Clinical Significance of miR-21-5p in Predicting Occurrence and Progression of Uremic Vascular Calcification in Patients with End-Stage Renal Disease
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Purpose: Vascular calcification (VC) is a common complication of end-stage renal disease (ESRD). This study aimed to examinechanges in the expression of miR-21-5p in ESRD patients with VC and to explore its clinical value in predicting the occurrenceand progression of uremic VC. Materials and Methods: 120 ESRD patients were divided into patients without VC group (n=38) and patients with VC group(n=82). All patients were followed up for 2 years to evaluate VC progression. qRT-PCR was used to detect serum miR-21-5p levels. Receiver operating characteristic curves were constructed to assess diagnostic value. Kaplan-Meier and log-rank methods wereutilized to calculate associations between VC progression and risk factors. Results: Serum miR-21-5p levels were significantly higher in ESRD patients with VC than in those without VC and increased progressivelywith increasing disease severity. Serum miR-21-5p levels were able to distinguish patients with VC from those withoutVC, with an area under the curve value of 0.883, a sensitivity of 81.7%, and a specificity of 84.2%. After 2 years of follow-up, miR-21-5p expression had increased in patients with worse VC severity, compared with those with stable VC severity. Patients withhigh miR-21-5p levels were more likely to develop more severe VC, indicating an association between miR-21-5p and VC progression(log-rank p=0.002). Multivariable Cox regression analysis suggested that serum miR-21-5p is an independent predictive factorof VC progression in ESRD patients (hazard ratio=2.064, 95% confidence interval=1.225–3.478, p=0.006). Conclusion: miR-21-5p is overexpressed in the serum of ESRD patients with VC. Our results suggest that overexpression of miR-21-5p is closely associated with VC progression.
Abstract
Purpose: Vascular calcification (VC) is a common complication of end-stage renal disease (ESRD). This study aimed to examinechanges in the expression of miR-21-5p in ESRD patients with VC and to explore its clinical value in predicting the occurrenceand progression of uremic VC. Materials and Methods: 120 ESRD patients were divided into patients without VC group (n=38) and patients with VC group(n=82). All patients were followed up for 2 years to evaluate VC progression. qRT-PCR was used to detect serum miR-21-5p levels. Receiver operating characteristic curves were constructed to assess diagnostic value. Kaplan-Meier and log-rank methods wereutilized to calculate associations between VC progression and risk factors. Results: Serum miR-21-5p levels were significantly higher in ESRD patients with VC than in those without VC and increased progressivelywith increasing disease severity. Serum miR-21-5p levels were able to distinguish patients with VC from those withoutVC, with an area under the curve value of 0.883, a sensitivity of 81.7%, and a specificity of 84.2%. After 2 years of follow-up, miR-21-5p expression had increased in patients with worse VC severity, compared with those with stable VC severity. Patients withhigh miR-21-5p levels were more likely to develop more severe VC, indicating an association between miR-21-5p and VC progression(log-rank p=0.002). Multivariable Cox regression analysis suggested that serum miR-21-5p is an independent predictive factorof VC progression in ESRD patients (hazard ratio=2.064, 95% confidence interval=1.225–3.478, p=0.006). Conclusion: miR-21-5p is overexpressed in the serum of ESRD patients with VC. Our results suggest that overexpression of miR-21-5p is closely associated with VC progression.
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