Abstract: Objective To investigate the expression level of long non-coding RNA HOX transcript antisense RNA ( LncRNA HOTAIR) in the serum of patients with diabetic nephropathy (DN), and to explore its value in the diagnosis of DN. Methods From January 2020 to January 2021, 80 patients with type 2 diabetic nephropathy (DN group) and 80 patients with type 2 diabetes without kidney damage (T2DM group) who were hospitalized in the Endocrinology and Nephrology department of Huai’an Hospital Affiliated to Xuzhou Medical University were selected as the study subjects, and 75 healthy non-diabetic patients who visited our hospital’s physical examination center during the same period were selected as the control group. Real-time fluorescent quantitative PCR (qRT-PCR) method was used to detect the expression level of LncRNA HOTAIR in the serum of subjects. ROC curve was used to evaluate the clinical diagnostic value of serum LncRNA HOTAIR for DN. Results The expression level of LncRNA HOTAIR in T2DM and DN patients was significantly higher than that in the healthy control group (P < 0. 05), and the expression level of LncRNA HOTAIR in the DN group was significantly higher than that in the T2DM group. The expression level of LncRNA HOTAIR in the serum of DN patients increased significantly with the increase of the urine protein content (P< 0. 05). It was positively correlated with the urine protein content,fasting blood glucose, glycosylated hemoglobin, triglycerides, and low-density lipoprotein ( P < 0. 05), and negatively correlated with glomerular filtration rate ( P < 0. 05). The area under the curve (AUC) of serum LncRNA HOTAIR for diagnosis of DN was 0. 885 (95 % CI: 0. 824- 0. 946), the sensitivity was 92. 5 % , and the specificity was 86. 3 % . Conclusion The expression level of serum LncRNA HOTAIR is related to the progress of DN in T2DM patients, and is expected to be a biomarker for predicting the occurrence of DN in T2DM patients 

Key words: diabetic nephropathy, type 2 diabetes, long non-coding RNA HOX transcript antisense RNA