非酒精性脂肪性肝病患者血清miR-183-5p和miR-96-5p水平变化及其临床意义探讨

Changes of serum miR-183-5p and miR-96-5p levels in patients with nonalcoholic fatty liver diseases

目的 探讨非酒精性脂肪肝病(NAFLD)患者血清miR-183-5p和miR-96-5p水平变化及其临床意义。方法 2019年11月~2022年1月我院诊治的NAFLD患者62例和同期性别和年龄相匹配且无过量饮酒史的健康体检者80例,采用实时荧光定量RT-PCR法检测血清miR-183-5p和miR-96-5p水平,应用多因素Logistic回归分析NAFLD发生的危险因素,应用受试者工作特征曲线(ROC)下面积(AUC)评估指标诊断严重脂肪性肝病的效能。结果 NAFLD患者BMI、胰岛素抵抗指数(HOMA-IR)、空腹血糖(FPG)和血脂水平显著高于健康人(P<0.05),血清miR-183-5p和miR-96-5p水平分别为(0.8±0.2)和(1.2±0.3),显著低于健康人【分别为(1.4±0.4)和(2.3±0.6),P<0.05】;17例重度NAFLD患者血清miR-183-5p和miR-96-5p水平分别为(0.4±0.1)和(0.8±0.2),显著低于21例中度患者【分别为(0.8±0.2)和(1.2±0.3),P<0.05】或24例轻度患者【分别为(1.1±0.3)和(1.5±0.4),P<0.05】;经Logistic回归分析结果显示,BMI、HOMA-IR、FPG、甘油三酯、低密度脂蛋白胆固醇以及血清miR-183-5p和miR-96-5p低水平是NAFLD发生的独立危险因素(P<0.05);应用血清miR-183-5p和miR-96-5p联合检测评估重度NAFLD发生的AUC为0.821,显著高于两项指标单独评估的0.713或0.718(P<0.05),其准确度、灵敏度和特异度分别达到77.4%、76.5%和77.8%。结论NAFLD患者血清miR-183-5p和miR-96-5p呈低水平,其水平越低,可能预示着肝内脂肪变程度越重,即它们的血清水平可在一定程度上反映疾病的严重程度,可作为诊断和评估病情的分子标志物,值得进一步研究。

Objective The aim of this study was to explore the implications of microRNA(miR)-183-5p and miR-96-5p level changes in patients with nonalcoholic fatty liver diseases(NAFLD). Methods 62 patients with NAFLD and 80 healthy individuals with matched gender and age and without history of excessive drinking were enrolled in our hospital between November 2019 and January 2022. Serum miR-183-5p and miR-96-5p levels were detected by real-time fluorescent quantitative RT-PCR, and the factors impacting the occurrence of severe NAFLD was analyzed by multivariate Logistic regression analysis. The diagnostic performance of miR-183-5p and miR-96-5p in predicting the severity of NAFLD was evaluated by the area under the receiver operating characteristic curves(AUC). Results The body mass index, HOMA-IR, fasting plasma glucose and blood fat levels in patients with NAFLD were significantly higher than in healthy persons(P<0.05), while serum miR-183-5p and miR-96-5p levels were(0.8±0.2) and(1.2±0.3), much lower than [(1.4±0.4) and(2.3±0.6), respectively, P<0.05] in healthy control;serum miR-183-5p and miR-96-5p levels in 17 patients with severe NAFLD were(0.4±0.1) and(0.8±0.2), significantly lower than [(0.8±0.2) and(1.2±0.3), respectively, P<0.05] in 21 patients with moderate NAFLD or [(1.1±0.3) and(1.5±0.4), respectively, P<0.05] in 24 patients with mild NAFLD;the multivariate Logistic regression analysis revealed that the BMI, HOMA-IR, FPG, triglyceride and low-density lipoprotein cholesterol as well as serum miR-183-5p and miR-96-5p levels were the independent risk factors for the existence of severe NAFLD(P<0.05);the AUC was 0.821, with the accuracy, sensitivity and specificity of 77.4%, 76.5% and 77.8% when the combination of serum miR-183-5p and miR-96-5p levels was applied to predict the severe NAFLD, much superior to anyone of the two parameters alone(with the AUC of 0.713 or 0.718, respectively, P<0.05). Conclusion Serum miR-183-5p and miR-96-5p levels are down-regulated in patients with NAFLD, and the lowest the serum levels of them, the more severe of the NAFLD, which hints the more severe intrahepatic steatosis, and warrants further clinical investigation.