糖尿病患者血清microRNA-152表达水平与血脂代谢、胰岛素抵抗的相关性

The correlation of serum microRNA-152 expression with lipid metabolism and insulin resistance in patients with diabetes mellitus

目的探讨糖尿病患者血清microRNA-152(miR-152)表达水平与血脂代谢、胰岛素抵抗的相关性。方法选取2018年1月—2018年11月在攀枝花市中西医结合医院就诊的血糖异常患者109例,分为2型糖尿病(T2DM)前期组(Pre-T2DM组)45例和T2DM组64例;另取同期该院门诊部健康体检者70例为对照组。检测血清空腹胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)水平,评估稳态胰岛素评价指数(HOMA-IR)与胰岛β细胞功能指数(HOMA-β);并分析miR-152与血脂水平及FBG、FINS、HOMA-IR、HOMA-β的相关性。结果与对照组相比,Pre-T2DM组、T2DM组患者血清miR-152、FBG、FINS、TG、TC、LDL-C、HOMA-IR较高(P <0.05),HDL-C、HOMA-β较低(P <0.05);与Pre-T2DM组相比,T2DM组患者血清miR-152、FBG、FINS、TG、TC、LDL-C、HOMA-IR较高(P <0.05),HDL-C、HOMA-β较低(P <0.05)。T2DM患者miR-152与TG、TC、LDL-C、FBG、FINS、HOMA-IR呈正相关(r=0.844、0.755、0.833、0.528、0.576和0.635,均P <0.05),与HDL-C、HOMA-β呈负相关(r=-0.655和-0.603,均P <0.05)。多因素一般Logistic回归分析结果显示,血清FBG[O^R=2.305(95%CI:1.369,3.882)]和miR-152[O^R=2.831(95%CI:1.736,4.618)]升高是影响胰岛素抵抗的危险因素。结论 T2DM患者血清miR-152上调,其可能通过调节血脂代谢影响T2DM病情发展。

Objective To investigate the correlation of serum miR-152 expression with glycolipid metabolism and insulin resistance in diabetic patients. Methods A total of 109 patients with abnormal blood sugar in our hospital from January to November 2018 were selected and divided into pre-T2 DM(type 2 diabetes mellitus)group(n = 45) and T2 DM group(n = 64). At the same time, 70 healthy people in outpatient department of our hospital were selected as control group. The serum levels of fasting insulin(FINS), total cholesterol(TC),triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG), and miR-152 were measured. The homeostasis model assessment of insulin resistance(HOMA-IR) and β-cell function(HOMA-β) were evaluated. Besides, the correlations of miR-152 with blood lipid,FBG, FINS, HOMA-IR and HOMA-β were analyzed. Results Compared with the control group, the levels of serum miR-152, FBG, FINS, TG, TC and LDL-C as well as HOMA-IR value were higher in pre-T2 DM group and T2 DM group(P < 0.05), while the serum levels of HDL-C and HOMA-β value were lower(P < 0.05). Compared with the pre-T2 DM group, the levels of serum miR-152, FBG, FINS, TG, TC and LDL-C as well as HOMA-IR value were higher in the T2 DM group(P < 0.05), while the serum levels of HDL-C and HOMA-β value were lower(P < 0.05).Further analysis showed that miR-152 positively correlated with TG(r = 0.844), TC(r = 0.755), LDL-C(r = 0.833),FBG(r = 0.528), FINS(r = 0.576) and HOMA-IR(r = 0.635)(P < 0.05), but negatively correlated with HDL-C(r =-0.655) and HOMA-β(r =-0.603) in patients with T2 DM(P < 0.05). Multivariate Logistic regression analysis indicated that the high level of serum miR-152 [O^R = 2.831(95% CI: 1.736, 4.618)] was a risk factor for insulin resistance. Conclusions The level of serum miR-152 is up-regulated in patients with T2 DM, which may affect the development of T2 DM by regulating lipid metabolism.