2型糖尿病微血管并发症患者血清miR-16,miR-126和miR-221水平检测及临床意义

Study on Serum Levels of miR-16,miR-126 and miR-221 and Their Clinical Significance in Type 2 Diabetes Patients with or Without Microvascular Complications

目的：检测2型糖尿病（T2DM）及其微血管并发症患者（T2DMC）血清中 miR-16，miR-126和 miR-221水平，分析其作为T2DMC潜在辅助诊断指标的潜能。方法运用实时荧光定量PCR技术（qRT-PCR）检测55例T2DM患者，55例T2DMC患者及55例健康对照血清中miR-16，miR-126和miR-221水平，生化分析仪测定相关生化指标，ROC曲线及逻辑回归分析三种血清 miRNAs对 T2DM及 T2DMC的辅助诊断价值。结果 qRT-PCR 结果显示，与健康对照组[miR-16（14.35±1.00）×10^－5，miR-126（11.75±1.47）×10^－5和 miR-221（32.26±3.98）×10^－5]相比，三种 miRNAs在 T2DM患者[miR-16（23.74±2.70）×10^－5，miR-126（25.01±4.13）×10^－5和miR-221（84.76±11.79）×10^－5]及T2DMC患者[miR-16（43.74±9.61）×10^－5，miR-126（17.66±2.20）×10^－5和 miR-221（82.52±12.48）×10^－5]血清中表达水平显著升高（P均＜0.05），其中miR-16变化最为显著；三种miRNAs用于T2DM诊断的ROC曲线下面积（AUCROC）分别为0.63（95％CI 0.53～0.74），0.64（95％CI 0.54～0.74）和0.74（95％CI 0.65～0.83）；用于T2DMC诊断的 ROC曲线下面积（AUCROC）分别为0.75（95％CI 0.66～0.84），0.62（95％CI 0.52～0.73）和0.73（95％CI 0.64～0.83）；进一步逻辑回归分析结果显示，这三种血清miRNAs是T2DM和T2DMC独立危险因素。结论血清中高表达的miR-16，miR-126和 miR-221是 T2DM及T2DMC患者潜在的非侵入性辅助诊断标志物及独立危险因素。

Objective To determine the serum levels of miR-16,miR-126 and miR-221 in type 2 diabetes （T2DM）patients with or without microvascular complications,and further evaluate their clinical significance.Methods The serum levels of miR-16,miR-126 and miR-221were examined in 55 T2DM patients,55 T2DM patients with microvascular complications and 5 5 healthy controls using quantitative real-time PCR （qRT-PCR）.The levels of fasting blood glucose,triglycerides,choles-terol,high density lipoprotein,low density lipoprotein and others biochemical parameters were determined by biochemical an-alyzer,and the diagnostic usefulness of the three miRNAs for T2DM patients and patients with microvascular complications were assessed by ROC curve analysis and logistic regression analysis.Results Compared with healthy controls [miR-1 6 （14.35±1.00）×10^-5 ,miR-126（11.75±1.47）×10^-5 and miR-221（32.26±3.98）×10-5 ],the miR-16,miR-126 and miR-221 expression were significantly increased in T2DM patients [miR-16（23.74±2.70）×10^-5,miR-126（25.01±4.13）× 10^-5 and miR-221（84.76±11.79）×10^-5 ]and T2DM patients with microvascular complications [miR-16（43.74±9.61）× 10^-5 ,miR-126（17.66±2.20）×10^-5 and miR-221（82.52±12.48）×10^-5 ].The area under ROC curve （AUCROC）of miR-16,miR-126 and miR-221 for T2DM patients were 0.63 （95%CI 0.53~0.74）,0.64 （95%CI 0.54~0.74）and 0.74 （95%CI 0.65~0.83）,respectively.For T2DM patients with microvascular complications,the area under ROC curve were 0.75 （95%CI 0.66~0.84）,0.62 （95%CI 0.52~0.73）and 0.73 （95%CI 0.64~0.83）,respectively.Furthermore,logistic re-gression revealed that the three miRNAs were novel independent risk factors for T2DM and T2DMC.Conclusion The levels of miR-16,miR-126 and miR-221 were significantly increased in the serum of T2DM patients with or without microvascular complications,and can be used as potential non-invasive biomarkers and risk factors for T2DM patients and T2DM patients with microvascular complications.