Diagnostic value of VDBP and miR-155-5p in diabetic nephropathy and the correlation with urinary microalbumin

Abstract

This study explored the diagnostic and therapeutic significance of vitamin D binding protein (VDBP) and miR-155-5p for diabetic nephropathy and the correlation with urinary microalbumin. A total of 145 patients with type 2 diabetes who attended the Hwamei hospital were selected as research objects and assigned to diabetic nephropathy group (DN group) and diabetes group according to whether they suffered from diabetic nephropathy (DN). The expression levels of urine VDBP and serum miR-155-5p in the two groups were detected, and the correlation between urinary microalbumin (mAlb), serum cystatin C (Cys C) and 24-h urinary protein was analyzed. The predictive value of single and joint detection of urinary VDBP and serum miR-155-5p for DN onset and poor prognosis was analyzed. In DN patients, urine VDBP and serum miR-155-5p were highly expressed, and urine VDBP, serum miR-155-5p and mAlb, Cys C and 24-h urine protein were positively correlated (P<0.05). Moreover, the joint detection of urine VDBP and serum miR-155-5p was more valuable in diagnosis and poor prognosis prediction of DN patients than its single detection. Urine VDBP and serum miR-155-5p have good diagnostic value for DN, but their joint diagnostic value is higher, and their expression levels are all related to mAlb of DN patients, which may be used as new biological indicators for diagnosis and disease assessment.

Keywords: VDBP; correlation; diabetic nephropathy; diagnostic value; miR-155-5p; urinary microalbumin.

Figure 1

Detection of other relevant indicators of DN. (A) Urine mAlb level of patients in the two groups. (B) Serum Cys C level of patients in the two groups. (C) 24-h urine protein level of patients in the two groups. ^*P<0.05. DN, diabetic nephropathy; mAlb, microalbumin; Cys C, cystatin C.

Figure 2

Correlation analysis of serum miR-155-5p, urine VDBP, mAlb, Cys C and 24-h urine protein in DN patients. (A) miR-155-5p and mAlb were positively correlated. (B) miR-155-5p and Cys C were positively correlated. (C) miR-155-5p was positively correlated with 24-h urine protein. (D) Urine VDBP and mAlb were positively correlated. (E) Urine VDBP was positively correlated with Cys C. (F) There was a positive correlation between urine VDBP and 24-h urine protein. VDBP, vitamin D binding protein; mAlb, microalbumin; Cys C, cystatin C; DN, diabetic nephropathy.

Figure 3

Diagnostic value of single and joint detection of serum miR-155-5p and urine VDBP in DN. (A) The diagnostic sensitivity of serum miR-155-5p to DN was 75.68%, specificity was 64.79%, AUC was 0.746, 95% CI was 0.664-0.828, and cut-off value was 2.6. (B) The diagnostic sensitivity of urine VDBP to DN was 85.14%, specificity was 83.10%, AUC was 0.859, 95% CI was 0.787-0.931, and the cut-off value was 31.24 ng/ml. (C) The diagnostic sensitivity of joint diagnosis of serum miR-155-5p and urine VDBP for DN was 93.24%, specificity was 76.06%, AUC was 0.904, and 95% CI was 0.851-0.958. VDBP, vitamin D binding protein; DN, diabetic nephropathy.

Figure 4

Predictive value of serum miR-155-5p and urine VDBP for poor prognosis of DN patients. (A) The predictive sensitivity of serum miR-155-5p to the occurrence of ESRD was 74.36%, specificity was 65.63%, AUC was 0.744, 95% CI was 0.628-0.861, and cut-off value was 3.409. (B) The predictive sensitivity of urine VDBP to the occurrence of ESRD was 782.05%, specificity was 71.88%, AUC was 0.849, 95% CI was 0.759-0.939, and the cut-off value was 62.06 ng/ml. (C) The predictive sensitivity of joint detection of serum miR-155-5p and urine VDBP for the occurrence of ESRD was 89.74%, specificity was 65.63%, AUC was 0.886, and 95% CI was 0.810-0.963. VDBP, vitamin D binding protein; DN, diabetic nephropathy; ESRD, end-stage renal disease.