胰岛素抵抗对多囊卵巢综合征患者妊娠结局的影响

目的:探讨胰岛素抵抗(IR)对多囊卵巢综合征(PCOS)患者妊娠结局的影响.方法:选择2005年1月～2009年1月就诊的40例PCOS患者,将稳态模型胰岛素抵抗指数( HOMA- IR)≥2.69的22例PCOS患者作为胰岛素抵抗组,余20例作为对熙组,比较两组妊娠合并症、并发症和新生儿情况.结果:在妊娠期糖尿病( ...     

非肥胖型多囊卵巢综合征抗苗勒管激素与胰岛素抵抗及性激素的相关性研究

目的探讨非肥胖型多囊卵巢综合征(PCOS)抗苗勒管激素(AMH)与胰岛素抵抗(IR)及性激素的关系。方法选取2018年1月1日至2018年7月31日我院确诊的非肥胖型PCOS患者121例,其中PCOS合并IR组55例,单纯PCOS组66例,同期非肥胖型健康女性50例作为对照组。比较3组患者血清AMH、HOMA-IR水平,以及AMH与IR、性激素的关系。结果 PCOS合并IR组血清AMH水平[(7.96±2.97)ng/ml]、HOMA-IR(5.35±4.00)显著高于单纯PCOS组[分别为(6.93±2.23)ng/ml、(1.66±0.52)]和对照组[分别为(5.15±0.20)ng/ml、(1.64±0.77)],差异有统计学意义(P0.05)。PCOS组AMH水平与T、DHEA、HOMA-IR呈正相关(分别为r=0.194,P=0.033;r=0.213,P=0.019;r=0.227,P=0.012),与E_2呈负相关(r=-0.229,P=0.011)。结论非肥胖型PCOS合并IR组患者血清AMH水平升高,AMH水平与T、DHEA、HOMA-IR、E_2相关。     

PCOS患者抗苗勒管激素水平与胰岛素抵抗及生殖激素水平的相关性研究

目的探讨多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)水平与胰岛素抵抗(IR)及生殖激素水平的相关性。方法选取2017年1月至2020年2月在东莞东华医院生殖医学科就诊的PCOS患者62例,根据患者是否存在胰岛素抵抗,分为胰岛素抵抗组(HOMA-IR>2.1,PCOS-IR组,34例)和非胰岛素抵抗组(HOMA-IR<2.1,PCOS-NIR组,28例);选择同时期在同院行健康体检的30例正常女性为对照组。测定所有研究对象的血清生殖激素(AMH、FSH、LH、E2、T、PRL、P)水平,以及硫酸脱氢表雄酮(DHEA)、性激素结合球蛋白(SHBG)及空腹血糖(GLU)空腹胰岛素(FIN)水平等指标,统计分析组间各指标的差异;采用Spearman相关分析分析AMH水平与稳态模型胰岛素抵抗指数(HOMA-IR)的关系。结果3组间平均年龄、体重指数(BMI)及血清FSH、P、PRL、SHBG及DHEA水平均无统计学差异(P>0.05)。与对照组比较,PCOS组(包括PCOS-IR组和PCOS-NIR组)血清AMH、LH及T水平显著升高(P<0.05);与PCOS-NIR组比较,PCOS-IR组FIN[(20.31±12.71)mU/L vs.(5.69±1.98)mU/L]、GLU[(5.58±1.98)mmol/L vs.(4.89±1.98)mmol/L]和HOMA-IR[3.7(2.42,7.09)vs.1.28(0.84,1.63)]显著升高(P<0.05)。相关性分析结果显示,PCOS患者AMH水平与LH水平(r=0.403,P=0.001)及T水平(r=0.403,P=0.000)呈正相关,与FSH水平呈负相关(r=-0.253.P=0.044),而与年龄、BMI、E 2、P、PRL、FIN、GLU、SHBG、DHEA及HOMA-IR不存在显著相关(P>0.05)。结论PCOS患者血清AMH水平高于正常女性,其原因与高雄激素密切相关;PCOS患者血清AMH水平与胰岛素抵抗无相关性。     

