循环miR-141、Nrf2表达水平与尿毒症血液透析患者微炎症状态的相关性

Correlation analysis between the expression of circulating miR-141 and Nrf2 and the microinflammatory state of uremic hemodialysis patients

目的探讨微小RNA-141(miR-141)、核因子E2相关因子2(Nrf2)在尿毒症维持性血液透析(MHD)患者循环外周血中的表达情况及与尿毒症MHD患者微炎症状态的相关性。方法选择2018年1月-2020年12月在湘南学院附属医院血液净化中心治疗的尿毒症MHD患者108例,根据C反应蛋白(CRP)水平分为微炎症状态组(CRP>5 mg/L)53例、非微炎症状态组(CRP<5 mg/L)55例。实时荧光定量PCR(qRT-PCR)法检测循环外周血miR-141、Nrf2水平,Pearson法分析微炎症状态患者miR-141、Nrf2与炎症指标的相关性,ROC曲线分析miR-141、Nrf2对MHD患者微炎症状态的诊断价值。结果微炎症状态组患者总胆固醇(TC)、白细胞介素-6(IL-6)、CRP、肿瘤坏死因子-α(TNF-α)水平显著高于非微炎症状态组,差异有统计学意义(P<0.05);与非微炎症状态组比较,微炎症状态组患者循环外周血miR-141表达水平升高、Nrf2表达水平降低,差异有统计学意义(P<0.05)。相关性分析显示,miR-141与IL-6、CRP、TNF-α呈正相关(P<0.05),Nrf2与miR-141、IL-6、CRP、TNF-α呈负相关(P<0.05)。miR-141、Nrf2联合预测MHD患者微炎症状态的敏感度为90.57%,特异度为83.64%,曲线下面积为0.918。结论在尿毒症MHD微炎症状态患者循环外周血中miR-141高表达,Nrf2低表达,二者水平与微炎症状态有关,可能作为预测MHD患者微炎症状态潜在的标志物。

Objective To explore the expression of microRNA-141(miR-141)and nuclear factor-erythroid 2-related factor-2(Nrf2)in the circulating peripheral blood of patients with uremic maintenance hemodialysis(MHD)and their correlation with the microinflammatory state of MHD patients. Methods A total of 108 patients with uremic MHD who were treated in the blood purification center of our hospital from January 2018 to December 2020 were selected and divided into 53 in the microinflammatory state group(CRP>5 mg/L)and 55 cases in the non-microinflammatory state group(CRP<5 mg/L)according to the level of C-reactive protein(CRP). Real-time fluorescent quantitative PCR(qRT-PCR)method was used to detect the levels of miR-141 and Nrf2 in circulating peripheral blood,Pearson method was used to analyze the correlation between miR-141,Nrf2 and inflammation-related indicators in patients with microinflammatory state. ROC curve was used to analyze of the diagnostic value of miR-141 and Nrf2 on the microinflammatory state of MHD patients. Results The levels of total cholesterol(TC),interleukin-6(IL-6),CRP,and tumor necrosis factor-α(TNF-α)in the microinflammatory state group were significantly higher than those in the non-microinflammatory state group(P<0.05);compared with the nonmicroinflammatory state group,the expression level of miR-141 in the circulating peripheral blood of patients in the microinflammatory state group increased,and the expression level of Nrf2 decreased,and the differences were statistically significant(P<0.05). Correlation analysis showed that miR-141 was positively correlated with IL-6,CRP,TNF-α(P<0.05),and Nrf2 was negatively correlated with miR-141,IL-6,CRP,and TNF-α(P<0.05). The sensitivity of miR-141 combined with Nrf2 to predict the microinflammatory state of pre-MHD patients was 90.57%,the specificity was 83.64%,and the area under the curve was 0.918. Conclusions miR-141 was highly expressed in the circulating peripheral blood of patients with uremic MHD microinflammatory state,and Nrf2 was expressed in low level. Both levels of miR-141 and Nrf2 were related to the microinflammatory state,and might be used as potential markers for predicting the microinflammatory state of MHD patients.