摘要
目的探讨血浆微小RNA(miR)-122和miR-33a与2型糖尿病合并冠心病患者冠状动脉病变程度的相关性。方法回顾性分析2019年1月至2021年10月徐州市第一人民医院196例2型糖尿病患者的临床资料。其中,合并冠心病81例(合并组),未合并冠心病115例(对照组)。采用实时荧光定量逆转录聚合酶链反应检测血浆miR-122、miR-33a水平,采用酶联免疫吸附法检测血浆N末端B型利钠肽前体(NT-proBNP)水平。合并组患者根据冠状动脉造影结果确定冠状动脉病变支数,并进行Gensini积分评价。采用线性回归模型分析血浆miR-122、miR-33a和NT-proBNP与2型糖尿病患者发生冠心病的关系。绘制受试者工作特征(ROC)曲线,分析血浆miR-122和miR-33a预测2型糖尿病患者发生冠心病的效能。合并组采用Spearman相关法分析血浆miR-122和miR-33a与冠状动脉病变支数的关系,采用Pearson相关法分析血浆miR-122和miR-33a与血浆NT-proBNP和Gensini积分的关系。结果合并组血浆miR-122、miR-33a和NT-proBNP明显高于对照组[5.76±1.35比1.18±0.33、1.39±0.37比0.65±0.11和(786.87±156.39)ng/L比(103.45±19.27)ng/L],差异有统计学意义(P<0.01)。线性回归分析结果显示,2型糖尿病患者血浆miR-122、miR-33a和NT-proBNP与冠心病发生呈正相关(P<0.01);ROC曲线分析结果显示,血浆miR-122、miR-33a单独和联合预测2型糖尿病患者发生冠心病的曲线下面积为0.816、0.845和0.912(95%CI 0.744~0.865、0.768~0.892和0.836~0.967)。冠状动脉造影结果显示,单支病变46例,2支病变25例,3支病变10例。3支病变患者血浆miR-122、miR-33a、NT-proBNP及Gensini积分明显高于2支病变患者和单支病变患者[6.52±0.96比4.95±0.85和3.74±0.52、1.45±0.31比1.06±0.25和0.81±0.13、(829.78±62.59)ng/L比(627.48±47.12)和(502.64±38.24)ng/L、(63.89±12.71)分比(42.18±6.03)和(22.36±2.41)分],2支病变患者明显高于单支病变患者,差异均有统计学意义(P<0.05)。Spearman相关分析结果显示,合并组血浆miR-122和miR-33a与冠状动脉病变支数呈正相关(r=0.879和0.825,P<0.05);Pearson相关分析结果显示,合并组血浆miR-122和miR-33a与血浆NT-proBNP和Gensini积分呈正相关(miR-122:r=0.896和0.788,miR-33a:r=0.871和0.765;P<0.05)。结论血浆miR-122、miR-33a水平与2型糖尿病患者冠心病发生及冠状动脉病变程度均相关,可用于指导2型糖尿病患者冠心病的防治。
Objective To investigate the correlation between plasma microRNA(miR)-122,miR-33a and the severity of coronary artery disease in patients with type 2 diabetes mellitus(T2DM)and coronary heart disease.Methods The clinical data of 196 patients with T2DM from January 2019 to October 2021 in Xuzhou First People′s Hospital were retrospectively analyzed.Among them,81 cases were complicated with coronary heart disease(combined group),115 cases were not complicated with coronary heart disease(control group).The plasma levels of miR-122 and miR-33a were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction,the plasma level of N-terminal B-type natriuretic peptide precursor(NT-proBNP)was detected by enzyme-linked immunosorbent assay.In combined group,the number of coronary artery lesions was determined according to the results of coronary angiography,and Gensini score was evaluated.Linear regression model was used to analyze the relationship between plasma miR-122,miR-33a and NT-proBNP levels with the incidence of coronary heart disease in patients with T2DM.Receiver operating characteristic(ROC)curve was used to analyze the plasma miR-122 and miR-33a in predicting efficiency of coronary heart disease in patients with T2DM.In combined group,Spearman correlation method was used to analyze the relationship between plasma miR-122,miR-33a and the number of coronary artery lesions,and Pearson correlation method was used to analyze the relationship between plasma miR-122,miR-33a and plasma NT proBNP,Gensini score.Results The plasma miR-122,miR-33a and NT-proBNP in combined group were significantly higher than those in control group:5.76±1.35 vs.1.18±0.33,1.39±0.37 vs.0.65±0.11 and(786.87±156.39)ng/L vs.(103.45±19.27)ng/L respectively,and there were statistical differences(P<0.01).Linear regression result showed that plasma miR-122,miR-33a,and NT-proBNP were positive correlation with occurrence of coronary heart disease in patients with T2DM(P<0.01);ROC curve analysis result showed that the area under curve of plasma miR-122,miR-33a and combination in predicting coronary heart disease in patients with T2DM were 0.816,0.845 and 0.912 respectively(95%CI 0.744 to 0.865,0.768 to 0.892 and 0.836 to 0.967).Coronary angiography result showed that there were 46 cases of single vessel lesions,25 cases of double vessel lesions and 10 cases of three vessel lesions.The plasma miR-122,miR-33a,NT-proBNP and Gensini score in patients with three vessel lesions were significantly higher than those in patients with double vessel lesions and patients with single vessel lesions:6.52±0.96 vs.4.95±0.85 and 3.74±0.52,1.45±0.31 vs.1.06±0.25 and 0.81±0.13,(829.78±62.59)ng/L vs.(627.48±47.12)and(502.64±38.24)ng/L,(63.89±12.71)scores vs.(42.18±6.03)and(22.36±2.41)scores,the indexes in patients with double vessel lesions were significantly higher than those in patients with single vessel lesions,and there were statistical differences(P<0.05).In combined group,Spearman correlation analysis result showed that the plasma miR-122 and miR-33a were positive correlation with the number of coronary artery lesions(r=0.879 and 0.825,P<0.05);Pearson correlation analysis result showed that the plasma miR-122 and miR-33a were positive correlation with the plasma NT-proBNP and Gensini score(miR-122:r=0.896 and 0.788,miR-33a:r=0.871 and 0.765;P<0.05).Conclusions The plasma levels of miR-122 and miR-33a are related to the occurrence of coronary heart disease and severity of coronary artery disease in patients with T2DM,which may be used to guide the prevention and treatment of coronary heart disease in patients with T2DM.
作者
赵立成
王园园
杜银苹
李菲
耿猛
史进
董国华
孙倩
Zhao Licheng;Wang Yuanyuan;Du Yinping;Li Fei;Geng Meng;Shi Jin;Dong Guohua;Sun Qian(Department of General Medicine,Xuzhou First People's Hospital,Xuzhou 221000,China)
出处
《中国医师进修杂志》
2022年第7期633-638,共6页
Chinese Journal of Postgraduates of Medicine
基金
徐州市科技项目(KC20151)。
作者简介
通信作者:孙倩,Email:zhao09lc@163.com。
