| Objective : Diabetic kidney disease is one of the most common microvascular complications of diabetes,and its incidence in the world is on the rise,which is the main cause of end-stage renal disease.Early diagnosis and treatment is one of the effective ways to delay diabetic kidney disease,looking for specificity and early diagnosis indicators with sensitive sensitivity have always been the focus of research by experts and scholars.Sirtuin 4(SIRT4)is a homologous analog of yeast sirtuin 2,a mitochondrial protein that regulates energy metabolism,with ADP-ribosyltransferase,deacetylase,ester amidase activity,participated in the regulation of insulin secretion,fatty acid oxidation,oxidative stress,inflammation and other biological processes,the above processes are involved in the occurrence and development of diabetic kidn ey disease.In previous studies,SIRT4 expression was decreased in glucose-induced podocytes in a concentration-dependent manner,and podocyte apoptosis was increased.When SIRT4 was overexpressed,intracellular oxidative stress and inflammation were inhibited,and podocyte apoptosis was reduced.SIRT4 may be associated with diabetic kidney disease.In this study,we investigated the expression of SIRT4 in patients with type 2 diabetic kidney disease at different stages,and explored the significance of silencing signal-regulated protein 4 in type 2 diabetic kidney disease,and explored whether SIRT4 can be used for the early diagnosis of diabetic kidney disease.Methods: According to the inclusion and exclusion criteria,a total of 90 inpatients in the First Affiliated Hospital of China Medical University from March 2018 to August 2018 were collected and used forscreening and diagnosis of microalbuminuria according to ADA(2012)recommended by the United States Urinary Albumin Excretion Rate(RACR,urinary albumin / urinary creatinine)were divided into normal albuminuria group(group A: UACR <30 mg/g,n=30),early diabetic kidney disease group(group B: 30 mg/g ? UACR ? 300 mg/g,n=30)and clinical diabetic kidney disease group(group C: UACR>300 mg/g,n=30).30 normal cases served as control group(N group).Real-time quantitative PCR(RT-PCR)and Western blotting were used to detect the expression of SIRT4 in peripheral blood of the subjects.At the same time,all people's fasting blood glucose,glycosylated hemoglobin,serum creatinine,blood lipids,urine microalbumin,urine creatinine and other general data were collected,and the glomerular filtration rate(e GFR)was calculated.All data were statistically analyzed with SPSS20.0 software.The measurement data were expressed by(X±S).One-way ANOVA and nonparametric tests were used for comparison between groups.The correlation analysis between blood SIRT4 and various factors was performed by Pearson correlation analysis.The correlation between SIRT4 and type 2 diabetic kidney disease was analyzed by logistic regression analysis.All data P < 0.05 were considered statistically significant.Restults: PCR and Western results showed that the expression level of SIRT4 in diabetic patients was lower than that in healthy subjects(P<0.05),and decreased with increasing UACR(r=-0.915,P<0.001).Correlation analysis showed that SIRT4 was negativaly with diabetes duration(P<0.001),BMI(P=0.001),TC(P=0.009),TG(P<0.001),Scr(P<0.001),UACR(P<0.001),Cysc(P<0.001),and was positively correlated withe e GFR(P < 0.001).Logistic regression analysis shows that SIRT4 was an independent protective factor for diabetic kidney disease,the odds ratio of carotid plaque was 0.589,95% confidence interval 0.364-0.954,P<0.05.Conclusion: SIRT4 in peripheral blood has a certain correlation with diabetic kidney disease,which may be one of the early diagnostic indicators of diabetic kidney disease,but its clinical reference value needs to be further explored.And SIRT4 in peripheral blood is an independent protective factor for diabetic kidney disease,and it also has certain clinical reference value in reflecting the renal function of patients with diabetic kidney disease. |
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