MiRNA-375在腹腔镜胃旁路术治疗2型糖尿病疗效评估与预测中的作用

目的探讨微小RNA-375（miR-375）在腹腔镜Roux-en-Y胃旁路术（LRYGB）治疗2型糖尿病疗效评估与预测中的作用。 方法回顾性分析2010年5月至2013年3月在苏州大学附属第一医院接受LRYGB治疗的17例2型糖尿病患者的临床资料和实验室数据。其中男7例,女10例;年龄（46±13）岁。所有患者均签署知情同意书,符合医学伦理学规定。比较患者术前和术后1、3、6个月的体质指数（BMI）、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（HOMA-IR）、空腹胰岛素（FIns）、空腹C肽（FCP)、总胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和miR-375水平。手术前后临床和实验室数据的比较采用t检验和Mann-Whitney U检验,miR-375与各因素间的相关性分析采用Spearman秩相关分析。 结果17例患者均成功完成LRYGB治疗。术后6个月,患者的BMI（26±5）kg/m²、FPG（6.3±1.7）mmol/L、HbA1c（6.5±0.8）%、FIns 6.1[3.5,8.6] mU/L、HOMA-IR 1.9[1.0,2.6]、TC（4.1±1.1）mmol/L、TG（0.9±0.4）mmol/L、LDL-C（2.3±0.7）mmol/L、miR-375 0.06[0.00,0.12],明显低于术前的（33±7）kg/m²、（11.1±3.6）mmol/L、（9.3±1.6）%、12.7[3.6,19.3] mU/L、5.4[1.9,13.7]、（5.0±1.0）mmol/L、（3.6±4.0）mmol/L、（3.1±0.7）mmol/L、1.20[0.60,1.85]（P值均<0.05）;患者的HDL-C为（1.23±0.19）mmol/L,明显高于术前的（1.05±0.14）mmol/L。miR-375与BMI、TC、TG、LDL-C、HbA1c、FPG、FIns、FCP、HOMA-IR均呈正相关关系（P<0.05）。 结论血清miR-375与血糖的控制、血脂的改善、胰岛素抵抗的好转密切相关,且在血清中检测切实可行,故可能成为一种新型的生物标志物,作为手术治疗T2DM后评估、预测疗效的指标。

Role of microRNA-375 in efficacy evaluation and prediction of laparoscopic gastric bypass in treating type 2 diabetes mellitus

ObjectiveTo investigate the role of microRNA-375 (miR-375) in efficacy evaluation and prediction of laparoscopic Roux-en-Y gastric bypass (LRYGB) in treating type 2 diabetes mellitus (T2DM). MethodsClinical and laboratory data of 17 patients with T2DM undergoing LRYGB in the First Affiliated Hospital of Soochow University from May 2010 to March 2013 were retrospectively studied. Among the 17 patients, 7 were males and 10 were females with an average age of (46±13) years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. Body mass index (BMI), fasting plasma glucose (FPG), glycosylated hemoglobin A1c (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), fasting insulin (FIns), fasting C peptide (FCP), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and miR-375 of all the patients were collected and compared before and 1, 3, 6 months after surgery. The comparisons of clinical and laboratory data before and after surgery were conducted using t test and Mann-Whitney U test, and the correlation analysis between miR-375 and each factor was conducted using Spearman rank correlation analysis. ResultsAll patients received LRYGB successfully. At 6 months after LRYGB, BMI was (26±5) kg/m², FPG was (6.3±1.7) mmol/L, HbA1c was (6.5±0.8)%, FIns was 6.1[3.5, 8.6] mU/L, HOMA-IR was 1.9[1.0, 2.6], TC was (4.1±1.1) mmol/L, TG was (0.9±0.4) mmol/L, LDL-C was (2.3±0.7) mmol/L and miR-375 was 0.06[0.00, 0.12], which were significantly lower than (33±7) kg/m², (11.1±3.6) mmol/L, (9.3±1.6)%, 12.7[3.6, 19.3] mU/L, 5.4[1.9, 13.7], (5.0±1.0) mmol/L, (3.6±4.0) mmol/L, (3.1±0.7) mmol/L and 1.20[0.60, 1.85] before operation respectively (P<0.05); and HDL-C of these patients was (1.23±0.19) mmol/L, which was significantly higher than (1.05±0.14) mmol/L before operation. The correlation analysis showed that miR-375 was positively correlated with BMI, TC, TG, LDL-C, HbA1c, FPG, FIns, FCP and HOMA-IR respectively (P<0.05). ConclusionsMiR-375 is closely related to blood glucose control and improvement of lipid and insulin resistance. Owing to the convenience and feasibility of being tested in serum, miR-375 may become a new biomarker, which can be used to evaluate and predict the curative effect of LRYGB on T2DM.