多囊卵巢综合征伴胰岛素抵抗患者肠道菌群分析

目的基于16S rRNA高通量测序技术对多囊卵巢综合征(PCOS)伴胰岛素抵抗(IR)患者肠道菌群的结构特征进行分析。方法选择2019年7月至2020年6月期间就诊于青岛大学附属烟台毓璜顶医院的新发PCOS女性,根据稳态模型胰岛素抵抗指数(HOMA-IR)分为IR-PCOS组(n=11)和NIR-PCOS组(n=10)。选择同期在毓璜顶医院体检中心行孕前检查的年龄匹配且排卵正常的女性为对照组(HC组,n=11)。对所有研究对象进行直肠拭子取样,扩增细菌的16S rRNA V3-V4片段然后对其进行测序,分析各组对象肠道菌群的组成特征及其与临床参数之间的相关性。结果相较于健康女性,PCOS患者肠道菌群结构发生了显著改变,表现为多样性降低(P<0.05),菌群中拟杆菌门相对丰度显著高于HC组(P<0.001),厚壁菌门显著减少(P<0.01);IR-PCOS组患者肠道菌群多样性降低程度显著大于NIR-PCOS组患者(P<0.05),拟杆菌门相对丰度也显著高于NIR-PCOS组患者(P<0.001)。菌群中弯曲杆菌、拟杆菌门、脱硫杆菌门和睾酮、黄体生成素、黄体生成素与卵泡刺激素之比、体质量指数、胰岛素抵抗指数、肿瘤坏死因子、血脂紊乱程度呈正相关,而变形菌门、放线菌门和绿弯菌门则与之呈负相关,其中弯曲杆菌和黄体生成素与卵泡刺激素之比、变形菌门和体质量指数、绿弯菌门和血清总胆固醇之间的相关性有统计学意义(P<0.05)。结论PCOS伴IR患者肠道菌群紊乱更加明显,肠道菌群失调可能是加重PCOS患者代谢异常的原因之一。     

METRNL在PCOS患者血清中的表达及意义

目的 探讨多囊卵巢综合征(PCOS)患者血清中METRNL的表达情况，寻找PCOS治疗的新靶点。方法 选取2022年7-10月就诊于河北大学附属医院生殖中心门诊被确诊为PCOS的131例患者为实验组(PCOS组),另收集同期确诊为男方因素不孕的且其他各项实验室检查结果均正常的50例女性作为正常对照组。应用酶联免疫吸附(ELISA)法检测血清中METRNL水平，化学发光法检测血清中睾酮(T)、卵泡刺激素(FSH)、黄体生成素(LH)水平；对所有研究对象进行胰岛素释放实验(IRT)及葡萄糖耐量实验(OGTT)。同时根据体质量指数(BMI)将PCOS组分为肥胖组及非肥胖组；根据胰岛素抵抗指数(HOMA-IR)将PCOS组分为胰岛抵抗组(PCOS-IR组)与非胰岛抵抗组(PCOS-非IR组),比较PCOS及PCOS亚组与对照组之间的METRNL、激素水平等差异，并用Pearson分析各指标间的相关性。结果 PCOS组与对照组比较，BMI、T、LH/FSH、 HOMA-IR及METRNL水平均有统计学差异(P<0.05)。PCOS肥胖组患者的HOMA-IR水平显著高于非肥胖者(P<0...     

