ABSTRACT
Objective To investigate the relationship between carotid artery intima-media thickness and renal function in patients with diabetes mellitus.Methods 424 patients of type 2 diabetes without dialysis were enrolled in a cross-sectional study.According to their artery intima-media thickness (IMT),the patients were divided into normal group and higher IMT group.All patients according to UAER or 24h urinary protein were divided into normal proteinuria group,micro-proteinuria group and clinical proteinuria group.The biochemical examination,eGFR,and atherosclerotic plaque of different groups were compared.Pearson or spearman correlation was used to analyze the relationship between eGFR,IMT and other parameters.Risk factors for eGFR decline were analyzed by binary logistic regression.Results Compared with normal group,patients in the higher IMT group were older [(63.3±10.2) year vs (52.5 ± 10.6) year,P ＜ 0.05],and underwent longer duration of diabetes [(8.9±6.7) year vs (6.2±5.7) year,P ＜ 0.05].Their level of eGFR was decreased [(75.92±28.00) ml/min vs (91.64±24.05) ml/ min,P ＜ 0.05],while plaque incidence (71.3％ vs 18.3％,x2=112.42,P ＜ 0.01) and prevalence of hypertension (56.4％ vs 29.6％,x2=27.22,P ＜ 0.01) increased.Correlation analysis showed that IMT was positively correlated with age (r=0.503,P ＜ 0.01),duration of diabetes (r=0.204,P ＜ 0.01),24 h urine protein (rs=0.175,P ＜ 0.05),plaque (rs=0.562,P ＜ 0.01),and hypertension (rs=0.193,P ＜ 0.01),but negatively correlated with eGFR (r=-0.307,P ＜ 0.01).Logistic regression analysis showed that age,serum uric acid,24 h urine protein and carotid artery intima-media thickness were independent risk factors for eGFR decline [OR=1.115,95％CI(1.053,1.165),P ＜ 0.001;OR=1.008,95％CI (1.002,1.014),P=0.006;OR=1.492,95％ CI(1.170,1.903),P=0.001;OR=1.619,95％ CI(1.121,2.339),P=0.010].Conclusion Carotid artery intima-media thickness is an independent risk factor for kidney function decline in patients of diabetes.
ABSTRACT
Objective To investigate the expression and clinical significance of serum microRNA (miRNA) expression profiling in the occurrence and progression of diabetic nephropathy.Methods The miRNA expression profiling was detected by miRNA TaqMan Low Density Array chip from 10 patient with diabetic nephropathy,10 diabetes patients with normoalbuminuria and 10 health control.Real-time quantitative PCR was applied to verify the result of miRNA array in serum samples of 66 patients with diabetic nephropathy (36 patients with microalbuminuria,30 patients with macroalbuminuria),40 diabetes patients with normoalbuminuria and 40 health control.And the relationship of differetial expression with clinical features was analyzed.Results miR-150-5p,miR-155-5p,miR-30e-5p and miR-3196 being validated by real-time quantitative PCR differentially expressed in 3 groups of serum samples from the diabetes patients with microalbuminuria (n=36),with normoalbuminuria (n=40) and health control (n=40) (P ＜ 0.05).Serum miR-150-5p (P=0.005) and miR-155-5p (P=0.006) changed significantly between diabetes patients with microalbuminuria (n=36) and with macroalbuminuria (n=30).Compared with the diabetes patients with microalbuminuria,serum miR-150-5p and miR-155-5p increased by 2.3 and 1.5 times in macroalbuminuria group,respectively.Estimated glomerular filtration rate and urinary albumin excretion rate significantly correlated with serum miR-150-5p and miR-155-5p level.Conclusions miR-150-5p and miR-155-5p may be involved in the process of pathological mechanisms of diabetic nephropathy.Serum miR-150-5p and miR-155-5p may be regarded as potential biomarkers to diagnosis the occurrence and development of diabetic nephropathy.