糖尿病肾脏病患者血清let-7d mRNA的相对表达量与肾功能进展的相关性研究

目的 探讨血清let-7d与糖尿病肾脏病(diabetic kidney disease,DKD)患者肾功能进展的关系.方法 选取2017年4月～2018年10月期间在赤峰市医院治疗的DKD患者164例,所有患者在入组后均进行2年的随访,共有154例患者有完整的随访资料,根据肾功能进展情况将其分为进展组(52例)和未进...

Study on the Correlation between Relative Expression of Serum let-7d mRNA and Renal Function Progression in Patients withDiabetic Nephropathy

Objective　To investigate the relationship between serum let-7d and the progression of renal function in patientswith diabetic kidney disease (DKD). Methods　A total of 164 patients with DKD who were treated in Chifeng Hospital fromApril 2017 to October 2018 were selected. All patients were followed up for 2 years after enrollment. A total of 154 patients hadcomplete follow-up data. According to the progress of renal function, they were divided into progressive group (52 cases) andnon progressive group (102 cases). The relative expression of let-7d mRNA was detected by real-time PCR. The influencingfactors of renal function progression in patients with DKD was analyzed. The correlation between the relative expression of let-7d mRNA in serum of patients with DKD and related indexes was analyzed. Receiver operating characteristic curve (ROC) wasused to analyze the predictive value of the relative expression of let-7d mRNA in serum for the progression of renal function inpatients with DKD. Results　The disease course of the progressive group was longer than that of the non progressive group,serum creatinine (SCr), urea nitrogen (BUN), cystatin C (Cys C) and transforming growth factor-β1 (TGF-β1) levels werehigher than that of the non progressive group, the estimated Glomerular filtration rate (eGFR) and the relative expression of let-7d mRNA were lower than those of the non progressive group, and the differences were statistically significant (t=2.403~7.436,all P<0.05). Multivariate unconditional Logistic regression analysis showed that excessively high levels of Cys C and TGF-β1were risk factors for the progression of renal function in patients with DKD, while excessively high levels of eGFR and let-7dmRNA were protective factors for the progression of renal function in patients with DKD (P<0.05). Pearson analysis showedthat the relative expression of let-7d mRNA in serum of patients with DKD was negatively correlated with SCr, BUN, Cys C andTGF-β1 (r =-0.491~-0.302, all P<0.05), and it was positively correlated with eGFR (r=0.405,P<0.05). ROC analysis resultsshowed that the relative expression of serum let-7d mRNA had a higher predictive value for the progression of renal function inpatients with DKD, and the area under the curve was 0.874. Conclusion　Let-7d was closely related to the progression of renalfunction in patients with DKD. It may be involved in the occurrence and development of the disease by regulating renal fibrosis.