罗格列酮对多囊卵巢综合征卵巢颗粒细胞芳香化酶的表达和雌二醇分泌的影响

研究罗格列酮对多囊卵巢综合征(PCOS)患者卵巢颗粒细胞芳香化酶(aromatase)的表达和雌二醇(E2)分泌的影响,以了解罗格列酮对PCOS卵巢颗粒细胞的局部作用。一、材料与方法1.研究对象:选择2004年11月至2005年3月在本院生殖中心接受体外受精-胚胎移植(IVF-ET)治疗并伴有胰岛素抵抗的PCOS患者(PCOS组)及同期非PCOS原因导致不育的患者(非PCOS组)各5例。胰岛素(INS)释放试验:空腹INS>16·15mIU/L,餐后(服75 g葡萄糖)INS 1 h>109·8mIU/L或2 h>89·0 mIU/L,其中一项阳性即为胰岛素抵抗。诊断标准,满足以下三项中的任意两项即可…     

PCOS患者胰岛素抵抗与肥胖对IVF结局的影响

目的探讨PCOS患者胰岛素抵抗与肥胖对IVF结局的影响,以期为临床加强对PCOS患者胰岛素抵抗及肥胖的管理提供一定参考。方法选择2015～2017年就诊于烟台毓璜顶医院生殖医学中心接受IVF助孕治疗的第一周期鲜胚移植/冻融胚胎移植(FET)的患者590人,根据是否合并PCOS分为PCOS组(347例)和对照组(243例)。PCOS组患者又根据稳态评估-胰岛素抵抗指数(HOMA-IR)分为两个亚组:合并胰岛素抵抗(IR)的PCOS-IR组(200例),不合并IR的PCOS-NIR组(147例);按照不同的体重指数(BMI)水平分为PCOS体重正常组(115例)、PCOS超重组(132例)和PCOS肥胖组(94例)。比较各组患者的基本情况、IVF治疗相关参数及妊娠结局。结果 (1)PCOS-NIR组的抗苗勒管激素(AMH)、b-LH、b-FSH、高密度脂蛋白(HDL)水平均显著高于PCOS-IR组(P0.05)。对照组Gn总量、HCG日大卵泡数、MⅡ卵数、2PN受精卵数、优胚数均显著低于PCOS-NIR、PCOS-IR组(P0.05),临床妊娠率显著高于PCOS-IR组(P0.05);PCOS-NIR组的着床率、临床妊娠率显著高于PCOS-IR组(P0.05)。(2)按BMI分组后发现,PCOS肥胖、超重组的HOMA-IR、TG均显著高于PCOS体重正常组(P0.05);对照组的Gn天数、HCG日大卵泡数、获卵数、MⅡ卵数、2PN受精卵数、优胚数均显著低于PCOS不同BMI亚组,临床妊娠率则显著高于不同BMI亚组(P0.05);PCOS体重正常组的着床率、临床妊娠率均显著高于PCOS超重、肥胖组(P0.05)。结论 PCOS合并IR与肥胖均会对IVF结局产生不利的影响,且肥胖可加剧PCOS患者的IR程度。     

多囊卵巢综合征患者血清25(OH)D3与糖脂代谢的相关性研究

目的观察多囊卵巢综合征(Polycystic ovary syndrome,PCOS)患者血清25羟维生素D_3[25 hydroxyvitamin D,25(OH)D_3]水平,探讨PCOS患者维生素D对糖脂代谢的影响。方法选取2015年12月至2016年9月我院住院及门诊新诊断的70例PCOS患者及70例年龄及体重指数均匹配的健康对照者。根据BMI分为四组:超重/肥胖PCOS组(OW/OB+PCOS组)36例,非肥胖PCOS组(PCOS组)34例,超重/肥胖对照组(OW/OB组)37例,非肥胖对照组(NC组)33例。测定血清25(OH)D_3、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(Hb Alc)、空腹胰岛素(Fins)、性激素水平,采用稳态模型HOMA-IR指数评估胰岛素抵抗(Insulin resistance,IR)程度。结果 OW/OB+PCOS组25(OH)D_3、HDL-C均较OW/OB组显著降低,而TG、Fins、HOMA-IR均较OW/OB组显著增高(P0.05);(2)OW/OB+PCOS组25(OH)D_3、HDL-C均较PCOS组显著减低、而TG、Fins、HOMA-IR均显著增高(P0.05);(3)PCOS组25(OH)D_3、HDL-C较NC组均显著减低,而TG、Fins、HOMA-IR、LH、TES则均显著增高(P0.05);(4)相关分析示25(OH)D_3水平与BMI、FINS、HOMA-IR、TG呈负相关(r=-0.208,P=0.034;r=-0.918,P=0.000;r=-0.799,P=0.000;r=-0.683,P=0.002),与HDL-C呈正相关(r=0.585,P=0.001)。结论 PCOS患者血清25(OH)D_3水平减低与肥胖和脂代谢紊乱密切相关。     

