2型糖尿病足溃疡患者外周血miR-155表达水平的改变及其临床意义

Expression of miR-155 in peripheral blood of type 2 diabetes patients associated with diabetic foot ulcer and its clinical significance

目的探讨2型糖尿病足溃疡患者外周血miR-155表达变化及其与糖尿病足溃疡(DFU)发病的相关关系。方法共入选60例新诊断2型糖尿病无足溃疡患者(T2DM组)、112例2型糖尿病合并足溃疡患者(DFU组)和60名糖耐量正常的对照人群(NC组)。应用实时定量PCR(qRT-PCR)方法测定受试者外周血miR-155表达水平,并对DFU的临床特点以及危险因素进行分析。结果T2DM组外周血miR-155表达水平较NC组降低(P<0.05),DFU组外周血miR-155表达水平较T2DM组增高(P<0.01)。DFU患者外周血miR-155表达水平与足溃疡病程以及足溃疡Wagner分级呈正相关(P=0.02,P=0.01),与8周后足溃疡愈合率呈负相关(P=0.04)。多元逐步Logistic回归分析显示高表达的miR-155为DFU的独立危险因素(OR=3.98,P=0.002)。结论2型糖尿病足溃疡患者外周血miR-155表达水平增高,为DFU的独立危险因素,并与DFU预后密切相关。

Objective To investigate the expression of miR-155 in peripheral blood of type 2 diabetes patients(T2DM)associated with diabetic foot ulcer(DFU)and its relationship with the onset of DFU.Methods Sixty newly diagnosed T2DM patients without DFU(T2DM group),112 T2DM patients with DFU(DFU group),and 60 healthy controls with normal glucose tolerance(NC group)were included.MiR-155 levels were determined by quantitative real-time PCR,while clinical features and risk factors of DFU were explored.Results A significant decrease in the expression level of miR-155 in peripheral blood was observed in T2DM group compared with NC group(P<0.05),and a markedly increased miR-155 expression level was noted in DFU group compared with T2DM group(P<0.01).Moreover,there was a positive correlation between the expression level of miR-155 in peripheral blood and the course of foot ulcer and Wagner grade of foot ulcer(P=0.02,P=0.01)while a negative correlation in the expression level of miR-155 with healing rate of DFU after eight weeks(P=0.04).The multiple stepwise logistic regression analysis confirmed that a high expression of miR-155 was an independent risk factor for DFU(OR=3.98,P=0.002).Conclusion An increased expression of miR-155 in peripheral blood of T2DM patients is an independent risk factor for DFU and is closely related to the prognosis of DFU.