血清外泌体miR-96表达与老年糖尿病患者骨质疏松的相关性

Correlation between serum exosomal miR-96 expression and osteoporosis in elderly patients with diabetes

目的检测血清外泌体miR-96在老年糖尿病患者中的表达水平,并分析其与骨质疏松(OP)的相关性。方法回顾性分析2019年1月至2021年5月杨浦区中心医院老年科收治的171例年龄≥60岁的2型糖尿病患者,根据骨质疏松诊断标准分为OP组(82例)和非OP组(89例);检测并比较两组患者血清外泌体miR-96表达水平、血清25-羟维生素D_(3)[25(OH)D_(3)]、I型胶原羧基端肽交联(β-CTX)、甲状旁腺激素(PTH)、骨钙素(BGP)和I型前胶原氨基末端前肽(PINP)水平;多因素Logistic回归分析老年糖尿病患者发生骨质疏松的相关因素;采用Pearson系数分析miR-96表达水平与各指标的相关性;采用受试者工作特征曲线(ROC)分析miR-96对老年糖尿病合并骨质疏松的诊断效能。结果OP组患者的β-CTX、HbA1c、PINP、PTH水平明显高于非OP组,而BMI、25(OH)D3、BGP明显低于非OP组,差异均有统计学意义(P<0.05);OP组患者的血清外泌体miR-96表达水平为1.42±0.31,高于非OP组的1.01±0.25,差异有统计学意义(P<0.05);经Pearson相关分析结果显示,miR-96与BMI、BGP、25(OH)D3呈负相关(r=-0.504、-0.425、-0.541,P<0.05),miR-96与β-CTX、PTH、Hb A1c、PINP呈正相关性(r=0.463、0.479、0.447、0.392,P<0.05);多因素Logistic回归分析结果显示,miR-96、BMI、HbA1c、BGP、25(OH)D_(3)、β-CTX、PTH、PINP是老年糖尿病患者发生骨质疏松的影响因素(P<0.05);ROC结果显示,miR-96诊断老年糖尿病患者合并骨质疏松的曲线下面积为0.878(95%CI:0.828~0.927)。结论老年糖尿病合并骨质疏松患者血清外泌体中miR-96表达水平升高,miR-96表达水平与骨质疏松密切相关,并对骨质疏松有较高的诊断效能。

Objective To detect the expression level of serum exosomal miR-96 in elderly diabetic patients and analyze its correlation with osteoporosis(OP).Methods A total of 171 patients with type 2 diabetes aged≥60 years who were admitted to the Department of Geriatrics,Yangpu District Central Hospital from January 2019 to May 2021 were retrospectively analyzed.They were divided into OP group(n=82)and non-OP group(n=89)according to the diagnostic criteria of osteoporosis.The serum exosomal miR-96 expression level and serum 25-hydroxyvitamin D_(3)[25(OH)D_(3)],type I collagen carboxy-terminal peptide cross-linking(β-CTX),parathyroid hormone(PTH),osteocalcin(BGP),type I Procollagen amino terminal propeptide(PINP)levels were detected and compared between the two groups.Multivariate Logistic regression analysis was used to analyze the related factors of osteoporosis in elderly diabetic patients.Pearson coefficient was used to analyze the correlation between the expression level of miR-96 and each index.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic performance of miR-96 in elderly diabetic patients with osteoporosis.Results The levels ofβ-CTX,HbA1c,PINP,and PTH in the OP group were significantly higher than those in the non-OP group,while BMI,25(OH)D3,and BGP were significantly lower than those in the non-OP group,with statistically significant differences(P<0.05).The expression level of miR-96 in the OP group was 1.42±0.31,which was significnatly higher than 1.01±0.25 in the non-OP group(P<0.05).The results of pearson correlation analysis showed that miR-96 was negatively correlated with BMI,25(OH)D_(3),and BGP(r=-0.504,-0.425,-0.541,P<0.05),and positively correlated withβ-CTX,PTH,HbA1c,and PINP(r=0.463,0.479,0.447,0.392,P<0.05).The results of multivariate Logistic analysis showed that miR-96,BMI,HbA1c,BGP,25(OH)D_(3),β-CTX,PTH and PINP were related factors affecting the occurrence of osteoporosis in elderly diabetic patients(P<0.05).ROC results showed that the area under the curve of miR-96 for diagnosing osteoporosis in elderly diabetic patients was 0.878(95%CI:0.828 to 0.927).Conclusion The miR-96 expression level is increased in the serum exosomes of elderly diabetic patients with osteoporosis.The miR-96 expression level is closely related to osteoporosis,which has a high diagnostic performance for osteoporosis.