miRNA-133与高血压左心室肥厚的相关性及预测价值

Relation and diagnosis of mi RNA-133 for being used as a prediction target molecular marker of left ventricular hypertrophy with hypertension

目的 先前国内外实验研究均表明miRNA-133 可通过调控RhoA 蛋白、细胞分化周期蛋白-42、参与心脏发生的核因子基因和结缔组织生长因子的表达而影响高血压左心室肥厚,但是上述实验并没有在临床上验证miRNA-133 对高血压左心室肥厚的预测价值,因此本研究旨在验证miRNA-133 对高血压左心室肥厚的预测价值.方法 收集未服用降压药物且发生左心室肥厚的单纯高血压患者和年龄性别相匹配的正常人外周血浆-80 ℃保存,采用RT-PCR 技术验证差异表达miRNA 的稳定性;组间比较用t 检验,采用受试者工作特征（ROC）曲线验证miRNA-133 对高血压左心室肥厚的预测价值.结果 66 例高血压左心室肥厚和33 例正常人入选,血压和左心室质量指数有统计学差异（P〈0.05）,而年龄、血脂等基线资料无统计学差异（P〉0.05）;RT-PCR 结果显示miRNA-133 在正常人和高血压左心室肥厚组相对表达量分别为0.04±0.005、0.30±0.44,差异有统计学意义（P〈0.05）;调整年龄、性别和体质量指数后,miRNA-133 表达水平与左心室肥厚具有相关性（ORs=1.654,95% CI 1.273～2.146,P〈0.05）;miRNA-133 对高血压心肌肥厚预测的ROC曲线下面积（AUC）为0.860（P=0.000）,95% CI 0.786～0.934（P〈0.05）.结论 miRNA-133 对高血压左心室肥厚有较好的预测价值.

Objective Previous experimental studies at home and abroad indicated thatmiRNA-133 had effect on left ventricular hypertrophy in hypertension by regulating and controlling RhoAprotein, cell division cycle protein-42, participating in the heart of nuclear factor gene and the expression ofconnective tissue growth factor, but those experiments were not clinically validated in the miRNA-133 forthe value of hypertensive left ventricular hypertrophy, so this study is to verify the predictive value ofmiRNA-133 to left ventricular hypertrophy in hypertension. Methods Peripheral blood plasma werepreserved at -80 ℃ that collected from hypertension patients with left ventricular hypertrophy and did nottake antihypertensive medications. Gene chip method was used to identify significant differences miRNAsbetween two groups and reverse transcription-polymerase chain reaction （RT-PCR） technique was used toverify the stability of miRNAs. The differences between groups were compared with t test, the receiveroperator characteristic （ROC） curve was used to verify the predictive value of miRNA-133 to leftventricular hypertrophy in hypertension. P value less than 0.05 was considered statistically significant.Results Sixty-six cases with hypertensive left ventricular hypertrophy and 33 cases of normal wereselected, blood pressure and left ventricular mass index between groups were statistical difference （P〈0.05）, and others baseline such as age, blood lipid had no statistical differences between groups（P〉0.05）; RT-PCR results showed the relative expression of miRNA-133 were 0.04±0.005 and 0.30±0.44,respectively, there was statistical difference （P〈0.05）; After age, sex, and body mass index were adjusted inthis model, the ORs for LVH was 1.654 （95% CI 1.273-2.146, P〈0.05）. The ROC curve of the relationshipbetween miRNA-133 and LVH demonstrated that the largest area under the curve （AUC） was 0.860（P〈0.05）, 95% CI was 0.786-0.934. Conclusion The miRNA-133 has certain predictive value of leftventricular hypertrophy in hypertension.