腰痛患者血清miR-133a-5p,SIRT1水平表达与功能障碍指数及疼痛评分的相关性研究

Expression Levels of Serum miR-133a-5p and SIRT1 and Its Correlation with Dysfunction Index and Pain Scale in Patients with Low Back Pain

目的 探究血清微小核糖核酸(microRNA,miR)-133a-5p和沉默信息调节因子1(silent information regulator1,SIRT1)水平变化与腰痛(low back pain,LBP)患者疼痛和功能障碍的相关性。方法 选取2019年5月~2022年4月在上海市长宁区天山中医医院骨伤科就诊治疗的89例LBP患者为研究组,另选取同期90例体检健康志愿者为对照组。采用Oswestry腰痛功能障碍指数(Oswestry disability index,ODI)评估LBP患者腰痛功能障碍;采用视觉模拟疼痛评分(visual anallogue scale,VAS)评估LBP患者疼痛程度;实时荧光定量PCR(RT-qPCR)检测血清miR-133a-5p和SIRT1表达水平;Pearson相关性检验分析血清miR-133a-5p和SIRT1表达水平与ODI指数和VAS评分的相关性;多因素Logistic回归分析LBP发生的影响因素。结果 研究组、对照组在饮酒史、体力活动强度、抑郁和焦虑方面比较差异具有统计学意义(χ^(2)=5.372,9.391,10.087,12.576,均P <0.05);与对照组比较,研究组血清miR-133a-5p(0.66±0.12 vs 1.01±0.15)和SIRT1(0.84±0.14 vs 1.12±0.18)表达水平明显降低,差异具有统计学意义(t=17.226,11.214,均P=0.000);与对照组比较,研究组ODI指数(28.86%±4.39%vs 9.86%±1.91%)和VAS评分(5.26±1.47分vs 1.34±0.21分)明显升高,差异具有统计学意义(t=37.617,25.042,均P=0.000);LBP患者血清miR-133a-5p表达水平与ODI指数和VAS评分呈显著负相关(r=-0.520,-0.416,均P <0.05);血清SIRT1表达水平与ODI指数和VAS评分呈显著负相关(r=-0.661,-0.588,均P <0.05)。Logistic回归分析结果显示,miR-133a-5p(OR=0.602,95%CI:0.464~0.788)和SIRT1(OR=0.569,95%CI:0.481~0.816)是LBP发生的保护因素(均P <0.05),饮酒(OR=1.104,95%CI:1.102~1.719)、抑郁(OR=1.328,95%CI:1.116~1.894)和高强度体力活动(OR=1.224,95%CI:1.097~1.862)是LBP发生的独立危险因素(均P <0.05)。结论 miR-133a-5p和SIRT1在LBP患者血清中表达降低,且与LBP患者疼痛程度和功能障碍具有相关性。

Objective To explore the correlation between the changes of serum microRNA(miR)-133a-5p and silent information regulator 1(SIRT1)levels and the pain and dysfunction in patients with low back pain(LBP).Methods A total of 89 patients with LBP treated in the Department of Orthopaedics,the Tianshan Hospital of Traditional Chinese Medicine of Shanghai Changning District from May 2019 to April 2022 were selected as the study group,and 90 healthy volunteers for physical examination in the same period were selected as the control group.The Oswestry low back pain dysfunction index(ODI)was used to evaluate low back pain dysfunction of LBP patients.Visual analogue scale(VAS)was used to evaluate the pain degree of LBP patients.The expression levels of miR-133a-5p and SIRT1 in serum were detected by RT-qPCR.Pearson method was applied to analyze the correlation between serum miR-133a-5p and SIRT1 expression levels and ODI indexesand VAS scores,and multivariate Logistic regression was used to analyze the influencing factors of LBP.Results There were significant differences in drinking history,physical activity intensity,depression and anxiety between the study group and the control group(χ^(2)=5.372,9.391,10.087,12.576,all P<0.05).Compared with the control group,the expression levels of serum miR-133a-5p(0.66±0.12 vs 1.01±0.15)and SIRT1(0.84±0.14 vs 1.12±0.18)in the study group were significantly decreased,and the differences were statistically significant(t=17.226,11.214,all P=0.000).Compared with the control group,the ODI index(28.86%±4.39%vs 9.86%±1.91%)and VAS score(5.26±1.47 scores vs 1.34±0.21 scores)in the study group were significantly higher,and the differences were statistically significant(t=37.617,25.042,all P=0.000).The expression level of serum miR-133a-5p in LBP patients was significantly negatively correlated with ODI index(r=-0.520,P<0.05)and VAS score(r=-0.416,P<0.05).The expression level of serum SIRT1 in LBP patients was obviously negatively correlated with ODI index(r=-0.661,P<0.05)and VAS score(r=-0.588,P<0.05).Logistic regression analysis showed that miR-133a-5p(OR=0.602,95%CI:0.464~0.788)and SIRT1(OR=0.569,95%CI:0.481~0.816)were protective factors for LBP(all P<0.05).Drinking(OR=1.104,95%CI:1.012~1.719),depression(OR=1.328,95%CI:1.116~1.894)and high intensity physical activity(OR=1.224,95%CI:1.097~1.862)were the risk factors of LBP(all P<0.05).Conclusion The expression of miR-133a-5p and SIRT1 in serum of LBP patients was decreased,and was correlated with the degree of pain and dysfunction in LBP patients.