2型糖尿病大血管病变患者miR-126、出芽相关蛋白1及血管内皮生长因子的变化及意义

Changes and significance of mi R-126,spred-1 and VEGF in patients with type 2 diabetes mellitus complicated with macroangiopathy

目的观察T2DM大血管病变患者微小核糖核酸126(miR-126)、出芽相关蛋白1(spred-1)、VEGF表达水平及变化规律。方法选取2019年6~12月于江苏大学附属武进医院内分泌科住院的T2DM患者110例,按照有无大血管病变分为单纯T2DM组(T2DM,n=54)和合并大血管病变组(MA,n=56)。检测两组FPG、2 hPG、TC、TG、HDL-C、LDL-C、BUN、血肌酐(Scr)、血尿酸(SUA)、HbA1c、FC-P、谷丙转氨酶(ALT)、谷草转氨酶(AST)。留晨尿检测UAlb、尿肌酐,计算UACR及eGFR。荧光定量PCR法测定miR-126及spred-1表达。ELISA法测定血VEGF含量。结果与T2DM组比较,MA组年龄、DM病程、spred-1升高(P<0.05),DBP、eGFR、miR-126、VEGF降低(P<0.05)。Pearson相关分析显示,miR-126与VEGF呈正相关(r=0.47,P<0.05),与年龄、DM病程呈负相关(r=-0.35、-0.20,P<0.05)。Logistic回归分析,结果显示,年龄、DM病程、FPG、spred-1、miR-126是T2DM大血管病变的影响因素。结论 T2DM大血管病变可能与miR-126、spred-1和VEGF变化相关,其机制可能是miR-126表达降低,对spred-1的抑制作用减弱,下调VEGF水平,导致T2DM大血管并发症。

Objective To observe the expression levels and changes of plasma micribonucleic-126(mi R-126),Sprouty-related proteins with an EVH1 domain(spred-1)and vascular endothelium growth factor(VEGF)in type 2 diabetes mellitus(T2 DM)complicated with macroangiopathy.Methods A total of110 T2 DM patients hospitalized in the Department of Endocrinology were divided into two groups:T2 DM group(n=54),MA group(n=56). The levels of FPG,2 h PG,TC,TG,HDL-C,LDL-C,BUN,SCR,SUA,Hb A1 c,fasting C-peptide(FC-P),ALT and AST,urine microalbumin and creatinine were detected and UACR was calculated. The expressions of mi R-126 and spred-1 were determined by fluorescence quantitative PCR. The content of VEGF in plasma was determined by ELISA.Results Compared with T2 DM group,the age,DM duration and spred-1 in MA group were increased(P<0. 05),while DBP,e GFR,mi R-126 and VEGF were decreased(P<0. 05). Pearson correlation analysis showed that the expressions of mi R-126 was positively correlated with plasma VEGF(r=0. 47,P<0. 05),and negatively correlated with age and DM course(r=-0. 35,-0. 20,P<0. 05). Logistic regression analysis showed that age,DM course,FPG,spred-1 and mi R-126 were the influencing factors for T2 DM macrovascular disease.Conclusion DM macrovascular disease may be related to the changes of mi R-126,spred-1 and VEGF,with the possible mechanism of decreased expression of mi R-126,weakened inhibition of spred-1 and down-regulated of VEGF level.