Identification and validation of biomarkers associated with lactic acid metabolism in diabetic nephropathy

Through a comprehensive analysis of bioinformatics methods, we identified two biomarkers-PTGS2 and NFE2L2-as significant candidates in DN. The nomogram demonstrated robust predictive efficacy, validating their utility. NFE2L2 and PTGS2 were positively correlated with the five signal pathways, such as hypoxia and IL2 STAT5 signaling. Both PTGS2 and NFE2L2 had the highest positive correlation with T follicular helper cells (correlation coefficient (cor) = 0.49, <i>p</i> < 0.01, and cor = 0.54, <i>p</i> < 0.01). Two biomarkers predicted multiple miRNAs and transcription factors (TFs), such as miR-144-3p, GATA2, and GATA3. Drug-target analysis highlighted high-affinity interactions for NFE2L2 -lagascatriol and PTGS2 -cimicoxib, further supported by molecular docking. Finally, RT-qPCR confirmed significantly elevated expression of PTGS2 and NFE2L2 in DN samples compared to controls (<i>p</i> < 0.05), aligning with bioinformatics predictions.