Changes of Plasma and Urine hsa-miR-223-3p Was Correlated with the Severity in Different Stages of Diabetes Kidney Disease of Type 2 Diabetes Patients in China

We have previously shown that hsa-miR-223-3p can be as a candidate novel biomarker performing important roles in Diabetes Kidney Disease (DKD) disease process,resulted from co-expression analysis from miRNA (Agilent chips) and lncRNAs (Affymetrix HTA2.0 chips) in plasma.This study involved into 90 patients with type 2 diabetes mellitus (T2DM) and normal control (n=28). Then we divided these diabetes patients into Normoalbuminuric groups(DM) (n=30), Microoalbuminuric group (Micro-DKD) (n=30) and Macroalbuminuric group (Macro-DKD) (n=30), according to urinary albumin to creatinine ratio (ACR) levels (<30mg/g; 30-300mg/g; >300mg/g). The clinical data and biochemical indexes of all the subjects were collected. Real-time qPCR to detect miR-223-3p expression of plasma and urine were reported and compared by using the one-way ANOVA. Statistical analysis was performed using SPSS version 23 software. Receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC) were used to estimate the diagnostic value of the candidate miRs. Compared with controls, the expression of miR-223-3p in plasma were decreased significantly from DM,Micro-DKD to Macro-DKD groups (P <0.001), and the decline was gradually accompanied with the progression of DKD (P <0.001). Same decline pattern was observed in urine expression among four groups, however discrimination was not significant due to the limited patients enrollment in the study. The ROC curve showed that the level of miR-223-3p in plasma can be distinguished among Micro-DKD, Macro-DKD with controls [AUC = 0.750, 95% CI = 0.569-0.923, p = 0.009; AUC = 0.998, 95% CI =0.992-1.000, p = 0.000]. Therefore, plasma hsa-miR-223-3p is a novel biomarker for the severity in Different Stages of DKD in China.