血清miR-27与老年2型糖尿病下肢血管病变及25（OH）D3水平的关系

目的分析血清miR-27与老年2型糖尿病下肢血管病变及25(OH)D3水平的关系。方法选取2017年10月-2019年5月河北省沧州市人民医院内分泌科确诊老年2型糖尿病患者86例为T2DM组,并以有无下肢血管病变分为下肢血管病变(LLPAD)亚组44例和非下肢血管病变(Non-LLPAD)亚组42例;选择同期医院门诊健康体检者76例为对照组,测定比较各组血清miR-27 mRNA表达及TC、TG、HDL-C、LDL-C、HbA1c、FPG、25(OH)D3、hs-CRP、Fib水平。结果 T2DM组miR-27 mRNA、TC、TG、LDL-C、Fib、HbA1c、hs-CRP、FPG水平高于对照组,25(OH)D3、HDL-C水平低于对照组(t=13.371、13.036、25.364、19.698、29.326、38.489、95.524、66.547,66.241、8.698,P均=0.000);LLPAD亚组miR-27 mRNA、TC、TG、LDL-C、Fib、HbA1c、hs-CRP、FPG水平高于Non-LLPAD亚组,25(OH) D3、HDL-C水平低于Non-LLPAD亚组(t=5.275、13.541、26.541、8.965、20.146、14.548、14.369、23.654、7.711、9.491,P均=0.000);miR-27 mRNA与25(OH)D3、HDL-C呈负相关(r=-0.486、-0.483,P=0.039、0.039),与TC、TG、LDL-C、Fib、HbA1c、hs-CRP、FPG呈正相关(r=0.651、0.572、0.494、0.747、0.438、0.523、0.591,P均<0.05);高水平的miR-27 mRNA、TC及低水平的25(OH)D3均为老年2型糖尿病合并下肢血管病变发生的危险因素(OR=2.43.7、4.268、13.625,P<0.05);miR-27 mRNA、25(OH)D3两者的AUC相近,均小于TC;miR-27 mRNA、25(OH)D3诊断老年2型糖尿病下肢血管病变的敏感度、特异度相近(P>0.05),均小于TC(P<0.05)。结论老年2型糖尿病下肢血管病变患者血清miR-27 mRNA水平升高,与25(OH)D3呈负相关;miR-27、25(OH)D3诊断2型糖尿病下肢血管病变具有较高的敏感度、特异度,可作为判定2型糖尿病下肢血管病变的生物学标志物。

Relationship between serum miR-27 and lower extremity vascular disease and 25(OH)D_3 level in elderly patients with type 2 diabetes mellitus

Objective To analyze the relationship between serum miR 27 and lower extremity vascular disease and25(OH) D3 level in elderly patients with type 2 diabetes mellitus(T2 DM).Methods From October 2017 to May 2019,86 elderly patients with type 2 diabetes diagnosed by the Department of endocrinology of Cangzhou people’s Hospital of Hebei Province were selected as T2 DM group.The patients with or without lower extremity vascular disease were divided into lower extremity vascular disease(LLPAD) sub group(44 cases) and non-lower extremity vascular disease(Non-LLPAD) sub group(42 cases).76 cases of healthy elderly physical examination were selected as the control group.The expression of miR-27 mRNA and the levels of TC,TG,HDL-C,LDL-C,HbA1 c,FPG,25(OH) D3,hs-CRP and Fib were measured and compared.Results The levels of miR-27 mRNA,TC,TG,LDL-C,Fib,HbA1 c,hs-CRP,and FPG were higher in the T2 DM group than in the control group,and 25(OH) D3 and HDL-C were lower than those in the control group(t=13.371,13.036,25.364,19.698,29.326,38.489,95.524,66.547,66.241,8.698,P=0.000).The levels of miR-27 mRNA,TC,TG,LDL-C,Fib,HbA1 c,hs-CRP,and FPG in the LLPAD subgroup were higher than those in the Non-LLPAD subgroup,and the levels of 25(OH) D3 and HDL-C were lower than those in the Non-LLPAD subgroup(t=5.275,13.541,26.541,8.965,20.146,14.548,14.369,23.654,7.711,9.491,all P=0.000).miR-27 mRNA was negatively correlated with 25(OH) D3 and HDL-C(r=-0.486,-0.483.P=0.039,0.039),and positively correlated with TC,TG,LDL-C,Fib,HbA1 c,hs-CRP,FPG(r=0.651,0.572,0.494,0.747,0.438,0.523,0.591,P <0.05).High levels of miR-27 mRNA,TC and low levels of 25(OH) D3 were all risk factors for senile type 2 diabetes with lower extremity vascular disease(OR=2.437,4.268,13.625,P <0.05).The AUCs of miR-27 mRNA and 25(OH) D3 were similar,and were smaller than TC.The sensitivity and specificity of miR-27 mRNA and 25(OH) D3 in the diagnosis of lower extremity vascular disease in elderly patients with type 2 diabetes mellitus were similar(P>0.05).Conclusion The level of serum miR-27 mRNA in elderly patients with type 2 diabetic lower extremity angiopathy was increased,which was negatively correlated with 25(OH)D3.miR-27 and 25(OH) D3 had high sensitivity and specificity in the diagnosis of type 2 diabetic lower extremity angiopathy,which could be used as biomarkers for the determination of type 2 diabetic lower extremity angiopathy.