Basic Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jan 15, 2024; 15(1): 92-104
Published online Jan 15, 2024. doi: 10.4239/wjd.v15.i1.92
Urinary exosomal microRNA-145-5p and microRNA-27a-3p act as noninvasive diagnostic biomarkers for diabetic kidney disease
Lu-Lu Han, Sheng-Hai Wang, Ming-Yan Yao, Hong Zhou
Lu-Lu Han, Hong Zhou, Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Lu-Lu Han, Ming-Yan Yao, Department of Endocrinology, Baoding No. 1 Central Hospital, Baoding 071000, Hebei Province, China
Sheng-Hai Wang, Department of Critical Care Medicine, The Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
Co-first authors: Lu-Lu Han and Sheng-Hai Wang.
Author contributions: Zhou H contributed to the conceptualization, methodology, resources, writing-reviewing and editing of this manuscript; Han LL participated in the visualization, writing-original draft preparation of this study; Wang SH took part in the investigation and data curation of this article; Yao MY was major in the interpretation of data, manuscript revision, language and format editing; and all authors were responsible for the content and proposed critical comments on the manuscript, as well as approving final version submission.
Supported by the Nature Science Foundation of Hebei Province, No. H2023104011.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki, all research protocols were approved by Ethical Committee of the Second Hospital of Hebei Medical University (approval number: 2022-R059, 28 February 2022) and the Chinese Clinical Trial Registry (approval number: ChiCTR2200066055). A written informed consent was demanded from each participant before they joined this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Hong Zhou, PhD, Chief Physician, Doctor, Department of Endocrinology, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang 050000, Hebei Province, China.
Received: September 7, 2023
Peer-review started: September 7, 2023
First decision: November 17, 2023
Revised: November 27, 2023
Accepted: December 25, 2023
Article in press: December 25, 2023
Published online: January 15, 2024
Research background

Diabetic kidney disease (DKD) is the primary cause of end-stage renal disease due to its irreversible and rapidly progressive evolution. DKD remains a serious threat to the lives of diabetic patients.

Research motivation

Early diagnosis and specific treatment can prevent DKD progression. Urinary exosomal microRNAs (miRNAs) are generally derived from renal cells and directly mirror the pathological changes in the kidney. Urinary exosomal miRNAs are remarkably stable and highly tissue-specific for the kidney and may act as promising biomarkers for DKD.

Research objectives

To explore whether urinary exosomal miRNAs from diabetic patients can serve as noninvasive biomarkers for the early diagnosis of DKD.

Research methods

Patients with type 2 diabetes mellitus (T2DM) were enrolled and divided into a DM group, diabetic patients without albuminuria, and a DKD group, diabetic patients with a urinary albumin to creatinine ratio of ≥ 30 mg/g. Healthy subjects were included in the normal control group. The relative expressions of urinary exosomal miR-145-5p, miR-27a-3p, and miR-29c-3p were detected using real-time quantitative polymerase chain reaction. Correlation analysis, receiver operating characteristic analysis, and bioinformatics analysis were used to explore the potential of urinary exosomal miR-145-5p and miR-27a-3p as DKD biomarkers.

Research results

The expression of urinary exosomal miR-145-5p and miR-27a-3p was significantly upregulated in the DKD group. They were closely related to kidney damage and abnormal glycolipid metabolism in T2DM patients. Exosomal miR-145-5p had higher sensitivity and specificity for diagnosing DKD; combining miR-145-5p and miR-27a-3p increased their diagnostic efficiency. Bioinformatics analysis suggested that miR-145-5p regulated various molecular biological functions and signaling pathways involved in the pathological processes of DKD, including apoptosis, inflammation, and fibrosis.

Research conclusions

Urinary exosomal miR-145-5p and miR-27a-3p may serve as novel noninvasive diagnostic biomarkers for DKD.

Research perspectives

Urinary exosomal miR-145-5p and miR-27a-3p may complement traditional DKD diagnostic methods. They may also be effective therapeutic targets for DKD cell-free therapy in the future.