胰岛素抵抗与尿毒症高血压的关系

目的 :探讨胰岛素抵抗 (IR)与尿毒症患者高血压的关系。方法 :对 4 5例高血压和 14例非高血压尿毒症的患者进行口服葡萄糖耐量试验 (OGTT)和胰岛素释放试验 (IRT) ,计算胰岛素敏感指数 (ISI)、机体糖代谢率 (M )、糖及胰岛素反应曲线下面积 (AUCG、AUCINS) ,分析上述指标与平均动脉压 (MBP)的关系。结果 :(1)尿毒症高血压组糖负荷后的血糖、胰岛素水平、AUCG、AUCINS均显著高于非高血压组 (P <0 .0 5 ) ,而ISI、M低于非高血压组 (P <0 .0 5 ) ;(2 )胰岛素抵抗组 (IR)血压值明显高于非胰岛素抵抗组 (NIR) ,P <0 .0 5 ;(3)尿毒症患者平均动脉压与ISI、M呈负相关 (r =- 0 .5 8、- 0 .5 4 ) ,与AUCG、AUCINS呈正相关 (r =0 .6 2、0 .5 3) ,P≤ 0 .0 0 1。结论 :IR、高胰岛素血症及糖耐量异常 (IGT)与尿毒症患者高血压明显相关 ,可能是引起尿毒症高血压的重要因素之一。     

声辐射力脉冲成像评估2型糖尿病胰岛素抵抗患者肝脏功能

目的应用声辐射力脉冲成像(ARFI)中的声触诊组织量化(VTQ)技术评估2型糖尿病(T2DM)胰岛素抵抗(IR)患者肝脏弹性的改变。方法收集62例T2DM患者,分为IR组(n=32)和非IR组(n=30);检测空腹血糖、空腹胰岛素、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、甘油三酯(TG),并计算稳态模型IR指数;应用VTQ技术测定肝脏剪切波速度(SWV),分析其与IR及脂代谢相关血液指标的相关性。结果 IR组平均肝脏SWV值为(1.33±0.18)m/s,非IR组平均肝脏SWV值为(1.04±0.10)m/s,差异有统计学意义(P0.05)。随着肝脏SWV值升高,TC、TG、LDL-C升高而HDL-C降低。结论 T2DM患者肝脏SWV值与IR情况及血脂水平有密切关系;ARFI技术可用于评估T2DM IR患者的肝脏弹性及脂代谢情况。     

实验性多囊卵巢综合征大鼠脂肪组织中抵抗素基因的表达及其意义

目的研究脱氢表雄酮(DHEA)诱导SD幼年雌性大鼠多囊卵巢综合征(PCOS)动物模型的脂肪组织中抵抗素(resistin)mRNA的表达与其性激素变化及胰岛素抵抗(IR)的关系。方法以DHEA皮下注射21d龄SD雌性大鼠,观察卵巢重量及光镜(HE染色)、透视电镜下形态学改变,测定糖耐量、血清胰岛素、雌二醇(E2)、睾酮(T)、孕酮(P)、泌乳素(PRL)水平,采用逆转录聚合酶链反应(RT PCR)法检测脂肪组织resistinmRNA的表达。结果实验组卵巢重量显著高于对照组(P<0.05),实验组卵巢呈多囊样改变而黄体形成比例减少;实验组血清T、E2和空腹血糖、胰岛素水平明显高于对照组(分别为P<0.001、<0.05、<0.001、<0.05),空腹血胰岛素与空腹血糖乘积的倒数(1/FINS×FGC)显著高于对照组(P<0.05);PCOS大鼠白色脂肪组织resistinmRNA表达显著高于对照组(P<0.05)。结论DHEA诱导的PCOS大鼠动物模型与PCOS患者相似,伴有IR现象;由白色脂肪组织分泌的resistin在PCOS发生机制中起部分调节的作用,并使PCOS的IR进一步加重。     

