摘要
目的研究血清miR-150、miR-21和中性粒细胞/淋巴细胞比率(NLR)在早期诊断妊娠期糖尿病(GDM)早期肾功能损害中的临床价值。方法选择2018年1月至2019年6月就诊的GDM患者88例,为GDM组。选择同期诊断为糖耐量异常的孕妇30例为糖耐量异常组和正常妊娠体检者30例为正常妊娠组。血清miR-150和miR-21表达采用实时RT-PCR进行检测。比较GDM组,糖耐量异常组和正常妊娠组血清miR-21,miR-150,NLR和β2-微球蛋白(β2-MG)水平变化,观察GDM组患者血清miR-21,miR-150,NLR和β2-MG水平与糖尿病严重程度,肾功能损害,肾脏损害严重程度的关系及其在诊断GDM肾功能损害的诊断效能。结果GDM组血清miR-21,NLR和β2-MG水平明显高于糖耐量异常组和正常妊娠组(P<0.01),而糖耐量异常组明显高于正常妊娠组(P<0.01),并且随着糖尿病病情严重程度,肾损伤严重程度和肾病严重程度升高而升高(P<0.01);GDM组血清miR-150表达明显低于糖耐量异常组和正常妊娠组(P<0.01),而糖耐量异常组明显低于正常妊娠组(P<0.01),随着糖尿病病情严重程度,肾损伤严重程度和肾病严重程度升高而降低(P<0.01)。血清miR-21(Z=2.339,P<0.05),miR-150(Z=2.127,P<0.05)和NLR(Z=2.355,P<0.05)水平在预测早期GDM肾病的效能明显优于β2-MG,而miR-21,miR-150和NLR差异无统计学意义(P>0.05),联合检测在预测GDM肾损伤的灵敏度为96.6%,特异性为97.1%,AUC为0.995明显高于单个指标miR-21(Z=2.461,P<0.05),miR-150(Z=2.496,P<0.05)和NLR(Z=2.272,P<0.05)。结论miR-150和miR-21参与了GDM发生发展,联合检测miR-150,miR-21和NLR在早期诊断GDM肾损伤具有较高的诊断效能。
Objective To investigate the clinical value of serum miR-150,miR-21 and neutrophil/lymphocyte ratio(NLR)in the early diagnosis of renal damage of in patients with gestational diabetes mellitus(GDM).Methods Eighty-eight patients with GDM who were treated in our hospital from January 2018 to June 2019 were enrolled as GDM group.Thirty pregnant women who were diagnosed as impaired glucose tolerance in our hospital at the same period were enrolled as impaired glucose tolerance group,moreover,the other 30 healthy pregnant patients who underwent physical examination were enrolled as normal pregnancy group.The expression levels of serum miR-150 and miR-21 were detected by real-time RT-PCR.And the changes of the serum levels of miR-21,miR-150,NLR andβ2 microglobulin(β2-MG)were observed and compared among the three groups.In addition the correlation between the serum miR-21,miR-150,NLR andβ2-MG levels and the severity of diabetes,renal damage,the severity of renal damage was analyzed,and their diagnostic efficacy in diagnosis of renal dysfunction was investugated.in the GDM group.Results The serum levels of miR-21,NLR andβ2-MG in GDM group were significantly higher than those in impaired glucose tolerance group and normal pregnancy group(P<0.01),moreover,which in impaired glucose tolerance group were significantly higher than those in normal pregnancy group(P<0.01),which were increased with the severity of GDM,renal damage and renal disease(P<0.01).The expression levels of serum miR-150 in GDM group were significantly lower than those in impaired glucose tolerance group and normal pregnancy group(P<0.01),which in impaired glucose tolerance group were significantly lower than those in normal pregnancy group(P<0.01),which were decreased with the severity of GDM,renal damage and renal disease(P<0.01).The serum levels of miR-21,miR-150 and NLR were significantly better than those ofβ2-MG in predicting early GDM,however,there were no significant differences in the levels of miR-21,miR-150 and NLR(P>0.05).The sensitivity of combined detection in predicting renal damage in GDM was 96.6%,the specificity was 97.1%,and the AUC was 0.995,which were significantly higher than those by simple detction of miR-21,miR-150 and NLR(P<0.05).Conclusion The miR-150 and miR-21 are involved in the occurrence and development of GDM.Combined detection of miR-150,miR-21 and NLR has a high diagnostic efficiency in the early diagnosis of renal damage in patients with GDM.
作者
陈艳华
谢旭雯
CHEN Yanhua;XIE Xuwen(Department of Obstetrics,Obstetrics and Gynecology Hospital Affiliated to Fudan University,Shanghai 200090,China)
出处
《河北医药》
CAS
2021年第6期819-823,共5页
Hebei Medical Journal
