微小RNA-126和微小RNA-155在冠心病合并糖耐量减低患者中的表达及阿卡波糖的干预作用

Expression of microRNA-126 and microRNA-155 in patients of coronary heart disease combined with impaired glucose tolerance and intervention of acarbose

目的探讨微小RNA(miR)-126和miR-155在冠心病(CHD)合并糖耐量减低(IGT)患者中的表达及阿卡波糖的干预作用.方法纳入CHD患者179例(单纯CHD组115例、CHD合并IGT组64例)和健康志愿者43例(对照组).比较3组受试者的生化指标和血糖相关指标,采用qRT-PCR检测血浆miR-126、miR-155的表达水平.单纯CHD组患者给予CHD常规治疗3个月;CHD合并IGT组患者给予CHD常规治疗和阿卡波糖片口服3个月,比较治疗前后其miR-126和miR-155表达水平等.结果 3组受试者miR-126、miR-155、2hPG、空腹胰岛素浓度(FIns)及胰岛素抵抗指数(HOMA-IR)比较,差异均有统计学意义(P<0.05).单纯CHD组miR-126和miR-155水平均低于对照组(P<0.05).CHD合并IGT组2h PG、FIns、HOMA-IR均高于对照组和单纯CHD组,miR-126和miR-155水平均低于对照组和单纯CHD组(P<0.05).Pearson相关分析结果显示,miR-126和miR-155水平与HOMA-IR及2h PG均呈负相关(P<0.05).二分类logistic逐步回归分析结果显示,HOMA-IR、2h PG、miR-126及miR-155均与CHD合并IGT相关(P<0.05).治疗后CHD合并IGT组患者miR-126和miR-155水平均高于治疗前,2h PG、FIns及HOMA-IR均低于治疗前(P<0.05).结论 CHD合并IGT患者血浆miR-126和miR-155水平下调,可能与胰岛素抵抗相关,而阿卡波糖可增加其水平.

Objective To explore expression of microRNA (miR)-126 and miR -155 in patients of coronaiy heart disease (CHD) combined with impaired glucose tolerance (IGT) and intei*vention of acarbose. Methods A total of 179 patients with CHD(115 patients in simple CHD group,64 patients in CHD combined with IGT group) and 43 healthy volunteers(control group) were concluded. Biochemical indicators and blood glucose related indicators among three groups were compared. qRT-PCR was used to detect the expression levels of plasma miR-126 and miR-155. Patients in simple CHD group were treated with conventional CHI) therapy for 3 months. Patients in CHD combined with IGT group were treated with conventional CHD therapy and acarbose tablets for 3 months,and xpression levels of miR-126 and miR-155 in patients of them before and after treatment were detected. Results MiR-126,miR-155,2h PG, Fins and HOMA-IR among three groups were significantly different (P<0. 05). MiR-126 and miR-155 levels in simple CHI) group were lower than those in control group(P <0. 05). 2h PG, Fins and HOMA-IR levels in CHD combined with IGT group were higher than those in control group and simple CHD group, miR-126 and miR-155 levels were lower than those in control group and simple CHD group (P<0. 05). Pearson correlation analysis showed that miR-126 and miR-155 levels were negatively conelated with HOMA-IR and 2h PG(P <0. 05). Binary logistic regression analysis showed that HOMA-IR,2h PG,miR-126 and miR-155 were all associated with CHD combined with IGT (P<0. 05). MiR-126 and miR-155 levels in patients with CHD combined with IGT group were higher,2h PG,Fins and HOMA-IR were lower than those before treatment(P <0. 05). Conclusion Levels of plasma miR-126 and miR-155 in patients of CHD combined with IGT decreased, which may be related with insulin resistance, and acarbose can increase their levels.