The Relationship of Visfatin Levels with Insulin Resistance and Left Ventricular Hypertrophy in Peritoneal Dialysis Patients

Background/objectives: Cardiovascular abnormalities are common in patients with chronic kidney disease. Visfatin influences lipid metabolism, insulin sensitivity, and cardiovascular health. The aim of this study was to explore the relation of serum visfatin to cardiovascular risk factors in nondiabetic peritoneal dialysis (PD) patients. Patients and methods: Eighty-seven nondiabetic patients (mean age 48 ± 15 years, 39 males) under PD were enrolled. Weight, anthropometric measurements, blood pressure, biochemical parameters, and insulin resistance (homeostatic model assessment-insulin resistance—HOMA-IR) were measured. Visfatin was measured and left ventricular mass index (LVMI) was calculated by echocardiography. Results: LVMI was correlated with body mass index (BMI; r = 0.47, p = 0.01), systolic blood pressure (SBP; r = 0.62, p = 0.04), and serum visfatin levels (r = 0.49, p = 0.03). According to HOMA-IR levels patients were grouped as insulin-resistant (IR) (HOMA-IR ≥2.0, n = 35) and noninsulin-resistant (non-IR) (HOMA-IR <2.0, n = 52) groups. The IR group had longer PD duration and higher BMI, total cholesterol, uric acid, and serum visfatin levels (p < 0.05). The study patients were divided into three groups according to their serum visfatin levels. Group 1 (≤34 ng/mL, n = 22) was considered as the lowest tertile of low visfatin and group 2 (35–42 ng/mL, n = 43) and group 3 (≥43 ng/mL, n = 22) in the upper tertile. Considering the visfatin groups, group 3 patients had significantly higher BMI (p = 0.00), total cholesterol (p = 0.03), C-reactive protein (CRP) (p = 0.03), HOMA-IR (p = 0.03), and LVMI (p = 0.02). In regression analysis, SBP (β = 0.19, p < 0.05) and serum visfatin levels (β = 0.74, p < 0.05) were independent variables affecting LVMI. Conclusion: Serum visfatin might be a sensitive marker than HOMA-IR evaluations for cardiac performance in nondiabetic PD patients.     

维持性血液透析患者血脂变化和胰岛素抵抗的相关分析

目的 通过对48例维持性血液透析患者空腹血糖、血清胰岛素和血脂各项指标的观察,计算胰岛素抵抗指数和胰岛素敏感指数,评价胰岛素抵抗情况.方法 选取我科维持性血液透析患者48例(观察组),同时选取30名健康体检者(对照组)作为正常对照,测定两组受试者的血糖、糖化血红蛋白、血清胰岛素、尿素氮、肌酐、尿酸、血脂指标,计算胰岛素抵抗指数和胰岛素敏感指数.结果 维持性血液透析患者的血糖、血清胰岛素、糖化血红蛋白、胰岛素抵抗指数水平升高,胆固醇、高密度脂蛋白、低密度脂蛋白与对照组比较差异有统计学意义(P＜0.05),其中胆固醇与血糖呈负相关(r=-0.3482,P＜0.05);高密度脂蛋白与血清胰岛素呈负相关(r=-0.2603,P＜0.05);低密度脂蛋白与血糖呈负相关(r=-0.3289,P＜0.05),而对照组仅甘油三酯与血糖、胰岛素抵抗指数呈正相关(r分别=0.371,0.368,P均＜0.05).结论 维持性血液透析患者中存在脂代谢紊乱,可能参与胰岛素抵抗.     

