中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
34期
35-39
,共5页
微RNAs%糖尿病肾病%糖尿病,2型
微RNAs%糖尿病腎病%糖尿病,2型
미RNAs%당뇨병신병%당뇨병,2형
MicroRNAs%Diabetic nephropathies%Diabetes mellitus,type 2
目的 探讨微RNA-192(miR-192)水平与糖尿病肾病(DN)患者预后的关系.方法 选择2010年1月至2011年7月诊治的2型糖尿病(T2DM)病程≥10年的患者59例.入院后测定miR-192水平,收集其他相关临床资料,并进行为期24个月的随访.根据患者的预后情况,将其分为DN组(20例)与非DN组(39例),并对两组相关资料进行统计学分析.结果 DN组miR-192水平较非DN组显著降低[(4.47±2.27) μg/L比(7.28±2.39)μg/L](P＜ 0.05).多因素Logistic回归分析显示高血压病史、吸烟史、高糖化血红蛋白水平、低空腹C肽水平、低24h尿蛋白定量水平、低miR-192水平、高体质量指数是T2DM患者不良预后的独立危险因素(P＜0.05).其中miR-192水平单项指标预测糖尿病患者进展至DN阶段的受试者工作特征(ROC)曲线下面积为0.697,未加入miR-192时其他6项的曲线下面积为0.823,加入之后7项指标预测曲线下面积显著增大(0.856,95％ CI:0.832～0.904).miR-192取其水平为5.14 μg/L时预测价值最佳,以该临界值为界,将患者分为miR-192＜ 5.14 μg/L组(28例)和miR-192≥5.14 μg/L组(31例),发现miR-192＜ 5.14μg/L组在24个月内进展至DN的例数显著多于miR-192≥5.14 μg/L组(16/28比4/31,P＜ 0.05).结论 miR-192水平降低是引起DN患者不良预后的独立危险因素,可对T2DM患者不良预后的几率进行有效预测.
目的 探討微RNA-192(miR-192)水平與糖尿病腎病(DN)患者預後的關繫.方法 選擇2010年1月至2011年7月診治的2型糖尿病(T2DM)病程≥10年的患者59例.入院後測定miR-192水平,收集其他相關臨床資料,併進行為期24箇月的隨訪.根據患者的預後情況,將其分為DN組(20例)與非DN組(39例),併對兩組相關資料進行統計學分析.結果 DN組miR-192水平較非DN組顯著降低[(4.47±2.27) μg/L比(7.28±2.39)μg/L](P＜ 0.05).多因素Logistic迴歸分析顯示高血壓病史、吸煙史、高糖化血紅蛋白水平、低空腹C肽水平、低24h尿蛋白定量水平、低miR-192水平、高體質量指數是T2DM患者不良預後的獨立危險因素(P＜0.05).其中miR-192水平單項指標預測糖尿病患者進展至DN階段的受試者工作特徵(ROC)麯線下麵積為0.697,未加入miR-192時其他6項的麯線下麵積為0.823,加入之後7項指標預測麯線下麵積顯著增大(0.856,95％ CI:0.832～0.904).miR-192取其水平為5.14 μg/L時預測價值最佳,以該臨界值為界,將患者分為miR-192＜ 5.14 μg/L組(28例)和miR-192≥5.14 μg/L組(31例),髮現miR-192＜ 5.14μg/L組在24箇月內進展至DN的例數顯著多于miR-192≥5.14 μg/L組(16/28比4/31,P＜ 0.05).結論 miR-192水平降低是引起DN患者不良預後的獨立危險因素,可對T2DM患者不良預後的幾率進行有效預測.
목적 탐토미RNA-192(miR-192)수평여당뇨병신병(DN)환자예후적관계.방법 선택2010년1월지2011년7월진치적2형당뇨병(T2DM)병정≥10년적환자59례.입원후측정miR-192수평,수집기타상관림상자료,병진행위기24개월적수방.근거환자적예후정황,장기분위DN조(20례)여비DN조(39례),병대량조상관자료진행통계학분석.결과 DN조miR-192수평교비DN조현저강저[(4.47±2.27) μg/L비(7.28±2.39)μg/L](P＜ 0.05).다인소Logistic회귀분석현시고혈압병사、흡연사、고당화혈홍단백수평、저공복C태수평、저24h뇨단백정량수평、저miR-192수평、고체질량지수시T2DM환자불량예후적독립위험인소(P＜0.05).기중miR-192수평단항지표예측당뇨병환자진전지DN계단적수시자공작특정(ROC)곡선하면적위0.697,미가입miR-192시기타6항적곡선하면적위0.823,가입지후7항지표예측곡선하면적현저증대(0.856,95％ CI:0.832～0.904).miR-192취기수평위5.14 μg/L시예측개치최가,이해림계치위계,장환자분위miR-192＜ 5.14 μg/L조(28례)화miR-192≥5.14 μg/L조(31례),발현miR-192＜ 5.14μg/L조재24개월내진전지DN적례수현저다우miR-192≥5.14 μg/L조(16/28비4/31,P＜ 0.05).결론 miR-192수평강저시인기DN환자불량예후적독립위험인소,가대T2DM환자불량예후적궤솔진행유효예측.
Objective To explore the relevance of the microRNA-192 (miR-192) levels and prognosis in patients with diabetic nephropathy (DN).Methods A total of 59 cases with duration of type 2 diabetes mellitus (T2DM) ≥10 years from January 2010 to July 2011 were retrospectively admitted.The miR-192 levels were determined after admission,and other relevant clinical data were collected.And the patients were followed-up for 24 months.According to the patient's prognosis,the patients were divided into DN group(20 cases) and non-DN group(39 cases),and the relevant information was analyzed in two groups.Results The miR-192 levels in DN group were lower than those in non-DN group[(4.47 ± 2.27) μ g/L vs.(7.28 ± 2.39) μ g/L],and there was significant difference (P ＜ 0.05).Multivariate Logistic regression analysis showed that hypertension history,smoking history,high glycosylated hemoglobin,low fasting C-peptide,low 24 h urine protein,low miR-192 level,high body mass index was the independent risk factors of prognosis of T2DM (P ＜ 0.05).The area under the receiver operating characteristic (ROC) curve was 0.697 in miR-192 levels individual predicting progression to DN stage,0.823 in six others without miR-192.After joining seven indicators forecast area under the curve increased significantly(0.856,95％ CI:0.832-0.904).The miR-192 levels 5.14 μ g/L was the best predictive value to the critical value of community,and the patients were divided into miR-192 ＜ 5.14 μ g/L group (28 cases) and miR-192 ≥ 5.14 μ g/L group (31 cases).The number of progression to DN within 24 months in miR-192 ＜ 5.14 μg/L group was more than that in miR-192 ≥5.14 μ g/L group (16/28 vs.4/31,P ＜ 0.05).Conclusions A reduced level of miR-192 is an independent risk factor that can lead to poor prognosis in patients with DN,and can predict adverse outcomes in patients with T2DM effectively.
