老年2型糖尿病合并脑梗死患者血清miR-126、GF-1表达水平与颈动脉内膜中层厚度的相关性

The correlations between the expression levels of serum miR-126, IGF-1 and carotid intima-media thickness in elderly patients with type 2 diabetes mellitus complicated with cerebral infarction

目的探究血清miR-126、胰岛素样生长因子-1(IGF-1)在老年2型糖尿病(T2DM)合并脑梗死患者血清中的表达情况,分析其与颈动脉内膜中层厚度(IMT)的相关性。方法将2018年2月-2019年4月在广元市中医医院住院收治的老年T2DM患者根据是否发生脑梗死分为单纯T2DM组(74例)与T2DM合并脑梗死组(132例),另选取同期在本院体检的80名健康者作为对照组,采用荧光定量PCR法(qRT-PCR)检测受试者血清miR-126表达,酶联免疫法检测血清IGF-1表达,Pearson相关性、Logistic回归分析miR-126、IGF-1与IMT的关系,受试者工作特征曲线(ROC)分析miR-126、IGF-1在T2DM合并脑梗死IMT异常中的诊断价值。结果 T2DM合并脑梗死组血清miR-126、IGF-1表达水平低于T2DM组、对照组,IMT高于T2DM组,差异有统计学意义(F/t=452.936、546.775、7.051,P<0.05)。IMT增厚组糖化血红蛋白(GHbA1c)、病程、低密度脂蛋白(LDL-C)高于IMT正常组,高密度脂蛋白(HDLC)、miR-126、IGF-1表达低于IMT正常组,差异有统计学意义(P<0.05)。T2DM合并脑梗死患者血清miR-126、IGF-1与IMT呈显著性负相关(r=-0.548、-0.647,P均<0.05)。GHbAlc、病程、LDL-C、miR-126、IGF-1是影响T2DM合并脑梗死者IMT异常的危险因素。miR-126、IGF-1对T2DM合并脑梗死者IMT异常诊断的AUC值为0.836(95%CI:0.761~0.894)、0.824 (95%CI:0.761~0.892)。结论老年T2DM脑梗死患者血清中miR-126、IGF-1表达降低,与IMT异常有关,是影响IMT异常的危险因素。

Objective To investigate the expression levels of serum miR-126 and insulin-like growth factor-1(IGF-1) in elderly patients with type 2 diabetes mellitus(T2 DM) and cerebral infarction,and analyze their correlations with carotid intima-media thickness(IMT).Methods The elderly patients with T2 DM in our hospital from February 2018 to April2019 were divided into simple T2 DM group(74 cases) and T2 DM combined with cerebral infarction group(132 cases)according to whether cerebral infarction occurred or not.Another 80 healthy persons who underwent physical examination in our hospital at the same time were selected as the control group.Quantitative fluorescence PCR(qRT-PCR) was used to detect the expression of serum miR-126;enzyme-linked immunosorbent assay(ELISA) was used to detect the expression of serum IGF-1;Pearson correlation and Logistic regression analysis were used to analyze the relationships between miR-126,IGF-1 and IMT,and receiver operating characteristic curve(ROC) was used to analyze the diagnostic values of miR-126 and IGF-1 in patients with T2 DM complicated with cerebral infarction.Results The levels of miR-126 and IGF-1 in T2 DM group with cerebral infarction were lower than those in T2 DM group and control group,and IMT was higher than those in T2 DM group(F/t=452.936,546.775,7.051,P<0.05).The expression levels of glycosylated hemoglobin(GHbA1 c),course of disease,low density lipoprotein-C(LDL-C) in IMT thickening group was higher than those in IMT normal group,and high density lipoprotein-C(HDL-C),miR-126 and IGF-1 level was lower than that in IMT normal group(P<0.05).Serum miR-126 and IGF-1 levels were negatively correlated with IMT(r=-0.548,-0.647,P<0.05).GHbA1 c,course of disease,LDL-C,miR-126 and IGF-1 were the risk factors of IMT abnormality in T2 DM patients with cerebral infarction.The AUC values of miR-126 and IGF-1 in diagnosing IMT abnormality of T2 DM patients with cerebral infarction was 0.836(95%CI:0.761-0.894) and 0.824(95%CI:0.761-0.892),respectively.Conclusion The expression levels of serum miR-126 and IGF-1 in elderly patients with T2 DM cerebral infarction were decreased;they were related to IMT abnormality and were risk factors for IMT abnormality.