摘要
目的探究2型糖尿病肾病(T2DN)患者血清半胱氨酸蛋白酶抑制剂SA(Cystatin SA),长链非编码RNA(lncRNA)CDKN1A反义链启动子DNA损伤激动RNA(PANDAR)的表达及临床意义。方法选取2021年2月~2023年10月上海交通大学医学院苏州九龙医院收治的142例2型糖尿病(T2DM)患者,根据是否合并肾脏疾病分为T2DN组(n=82)和非T2DN组(n=60),以同期60例体检的健康人为对照组。采用酶联免疫吸附试验(ELISA)检测血清Cystatin SA水平,实时荧光定量PCR检测血清lncRNA PANDAR水平。Pearson相关分析T2DN患者血清Cystatin SA,lncRNA PANDAR与临床参数的相关性。Logistic回归分析T2DN发生的影响因素。受试者工作特征曲线(ROC)分析血清Cystatin SA,lncRNA PANDAR对T2DN的预测价值。结果T2DM组血清Cystatin SA(236.28±44.63ng/L),血清lncRNA PANDAR(3.21±0.34)均高于对照组(91.25±22.33ng/L,1.06±0.23),差异具有统计学意义(t=23.127,42.379,均P<0.001)。T2DN组血清Cystatin SA(275.08±46.83ng/L),lncRNA PANDAR(3.64±0.38)高于非T2DN组(183.25±40.88ng/L,2.62±0.30),差异具有统计学意义(t=12.169,17.226,均P<0.001)。T2DN患者血清Cystatin SA,lncRNA PANDAR与糖尿病病程、血肌酐(sCr)、血尿素氮(BUN),尿白蛋白/肌酐比值(UACR)呈正相关(r=0.562~0.750,均P<0.001),与估计肾小球滤过率(eGFR)呈负相关(r=-0.656,-0.634,均P<0.001)。血清Cystatin SA,lncRNA PANDAR,糖尿病病程、UACR,sCr是影响T2DN发生的危险因素,eGFR是保护因素(Waldχ^(2)=4.257~12.360,均P<0.001)。血清Cystatin SA,LncRNA PANDAR联合对T2DN发生预测的曲线下面积(AUC)为0.920(0.899~0.960),大于单项指标[0.847(0.791~0.887),0.851(0.803~0.896)],差异具有统计学意义(Z=4.522,4.319,均P<0.05)。结论T2DN患者血清Cystatin SA,lncRNA PANDAR升高,两者与患者肾功能指标有关,是影响T2DN发生的危险因素,两者联合能有效预测T2DN的发生。
Objective To investigate the expression and clinical significance of serum cystatin SA(Cystatin SA)and long non-coding RNA(lncRNA)promoter of CDKN1A antisense DNA damage activated RNA(PANDAR)in patients with type 2 diabetic kidney disease(T2DN).Method A total of 142 patients with type 2 diabetes mellitus(T2DM)admitted to Shanghai Jiao Tong University School of Medicine Suzhou Jiulong Hospital from February 2021 to October 2023 were selected.According to whether they had nephropathy,they were divided into T2DN group(n=82)and non-T2DN group(n=60).60 healthy people who underwent physical examination during the same period were used as the control group.Serum Cystatin SA levels were detected by enzyme-linked immunosorbent assay(ELISA).Serum lncRNA PANDAR level was detected by real-time fluorescence quantitative PCR.Pearson correlation analysis was used to analyze the correlation between serum Cystatin SA,lncRNA PANDAR and clinical parameters in T2DN patients.Logistic regression analysis was used to analyze the influencing factors of T2 DN.The receiver operating characteristic(ROC)curve was used to analyze the value of serum Cystatin SA and lncRNA PANDAR in the evaluation of T2DN.Results Serum Cystatin SA(236.28±44.63 ng/L)and serum lncRNA PANDAR(3.21±0.34)in the T2DM group were higher than those in the control group(91.25±22.33 ng/L,1.06±0.23),and the differences were statistically significant(t=23.127,42.379,all P<0.001).Serum Cystatin SA(275.08±46.83 ng/L)and lncRNA PANDAR(3.64±0.38)in T2DN group were higher than those in non-T2DN group(183.25±40.88 ng/L,2.62±0.30),and the differences were statistically significant(t=12.169,17.226,all P<0.001).Serum Cystatin SA and lncRNA PANDAR in T2DN patients were positively correlated with diabetes duration,serum creatinine(sCr),blood urea nitrogen(BUN)and UACR(r=0.562~0.750,all P<0.001),and negatively correlated with eGFR(r=-0.656,-0.634,all P<0.001).Serum Cystatin SA,lncRNA PANDAR,duration of diabetes,UACR,sCr were risk factors for T2DN,eGFR was a protective factor(Waldχ^(2)=4.257~12.360,all P<0.001).The area under the curve(AUC)of serum Cystatin SA combined with lncRNA PANDAR in predicting T2DN was 0.920(0.899~0.960),which was greater than that of single index[0.847(0.791~0.887),0.851(0.803~0.896)],and the differences were statistically significant(Z=4.522,4.319,all P<0.05).Conclusion Serum Cystatin SA and lncRNA PANDAR are elevated in patients with T2DN,which are related to renal function indexes and are risk factors affecting the occurrence of T2DN.The combination of the two can effectively evaluate the occurrence of T2DN.
作者
朱晓娟
庄建成
汪浩
胡振华
王瑾枫
李文亚
ZHU Xiaojuan;ZHUANG Jiancheng;WANG Hao;HU Zhenhua;WANG Jinfeng;LI Wenya(Department of Clinical Laboratory,Shanghai Jiao Tong University School of Medicine Suzhou Jiulong Hospital,Jiangsu Suzhou 215127,China;Department of Endocrine,Shanghai Jiao Tong University School of Medicine Suzhou Jiulong Hospital,Jiangsu Suzhou 215127,China)
出处
《现代检验医学杂志》
2025年第6期80-85,共6页
Journal of Modern Laboratory Medicine
基金
江苏省卫生健康委科研课题(BJ21037)。
