Study On The Differential Expression Of MiRNA-21 And MiRNA-192 In Serum Of Patients With Diabetic Kidney Disease In Different Stages And Its Correlation With UACR

Objective:In order to clarify the expression of miRNA-21 and miRNA-192 in the serum of patients with diabetic kidney disease(DKD)at different stages;and to explore the correlation between miR-21 and miR-192 and clinical indicators such as blood creatinine and UACR in patients with DKD;to explore miRNA-21 and The value of miRNA-192 in the early diagnosis of DKD.Methods:A total of 51 patients with simple DM and DKD who were treated in the Department of Nephrology and Endocrinology,People’s Hospital of Shanxi Medical University from February 2018 to October 2020 were selected as the experimental group,including 32 males and 19 females.The experimental components were simple DM group(n=10)and DKD group(n=41).The healthy volunteers who matched the age and gender of our hospital’s physical examination center during the same period were selected as the healthy control group(n=10),including 5 males and 5 females.We judge the severity of DKD based on the latest KDIGO guidelines,combined with CKD staging(G1～G5)and albuminuria staging(A1 stage: UACR<30mg/g,A2 stage: UACR 30～300mg/g,A3 stage:UACR> 300mg/g).We divide the DKD group into G2A2 group(n=10),G2A2 group(n=6),G3A3 group(n=10),G4A3 group(n=6),G5A3 group(n=9).Real-time fluorescent quantitative PCR(quantitative Real Time PCR,q RT-PCR)technology was used to detect the expression of miRNA-21 and miRNA-192 in the serum of DKD patients.Measure and record the height,weight,and blood pressure of the two groups of experimental subjects respectively,and calculate the body mass index.Fasting plasma glucose(FBG)was detected by glucose oxidase method,and fasting serum creatinine(Scr),urea nitrogen(BUN)and blood lipids(including TC,TG,HDL-C,LDL-C)were detected by enzyme immunoassay.Full glycated hemoglobin(Hb A1c)is detected by ion exchange high performance liquid chromatography.An automatic urine ACR quantitative analysis system was used to detect the urinary albumin/creatinine ratio(UACR).Analyze the correlation between serum miRNA-21 and miRNA-192 expression and clinical indicators such as serum creatinine and UACR in DKD patients.Results:The expression of miRNA-21 and miRNA-192 in the serum of the healthy control group,the diabetes group and the diabetic nephropathy group of different stages were different(P<0.05).Compared with the healthy control group(n=10),the expression of miR-21 in the serum of patients in the DKD group was increased,especially in the G5A3 stage DKD patients(n=9),the expression of miR-21 in the serum was significantly higher than that in the healthy control group.And the difference was statistically significant(P<0.05).The expression level of miR-192 in serum of DM alone and DKD group of different stages was lower than that of healthy control group.The expression level of serum miR-192 in the G4A3 group and G5A3 group was significantly lower than that of the healthy control group.Correlation analysis showed that miRNA-21 was positively correlated with Scr,BUN,and 24 h urine protein,negatively correlated with ALB(P<0.05),and had no correlation with Hb A1 c,TC,TG,LDL-C,HDL-C.miRNA-192 was negatively correlated with Scr,BUN,and 24 h urine protein,positively correlated with ALB(P<0.05),and had no correlation with other clinical indicators.miR-21 and miR-192 are correlated with urinary albumin/creatinine ratio(UACR).In DKD patients,the serum miR-21 expression level is positively correlated with UACR;the serum miR-192 expression level is negatively correlated with UACR.Conclusion:1.This study found that as the course of DKD progressed,the expression of miRNA-21 in serum gradually increased;the expression of miRNA-192 gradually decreased.2.The serum miRNA-21 and miRNA-192 of DKD patients are correlated with UACR,miRNA-21 is positively correlated with UACR,and miRNA-192 is negatively correlated with UACR.3.miRNA-21 and miRNA-192 are closely related to the disease progression of DKD,and their differential expression reflects the kidney damage in patients with DKD.4.Detection of serum miRNA-21 and miRNA-192 expression in DKD patients can provide genetic basis for early detection and treatment of DKD patients.