多囊卵巢综合征合并妊娠期糖尿病患者铁代谢与胰岛素抵抗的关系

目的分析多囊卵巢综合征(polycystic ovary syndrome,PCOS)合并妊娠期糖尿病(gestational diabetes mellitus,GDM)患者铁代谢改变及与胰岛素抵抗(insulin resistance,IR)的关系。方法选择2017年1月至2018年2月在烟台毓璜顶医院常规产检,妊娠24~28周的孕妇为筛查对象。确诊为GDM的孕妇60例为GDM组,既往诊断为PCOS且合并GDM的孕妇60例为多囊卵巢合并妊娠期糖尿病(polycystic ovary syndrome with gestational diabetes mellitus,PGDM)组,同时按年龄段进行1∶1∶1匹配,选择正常孕妇60例为正常对照(NC)组。检测3组患者血糖、胰岛素、血红蛋白(Hb)、铁代谢(血清铁、铁蛋白、转铁蛋白饱和度)水平,并评估患者氧化应激损伤及炎症水平的改变,利用多元线性回归法分析铁代谢指标与炎症指标及IR的关系。结果与NC组相比,PGDM组Hb水平降低,铁蛋白(SF)、转铁蛋白饱和度(TS)升高(F=3.55、8.24、5.10,均P<0.05);丙二醛(MDA)水平升高,超氧化物歧化酶(SOD)水平降低(F=11.11、7.24,均P<0.01);肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平升高(F=4.02、19.06,均P<0.05);与GDM组相比,PGDM组Hb水平降低,SF、TS升高,HOMA-IR、MDA、TNF-α、IL-6水平均升高(均P<0.05)。MDA、TNF-α、IL-6与SF呈正相关(r=0.42、0.43、0.56,均P<0.05),与TS呈正相关(r=0.61、0.42、0.52,均P<0.01);SF、TS与胰岛素抵抗指数呈正相关(r=0.39、0.41,均P<0.01)。结论PGDM患者铁沉积状况导致机体氧化应激损伤程度升高,炎症反应增加,从而加重了IR程度。铁代谢紊乱可能与PGDM患者血糖升高机制有关。     

Polymorphism of insulin gene variable number tandem repeats correlated with polycystic ovary syndrome

Objective: To investigate the correlation between the insulin gene variable number tandem repeats (INS-VN-TR) with polycystic ovary syndrome(PCOS) and metabolic features related to insulin resistance (IR).Methods: One hundred and thirty patients with PCOS (PCOS group) and 130 normal women (control group) were included. Genotyping of INS-VNTR was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).Results: The distribution of genotype of INS-VNTR was similar in PCOS group, but the Ⅲ allele frequency of INS-VNTR was higher in PCOS patients than that in controls, and Logistic regression analysis revealed that the Ⅲ allele was associated with increased risk of PCOS[adjusted odd ratio(OR) = 2.31;95% confidence interval(CD =1.07-4.98), compared with the Ⅰ allele. The distribution of genotype and the Ⅲ allele frequency of INS-VNTR in PCOS insulin resistance (PCOS-IR) group were significantly higher than that in PCOS non-insulin resistance group (PCOS-NIR). Moreover, PCOS women with Ⅲ allele had statistically significantly higher fasting insulin level and HOMA-IR than those of PCOS women with Ⅰ allele.Conclusion: INS-VNTR may not be a susceptibility gene, but INS-VNTR polymorphism may play an important role in the occurrence of insulin resistance in patients with PCOS.     

