尿外泌体miR-150-5p、miR-155-5p在早期糖尿病肾病诊断及病情评估中的价值OA

Objective To investigate the value of urinary exosomal miR-150-5p and miR-155-5p in the diag-nosis and evaluation of early diabetic nephropathy.Methods A total of 160 patients with DKD admitted to Huangshi Central Hospital from May 2023 to January 2025 were selected as the DKD group.According to the urine microalbumin/urine creatinine ratio,the DKD group was divided into early DKD group(105 cases)and clinical DKD group(55 cases).A total of 160 patients with type 2 diabetes mellitus(T2DM)admitted to Huangshi central hospital during the same period were selected as the T2DM group.Another 160 healthy peo-ple who underwent physical examination in Huangshi central hospital during the same period were selected as the control group.Real-time fluorescence quantitative polymerase chain reaction was used to detect the levels of miR-150-5p and miR-155-5p in urinary exosomes of all subjects.Pearson correlation analysis was used to analyze the correlation of urinary exosomal miR-150-5p and miR-155-5p levels with serum creatinine(SCr),blood urea nitrogen(BUN),transforming growth factor-β1(TGF-β1),fasting blood glucose(FBG),glycosylat-ed hemoglobin(HbA1c)and glomerular filtration rate(eGFR)in DKD patients.Multivariate Logistic regres-sion was used to analyze the influencing factors for early DKD in patients with T2DM.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of urinary exosomal miR-150-5p,miR-155-5p alone and their combination for early DKD in patients with T2DM.Results The levels of FBG,HbA1c and TGF-β1 in T2DM group,early DKD group and clinical DKD group were higher than those in control group,and the differences were statistically significant(P<0.05).The levels of SCr and BUN in the early DKD group and the clinical DKD group were higher than those in the control group and the T2DM group,and the eGFR was lower than that in the control group and the T2DM group,and the differences were statistically significant(P<0.05).The levels of SCr,BUN and TGF-β1 in the clinical DKD group were higher than those in the early DKD group,and the eGFR was lower than that in the early DKD group,and the differences were statistically significant(P<0.05).The levels of urinary exosomal miR-150-5p and miR-155-5p in the clinical DKD group,the early DKD group,and the T2DM group were all higher than those in the control group.The levels of urinary exosomal miR-150-5p and miR-155-5p in the clinical DKD group and the early DKD group were both higher than those in the T2DM group.The levels of urinary exosomal miR-150-5p and miR-155-5p in the clinical DKD group were both higher than those in the early DKD group.All the differences were statis-tically significant(P<0.05).Pearson correlation analysis showed that the levels of urinary exosomal miR-150-5p and miR-155-5p in DKD patients were positively correlated with SCr,BUN and TGF-β1 levels(P<0.05),and negatively correlated with eGFR(P<0.05),but not with FBG and HbA1c(P>0.05).Multivari-ate Logistic regression analysis showed that the increased levels of SCr,BUN,TGF-β1,miR-150-5p,and miR-155-5p were risk factors for early DKD in patients with T2DM(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of urinary exosomal miR-150-5p,miR-155-5p alone and their combination in the diagnosis for early DKD in patients with T2DM were 0.798,0.800 and 0.928,respectively.The AUC of the combination of miR-150-5p and miR-155-5p in the diagnosis of early DKD was greater than that of urinary exosomal miR-150-5p or miR-155-5p alone(Z=4.975,5.828,P<0.05).Conclusion The levels of urinary exosomal miR-150-5p and miR-155-5p were increased in patients with early DKD,and the increased levels of urinary exosomal miR-150-5p and miR-155-5p were related to the progression of DKD.The combined detec-tion of urinary exosomal miR-150-5p and miR-155-5p has a high diagnostic value for early DKD in patients with T2DM.