2型糖尿病患者血清miR-26a与IMT和颈动脉粥样硬化斑块之间的关系

Relationships of serum miR-26a with carotid intima-media thickness and carotid atherosclerotic plaques in patients with type 2 diabetes

目的研究2型糖尿病患者血清miR-26a与IMT(颈动脉内膜中层厚度)和颈动脉粥样硬化斑块之间的关系。方法选取2018年2月至2019年12月在本院门诊部及体检中心诊治的152例2型糖尿病患者,按IMT(颈动脉内膜中层厚度)分为颈动脉正常组50例,增厚组59例,斑块组43例。检测患者血清miR-26a相对表达量,分析颈动脉IMT与血清miR-26a及其他临床指标的关系,分析颈动脉粥样硬化斑块形成的危险因素。结果三组患者性别、年龄、体质量、病程、糖尿病史、血清TG、UA、HDL-C指标比较,差异均无统计学意义(均P>0.05);斑块组血清FBG、GHb、TC、LDL-C指标与增厚组、正常组比较,差异均有统计学意义(均P<0.05);斑块组颈动脉IMT指标高于增厚组、正常组,差异有统计学意义(P<0.05);斑块组miR-26a相对表达量指标低于增厚组、正常组,差异有统计学意义(P<0.05);颈动脉IMT与年龄、病程、GHb、LDL-C呈显著正相关关系(r=0.368、0.389、0.512、0.614,P=0.047、0.034、<0.001、<0.001),与血清miR-26a呈显著负相关(r=-0.598,P<0.001);颈动脉IMT与性别、体质量、糖尿病病史、FBG、TG、TC、UA、HDL-C无相关关系;影响颈动脉粥样硬化斑块形成的独立危险因素可归纳为GHb、LDL-C、FBG、TC,保护因素为miR-26a。结论2型糖尿病患者血清miR-26a表达水平随颈动脉IMT增厚而降低,降低miR-26a表达可降低颈动脉粥样硬化斑块发生风险。

Objective To study the relationships of serum miR-26a with carotid intima-media thickness and carotid atherosclerotic plaques in patients with type 2 diabetes.Methods A total of 152 patients with type 2 diabetes in the Department of Endocrinology of our hospital from February,2018 to December,2019 were divided into a normal carotid artery group(n=50),a thickening group(n=59),and a plaque group(n=43)according to the carotid intima-media thickness(IMT).The relative expression of miR-26a in the serum of the patients was detected.The relationships of carotid IMT with serum miR-26a and other clinical indicators were analyzed.The risk factors for the formation of carotid atherosclerotic plaques were analyzed.Results There were no statistical differences in gender,age,BMI,disease course,diabetic history,and serum levels of TG,UA,and HDL-C between the 3 groups(all P>0.05).The serum levels of FBG,GHb,TC,and LDL-C in the plaque group were statistically different from those in the thickening group and from those in the normal carotid artery group(all P<0.05).The IMT was higher in the plaque group than in the thickening group and the normal carotid artery group(both P<0.05).The relative expression of serum miR-26a was significantly lower in the plaque group than in the thickening group and the normal carotid artery group(both P<0.05).The carotid artery IMT was positively correlated with age,disease course,GHb,and HDL-C(r=0.368,0.389,0.512,0.614,P=0.047,0.034,<0.001,and<0.001),and negatively with serum miR-26a(r=-0.598,P<0.001).The independent risk factors affecting the formation of carotid atherosclerotic plaques could be summarized as GHb,LDL-C,FBG,and TC,and the protective factor is mir-26a.Conclusion The level of serum miR-26a in type 2 diabetic patients decreases with the increase of carotid IMT;reducing expression of miR-26a may reduce the risk of carotid atherosclerotic plaque.