2型糖尿病微血管并发症患者血清miR-16,miR-126和miR-221水平检测及临床意义

目的 检测2型糖尿病(T2DM)及其微血管并发症患者(T2DMC)血清中miR-16,miR-126和miR-221水平,分析其作为T2DMC潜在辅助诊断指标的潜能。方法 运用实时荧光定量PCR技术(qRT-PCR)检测55例T2DM患者,55例T2DMC患者及55例健康对照血清中miR-16,miR-126和miR-221水平,生化分析仪测定相关生化指标,ROC曲线及逻辑回归分析三种血清miRNAs对T2DM及T2DMC的辅助诊断价值。结果 qRT-PCR 结果显示,与健康对照组miR-16(14.35±1.00)×10^-5,miR-126(11.75±1.47)×10^-5和miR-221(32.26±3.98)×10^-5]相比,三种miRNAs在T2DM患者miR-16(23.74±2.70)×10^-5,miR-126(25.01±4.13)×10^-5和miR-221(84.76±11.79)×10^-5]及T2DMC患者miR-16(43.74±9.61)×10^-5,miR-126(17.66±2.20)×10^-5和miR-221(82.52±12.48)×10^-5]血清中表达水平显著升高(P均<0.05),其中miR-16变化最为显著; 三种miRNAs用于T2DM诊断的ROC曲线下面积(AUC_ROC)分别为0.63(95%CI 0.53～0.74),0.64(95%CI 0.54～0.74)和0.74(95%CI 0.65～0.83); 用于T2DMC诊断的ROC曲线下面积(AUC_ROC)分别为0.75(95%CI 0.66～0.84),0.62(95%CI 0.52～0.73)和0.73(95%CI 0.64～0.83); 进一步逻辑回归分析结果显示,这三种血清miRNAs是T2DM和T2DMC独立危险因素。结论 血清中高表达的miR-16,miR-126和miR-221是T2DM及T2DMC患者潜在的非侵入性辅助诊断标志物及独立危险因素。

Study on Serum Levels of miR-16,miR-126 and miR-221 and Their Clinical Significance in Type 2 Diabetes Patients with or Without Microvascular Complications

Objective To determine the serum levels of miR-16,miR-126 and miR-221 in type 2 diabetes(T2DM)patients with or without microvascular complications,and further evaluate their clinical significance.Methods The serum levels of miR-16,miR-126 and miR-221were examined in 55 T2DM patients,55 T2DM patients with microvascular complications and 55 healthy controls using quantitative real-time PCR(qRT-PCR).The levels of fasting blood glucose,triglycerides,cholesterol,high density lipoprotein,low density lipoprotein and others biochemical parameters were determinedby biochemical analyzer,and the diagnostic usefulness of the three miRNAs for T2DM patients and patients with microvascular complications were assessed by ROCcurve analysis and logistic regression analysis.Results Compared with healthy controls miR-16(14.35±1.00)×10^-5,miR-126(11.75±1.47)×10^-5 and miR-221(32.26±3.98)×10^-5],the miR-16,miR-126 and miR-221 expression were significantly increased in T2DM patients miR-16(23.74±2.70)×10^-5,miR-126(25.01±4.13)×10^-5 and miR-221(84.76±11.79)×10^-5] and T2DM patients with microvascular complications miR-16(43.74±9.61)×10^-5,miR-126(17.66±2.20)×10^-5 and miR-221(82.52±12.48)×10^-5].The area under ROC curve(AUC_ROC)of miR-16,miR-126 and miR-221 for T2DM patients were 0.63(95%CI 0.53～0.74),0.64(95%CI 0.54～0.74)and 0.74(95%CI 0.65～0.83),respectively.For T2DM patients with microvascular complications,the area under ROC curve were 0.75(95%CI 0.66～0.84),0.62(95%CI 0.52～0.73)and 0.73(95%CI 0.64～0.83),respectively.Furthermore,logistic regression revealed that the three miRNAs were novel independent risk factors for T2DM and T2DMC.Conclusion The levels of miR-16,miR-126 and miR-221 were significantly increased in the serum of T2DM patients with or without microvascular complications,and can be used as potential non-invasive biomarkers and risk factorsfor T2DM patients and T2DM patients with microvascular complications.