r=-0.62，P<0.05）、HA（r=-0.53，P<0.05）、PC Ⅲ（r=-0.60，P<0.05）及Ⅳ-C（r=-0.58，P<0.05）表达水平呈负相关。受试者工作特征曲线（ROC曲线）分析显示 miR-30c表达水平对 DN有预测价值。结论：miR-30c低表达参与了DN肾间质纤维化进程，其有可能成为DN诊断、病情评估的分子标志物以及临床治疗的分子靶点。

Objective:To observe the relationship between microRNA-30c(miR-30c) and renal interstitial fibrosis in patients with diabetic nephropathy(DN). Methods:60 patients with Type 2 diabetes(T2DM)and 60 patients with DN were selected in this study, Another 40 healthy people were used as control. The expression of miR-30c was determined by fluorescent quantitative polymerase chain reaction analysis. The TGF-β expression was detected by ELISA analysis. The HA, PC Ⅲ, and Ⅳ-C expression was detected by chemiluminescence analysis.Results: The 2^-ΔΔCt values of miR-30c in control group, T2DM group, mild DN group and moderate to severe DN group was 0.62±0.11, 0.47±0.08, 0.32±0.06, and 0.25±0.04. The 2^-ΔΔCt values in DN group was lower than that in control and T2DM group(P<0.01), and in moderate to severe DN group was lower than that in mild DN group(P<0.05). The expression of TGF-β, HA, PC Ⅲ, and Ⅳ-C in DN group was higher than that in control and T2DM group(P<0.01), and in moderate to severe DN group was higher than that in mild DN group(P<0.05). The 2^-ΔΔCt values of miR-30c was negatively related with TGF-β, HA, PC Ⅲ, and Ⅳ-C expression(P<0.05). ROCanalysis showed that miR-30c expression had predictive value for DN.Conclusion: The low expression of miR-30c is involved in the process of renal interstitial fibrosis in DN. It may be a molecular target for DN diagnosis, disease assessment and clinical treatment.

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