Abstract：【Objective】To investigate the relationship between serum levels of microRNA-21 (miR-21), Cystatin C (cys C), soluble leukocyte differentiation antigen CD40 ligand (sCD40L) and soluble intercellular adhesion factor-1 (sICAM-1) and diabetes nephropathy (DN). 【Methods】A total of 162 patients with type 2 diabetes admitted to our hospital from October 2019 to October 2021 were selected. According to urinary microalbumin excretion rate (UACR), they were divided into group A (UACR<30 mg/24 h, simple type 2 diabetes) 70 cases, group B (UACR 30-300 mg/24 h, early DN) 52 cases, and group C (UACR >300 mg/24 h,DN) 40 cases; In addition, 60 healthy volunteers who underwent physical examination in our hospital in the same period were selected as Group D. The serum levels of miR-21, cys C, sCD40L, sICAM-1 and their correlations with various biochemical indexes were compared in each group. The diagnostic efficacy of the above indexes for early DN was analyzed by using the receiver operating characteristic (ROC) curve. 【Results】 The levels of serum miR-21 in group A, B and C were significantly lower than those in group D (P<0.05), and the levels of serum cys C, sCD40L and sICAM-1 were significantly higher than those in group D (P<0.05); The levels of serum miR-21 in group A, group B and group C gradually decreased (P<0.05), and the levels of serum cys C, sCD40L and sICAM-1 gradually increased (P<0.05). Serum miR-21, cys C, sCD40L and sICAM-1 were positively correlated with HbA1c, TG, LDL-C and UACR (P<0.05), and negatively correlated with estimated glomerular filtration rate (EGFR) (P<0.05). Serum miR-21,cys C,sCD40L and sICAM-1 had certain diagnostic efficacy for early DN, and the area under the curve was 0.801, 0.774, 0.873 and 0.789, respectively.【Conclusion】miR-21, cys C, sCD40L and sICAM-1 are all involved in the pathogenesis of DN and are related to the severity of the disease. They can be used as reliable markers for early diagnosis of DN.
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2022, Vol. 39 
