| Objective: Renal impairment is a severe complication of Multiple Myeloma.Renal involvement was present in some patients at initial diagnosis of Multiple myeloma.The occurrence of renal failure seriously affects the prognosis of MM patients,so early detection,early prevention,clear degree of kidney damage and individualized treatment are particularly important.The two micro RNAs selected by previous studies were miRNA-155 and miRNA-483.The differential expression of Multiple Myeloma with different degrees of renal impairment and the healthy control group was compared.The correlation between the expression levels of the two and the clinical characteristics of patients with Multiple Myeloma was analyzed.To investigate the diagnostic value of serum miRNA-155 and miRNA-483 expression levels in Multiple Myeloma with different degrees of renal impairment,predict the progression rate of Multiple Myeloma with different stages of renal impairment,and provide a theoretical basis for clinical diagnosis and individualized treatment.Methods: The study included 39 newly diagnosed Multiple Myeloma patients admitted to the Department of Hematology,Department of Nephrology,Department of Intensive Care,Department of Emergency of the first people’s Hospital of Jining from July 2021 to November 2022.According to the Renal function grading,they were divided into MM with normal renal function group,MM with mild to In the moderate renal impairment group and MM with moderate to severe(including severe)renal impairment group,17 healthy person who underwent physical examination in our hospital during the same period were selected as the normal control group.The fasting venous blood of the case group and the healthy control group was collected in the morning,and the upper serum was retained after centrifugation.The Quantitative Real-Time Polymerase Chain Reaction(q RT-PCR)was used to detect the above miRNAs,and the Ct value was calculated,Statistical analysis was carried out based on clinical data and laboratory examination of the patients included in this study.Results: 1.Differences in expression: miRNA-155 tended to be up-regulated in the three case groups.miRNA-483 was significantly up-regulated in the combined moderate to severe(including severe)group of MM,while there was no statistically significant difference in expression among the other three groups.2.Correlation analysis: The expression level of miRNA-155 was positively correlated with blood urea,blood uric acid,lactate dehydrogenase,and hydroxybutyrate dehydrogenase levels;the relative expression level of miRNA-483 was positively correlated with blood urea and blood uric acid levels.3.Logistic regression analysis: the results showed that the expression level of serum miRNA-155 had a statistically significant effect on the degree of renal impairment in MM,and the higher the expression level,the greater the probability of aggravating the degree of renal impairment in MM(P<0.001).4.Sensitivity and specificity:The areas under the curve of miRNA-155 and miRNA-483 in diagnosing MM with moderate to severe(including severe)renal impairment were 0.759 and 0.733 respectively.The area under the curve of miRNA-155 for diagnosing MM with mild to moderate renal impairment is 0.800.5.When miRNA-155 and blood β2 microglobulin were combined,the sensitivity and specificity of MM combined with mild to moderate kidney damage were higher than those of the two alone.The sensitivity and specificity of miRNA-155,miRNA-483 and blood urea in the diagnosis of MM combined with moderate to severe(including severe)were higher than those of the three indexes alone.Conclusion: Serum miRNA-155 and miRNA-483 may be potential biomarkers for diagnosing MM with different degrees of renal damage,and the two combined with β2-microglobulin or blood urea have higher diagnostic efficiency. |
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