关键词:

糖尿病肾病, 尿外泌体miR-155, 脂联素, 三酰甘油, 高密度脂蛋白, 白脂素, 相关性

Abstract:

Objective　To explore the correlation of urinary exosomal miR-155 (exo-miR-155) and lipid levels with the severity of diabetic nephropathy (DN). Methods　A retrospective analysis was conducted on 150 patients with DN treated at Yulin Hospital, The First Affiliated Hospital of Xi'an Jiaotong University between June 2022 and June 2024. The patients were divided into a normoalbuminuria group [40 cases; 25 males and 15 females; (62.31±7.16) years old], a microalbuminuria group [48 cases; 28 males and 20 females; (62.65±7.32) years old], and a macroalbuminuria group [62 cases; 37 males and 25 females; (62.58±7.21) years old] based on the urinary albumin-to-creatinine ratio (UACR). The clinical and laboratory indicators were compared between the three groups. The multivariate logistic regression was used to identify the risk factors for DN severity. The Spearman correlation analysis was used to assess the relationships of urinary exosomal miR-155 and lipid levels with DN severity. The diagnostic performance was evaluated using the receiver operating characteristic curves (ROC). The statistical methods included analysis of variance (ANOVA), Kruskal-Wallis H test, χ² test, logistic regression analysis, Spearman correlation analysis, and ROC analysis. Results　There were no statistical differences in diabetes duration, hypertension history, systolic and diastolic blood pressures, UACR, tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), adiponectin, triglycerides, high-density lipoprotein (HDL), visfatin, and urinary exosomal miR-155 between the 3 groups (all P0.05). The logistic regression analysis identified adiponectin, triglycerides, HDL, visfatin, and urinary exo-miR-155 as the independent risk factors for DN severity (OR=1.211, 6.409, 0.023, 4.930, and 3.185; all P0.05). The Spearman correlation analysis revealed that DN severity was positively correlated with adiponectin (r=0.554), triglycerides (r=0.855), visfatin (r=0.845), and urinary exo-miR-155 (r=0.582) (all P0.05), and negatively correlated with HDL (r=-0.861; P0.05). The ROC analysis demonstrated that the combined detection of lipid levels and urinary exo-miR-155 achieved an area under the curve of 0.977 (95%CI 0.952-1.000). Conclusion　Urinary exo-miR-155, adiponectin, triglycerides, HDL, and visfatin are closely associated with DN severity.

Key words:

Diabetic nephropathy, Urinary exosomal miR-155, Adiponectin, Triglycerides, High-density lipoprotein, Visfatin, Correlation