摘要
目的探讨血清微小RNA-217(MicroRNA-217)水平与2型糖尿病患者肾损害的相关性研究。方法回顾性分析2015年1月至2016年9月期间我院确诊治疗的2型糖尿病患者160例的临床资料,依据尿蛋白排泄率(尿白蛋白/尿肌酐,ACR)分为正常尿蛋白组(80例,ACR<30mg/g)和尿蛋白过量组(80例,ACR≥30mg/g),同期选取体检中心30例健康人员作为健康组,采用聚合酶链式反应技术(PCR)检测血清MicroRNA-217水平,采用酶联免疫吸附法(ELISA)检测血清沉默信息调节因子1(Sirt1)及低氧诱导因子1α(HIF-1α),采用Pearson相关性分析法分析病程、空腹血糖(FPG)、血清中低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(LDL-H)、总胆固醇(TC)、三酰甘油(TG)、血尿酸(UA)、血尿素氮(BUN)、血肌酐(Scr)、RNA-217、Sirt1、HIF-1α与ACR的关系,采用logistic回归性分析法分析上述因子与2型糖尿病患者肾损害的关系,统计分析所有研究对象的临床资料及上述因子水平。结果尿蛋白过量组患者病程、FPG、血清中LDL-C、TC、TG、UA、BUN、Scr、MicroRNA-217、HIF-1α水平明显高于正常尿蛋白组,正常尿蛋白组患者上述因子水平明显高于健康组,有统计学差异(P<0.05);尿蛋白过量组患者血清中LDL-H、Sirt1水平明显低于正常尿蛋白组,正常尿蛋白组患者上述因子水平明显低于健康组,有统计学差异(P<0.05);Pearson相关性分析法结果显示,病程、FPG、血清中LDL-C、TC、TG、UA、BUN、Scr、MicroRNA-217、HIF-1α水平与ACR水平呈正相关,LDL-H、Sirt1水平与ACR水平呈负相关(P<0.05);logistic回归性分析法结果显示,病程、FPG、血清中LDL-C、TC、TG、UA、BUN、Scr、MicroRNA-217、HIF-1α水平过高是2型糖尿病患者肾损害的独立危险因素,高LDL-H和Sirt1水平是2型糖尿病患者肾损害的独立保护因素(P<0.05)。结论病程、FPG、血清中LDL-C、TC、TG、UA、BUN、Scr、MicroRNA-217、HIF-1α水平过高与2型糖尿病患者肾损害的发生发展有关,上述因子水平是后者的独立危险因素,高LDL-H和Sirt1水平则可能保护患者肾脏组织,MicroRNA-217可能通过促进肾脏炎症、纤维化等作用来损伤肾脏组织,导致患者肾功能损害的发生,检测上述因子水平有利于医师预测患者肾损害及评估其病情,值得临床作进一步推广。
Objective：To discuss the correlation research of serum small RNA-217（Micro RNA-217）level and renal damage in patients with type 2 diabetes. Methods：160 type 2 diabetes patients with clinical data were retrospective analyzed from January 2015 to September 2015 in our Hospitals. According to the urinary albumin excretion rate（urinary albumin/uric creatinine,ACR）,all patients were divided into normal urinary protein group（80 cases,ACR30 mg/g）and urine protein excess group（80 cases,the ACR ≥ 30 mg/g）,30 cases of healthy persons at the same time were chose from a medical center as health group,polymerase chain reaction（PCR）was used to detect serum Micro RNA-217 levels,enzyme-linked immunosorbent（ELISA）was used to detect serum silent information adjustment factor 1（Sirt1）and hypoxia inducible factor 1 alpha（HIF-1α）,the Pearson correlation analysis was used to analyze the relationship between course,fasting plasma glucose（FPG）,serum low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（LDL-H）,total cholesterol（TC）,three acyl glycerin（TG）,blood uric acid（UA）,Blood urea nitrogen（BUN）,serum creatinine（Scr）,Micro RNA-217,Sirt1,HIF-1 alpha and ACR,logistic regression analysis method was used to analyze the above factors and the relationship between renal damage in patients with type 2 diabetes,statistical analyzed the clinical data of all the research object and the factor levels. Results：excessive course,FPG,serum LDL-C,TC,TG,UA,BUN,Scr,Micro RNA-217,HIF-1 alpha level of urine protein excess group patients were significantly higher than that of normal urinary protein group,above factor levels of normal urinary protein group patients were significantly higher than that of healthy group,there were statistically significant（P〈0.05）;serum LDL-H,Sirt1 level of urine protein excess group patients were significantly lower than that of normal urinary protein group,above factor levels of normal urinary protein group patients were significantly lower than that of healthy group,there were statistically significant（P〈0.05）;Pearson correlation analysis,the results showed that,the course disease,FPG,serum LDL-C,TC,TG,UA,BUN,Scr,Micro RNA-217,HIF-1 alpha levels were positively related with ACR level,the LDL-H,Sirt1 level were negatively correlated with ACR level（P〈0.05）;the results of logistic regression analysis showed that,the course,FPG,serum LDL-C,TC,TG,UA,BUN,Scr,Micro RNA-217,HIF-1 alpha levels were independent risk factors for renal damage in patients with type 2 diabetes,the high LDL-H and Sirt1 level were independent protection factor in patients with type 2 diabetes,renal damage（P〈0.05）.Conclusions：Course,FPG,serum LDL-C,TC,TG,UA,BUN,Scr,Micro RNA-217,HIF-1 alpha levels and the occurrence of renal damage in patients with type 2 diabetes development is related to the above factor levels are independent risk factors for the development of the latter,the high level of LDL-H and Sirt1 may protect the patient′s kidney tissue,Micro RNA-217 may by promoting kidney inflammation,fibrosis,and role to damage to the kidney tissue,lead to patients with renal impairment,and detect the factor levels help physicians predict renal damage and assess the patient,it′s worth for further clinical promotion.
出处
《中国优生与遗传杂志》
2017年第3期18-22,共5页
Chinese Journal of Birth Health & Heredity