Effect of treatment of overt hypothyroidism on insulin resistance

AIM: To investigate the impact of hypothyroidism and thyroxine therapy on insulin sensitivity in patients with overt hypothyroidism.METHODS: The study included twenty seven overtly hypothyroid and fifteen healthy euthyroid South Western Asian females.Both groups had matching age and body mass index.Physiological and pathological conditions as well as medications that may alter thyroid function,glucose homeostasis or serum lipids were ruled out.Serum thyrotropin(TSH),free tetraiodothyronine(FT4),free triiodothyronine(FT3),fasting insulin(FI),fasting plasma glucose(FPG),total cholesterol and triglycerides were measured before and six months after initiating thyroxine therapy for hypothyroid patients and once for the control group.Insulin resistance(IR) was estimated using homeostasis model assessment(HOMA-IR) and Body mass index(BMI) was calculated.RESULTS: Both study groups,hypothyroid patients and euthyroid control subjects,had matching age and body mass index(P-value 0.444,0.607 respectively).No significant difference was found between the hypothyroid patients and the euthyroid control group regarding fasting plasma glucose,fasting insulin,insulin resistance,total cholesterol and triglycerides(P-values 0.432,0.621,0.883,0.586,0.05 respectively).In the hypothyroid patients,triglycerides showed direct correlation to TSH and inverse correlation to FT3.Similarly total cholesterol inversely correlated to FT3 but its direct correlation to TSH did not reach statistical significance.After thyroxine replacement and reaching an euthyroid state as confirmed by clinical and laboratory data,there was no significant change in fasting plasma glucose,insulin resistance or triglyceride level(P-value 0.216,0.204,0.175 respectively) while total cholesterol significantly decreased(P-value 0.043) and fasting insulin significantly increased(P-value 0.047).CONCLUSION: Hypothyroidism has no impact on insulin sensitivity.Correction of hypothyroidism is not associated with a significant change of insulin sensitivity or triglycerides,but with a significant reduction of total cholesterol.     

The efficiency of serum lncRNA GAS5/miR-21 as biomarkers in patients with diabetes and diabetic nephropathy

Objective To elucidate the efficiency lncRNA GAS5 and miR-21 as biomarkers in diabetes mellitus and diabetic nephropathy. Methods The patients were divided into three groups, diabetic nephropathy group (DN group proven by renal biopsy, n=25, 14 males and 11 females), diabetes group (DM group, with normal urine albumin creatinine ratio, n=10, 4 males and 6 females), and normal control group (NC group, n=9, 4 males and 5 females). The expressions of lncRNA GAS5 and miR-21 in serum samples were detected by real-time quantitative PCR. The correlation between serum lncRNA GAS5 and miR-21 expressions and the clinical parameters was analyzed by T-test, Pearson, Spearman test and multivariate linear regression analysis. Differences of lncRNA GAS5 and miR-21 in different groups were analyzed by one-way analysis of variance. The ROC curve was used to analyze the diagnostic efficacy of lncRNA GAS5 and miR-21 in diabetes and diabetic nephropathy. All data were analyzed by SPSS 20.0 and GraphPad software, with P＜0.05 as considered statistically significant. Results (1) The expression of serum lncRNA GAS5 was significantly down-regulated and serum miR-21 was significantly up-regulated in both diabetes mellitus and diabetic nephropathy patients compared to the NC group all (P＜0.05). (2) In DN patients, the expression of serum lncRNA GAS5 was gradually up-regulated along with the increment of 24 h urinary protein. The expression of serum miR-21 was gradually up-regulated along with renal biopsy stage IIb-Ⅲ of DN (P＜0.05). (3) FBG and HbA1c were all negatively correlated with serum lncRNA GAS5 (P＜0.05), and FBG was independently correlated with serum lncRNA GAS5 (P＜0.05). Urine microalbumin, Total cholesterol(TC), Scr, Urea and SBP were all positively correlated with serum miR-21(P＜0.05). Albumin (ALB) and estimated GFR (eGFR) were negatively correlated with serum miR-21(P＜0.05), and ALB was independently correlated with serum miR-21 (P＜0.05). (4) The diagnostic efficiency of serum lncRNA GAS5, miR-21 and lncRNA GAS5/miR-21 as "diagnostic signature" for DM were was good (P＜0.05). (5) The diagnostic efficiency of serum miR-21 and lncRNA GAS5/miR-21 as "diagnostic signature" for DN were was good (P＜0.05). Conclusions (1) Serum lncRNA GAS5 had good diagnostic efficiency in diabetes mellitus. The sensitivity of lncRNA GAS5/miR-21 for diagnosis of diabetes was 85.71%, and specificity was 88.89%. (2) The level of serum miR-21 can be used as a noninvasive diagnostic marker for diabetic nephropathy.