Abstract
BACKGROUND: Type 2 diabetic nephropathy (T2DN) is a severe complication of diabetes mellitus, and identifying biomarkers for its prognosis remains a critical challenge. Previous studies have suggested potential roles of microRNAs (e.g., miR-495-3p), adiponectin (ADPN), and cardiometabolic index (CMI) in metabolic and renal pathologies. However, their combined predictive value for T2DN prognosis is not well understood. AIM: To explore serum miR-495-3p, ADPN, and CMI levels in T2DN and their value in predicting prognosis. METHODS: A total of 98 T2DN patients (study group) and 49 type 2 diabetic patients with normal renal function (control group) were enrolled from February 2020 to February 2022. Serum levels of miR-495-3p, ADPN, and CMI were measured in both groups. Patients were followed up for 6 months to assess prognosis. Differences between groups were analyzed, and multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the predictive value of these biomarkers. RESULTS: The study group exhibited significantly lower miR-495-3p levels and higher ADPN and CMI levels compared to the control group (P < 0.05). Poor prognosis patients had even lower miR-495-3p and higher ADPN and CMI levels than those with good prognosis (P < 0.05). Multivariate analysis identified alanine aminotransferase, aspartate aminotransferase, urea nitrogen, serum creatinine, miR-495-3p, ADPN, and CMI as independent predictors of prognosis (P < 0.05). ROC analysis revealed area under the curve values of 0.762 (miR-495-3p), 0.902 (ADPN), 0.757 (CMI), 0.899 (alanine aminotransferase), 0.852 (aspartate aminotransferase), 0.916 (urea nitrogen), and 0.910 (serum creatinine) for predicting poor prognosis (P < 0.05). CONCLUSION: Low miR-495-3p and high ADPN and CMI levels are linked to T2DN and poor prognosis, highlighting their potential for risk prediction and clinical management.