双相情感障碍患者血清Hepcidin,LncRNA MIAT和CRE的水平表达及与病情程度关系研究

Expression of Serum Hepcidin,LncRNA MIAT and CRE in Patients with Bipolar Disorder and Their Relationship with Disease Severity

目的探究双相情感障碍(bipolar disorder,BPD)患者血清铁调素(Hepcidin)、血清长链非编码RNA心肌梗死转录本(long non-coding RNA myocardial infarction-associated transcript,LncRNA MIAT)和肌酐(creatinine,CRE)表达及与病情程度的关系。方法选取2021年3月~2023年3月宝鸡市中心医院收治的150例BPD患者作为研究对象并纳入BPD组,另选取健康者150例为对照组,采用汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评价抑郁,采用杨氏躁狂量表(Young mania ratings scale,YMRS)评价躁狂程度,所有研究对象均接受血清Hepcidin,LncRNA MIAT和CRE水平的检测。对比对照组和BPD组血清Hepcidin,LncRNA MIAT和CRE水平;对比不同抑郁、躁狂程度BPD组血清Hepcidin,LncRNAMIAT和CRE水平;受试者工作特征(receiver operating characteristic,ROC)曲线分析血清Hepcidin,LncRNA MIAT和CRE对BPD的诊断价值;分析血清Hepcidin,LncRNA MIAT和CRE与BPD病情程度的关系。结果BPD组血清Hepcidin(46.17±9.17ng/L),LncRNA MIAT(11.92±2.65)和CRE(74.02±11.89μmol/L)水平均明显高于对照组(22.16±5.23 ng/L,4.11±0.95,57.16±8.61μmol/L),差异具有统计学意义(t=-27.856,-43.079,-14.066,均P<0.05);随着BPD患者抑郁、躁狂程度的增加,血清Hepcidin,LncRNA MIAT和CRE水平呈现升高的趋势(F=22.036,25.463,17.499;19.552,15.791,18.335,均P<0.05);血清Hepcidin,LncRNA MIAT和CRE联合检测(95%CI:0.866~0.949)对BPD诊断ROC曲线下面积为0.914,具有较高的特异度和敏感度,显著高于血清Hepcidin(95%CI:0.693~0.816),LncRNA MIAT(95%CI:0.696~0.819)和CRE(95%CI:0.587~0.701)单独检测(AUC=0.759,0.762,0.614,均P<0.05);血清Hepcidin,LncRNA MIAT和CRE与BPD患者抑郁严重程度呈显著正相关(r=0.784,0.771,0.826,均P<0.05);血清Hepcidin,LncRNA MIAT和CRE与BPD患者躁狂严重程度呈显著正相关(r=0.806,0.793,0.831,均P<0.05)。结论BPD患者血清Hepcidin,LncRNA MIAT和CRE水平相较正常人群更高,且与疾病严重程度呈显著正相关,联合检测对其具有较高诊断价值。

Objective To explore the expression of serum Hepcidin,long non-coding RNA myocardial infarction-associated transcript(LncRNA MIAT)and creatinine(CRE)in patients with bipolar disorder(BPD)and their relationship with the severity of the disease.Method In this study,150 patients with BPD who were admitted to Baoji Central Hospital from March 2021 to March 2023 were selected as the study subjects and were included in the BPD group.Another 150 healthy subjects were selected as the control group.Hamilton Depression Scale(HAMD)was used to evaluate depression.Young mania ratings scale(YMRS)was used to evaluate the degree of mania.All subjects were tested for serum Hepcidin,LncRNA MIAT and CRE levels.The levels of serum Hepcidin,LncRNA MIAT and CRE were compared between control group and BPD group.The levels of serum Hepcidin,LncRNA MIAT and CRE in BPD groups with different depression/mania degrees were compared.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum Hepcidin,LncRNA MIAT and CRE in BPD.The relationship between serum Hepcidin,LncRNA MIAT and CRE and the severity of BPD was analyzed.Results The levels of serum Hepcidin(46.17±9.17 ng/L),LncRNA MIAT(11.92±2.65)and CRE(74.02±11.89μmol/L)in BPD group were higher than those in control group(22.16±5.23 ng/L,4.11±0.95,57.16±8.61μmol/L),with significant differences(t=-27.856,-43.079,-14.066,all P<0.05).The levels of serum Hepcidin,LncRNA MIAT and CRE increased with the increase of depression/mania in BPD patients(F=22.036,25.463,17.499,19.552,15.791,18.335,all P<0.05).The combined detection of serum Hepcidin,LncRNA MIAT and CRE(95%CI:0.866~0.949)for BPD diagnosis had an area under the ROC curve of 0.914,with high specificity and sensitivity,which was significantly higher than that of serum Hepcidin alone(95%CI:0.693~0.816),LncRNA MIAT(95%CI:0.696~0.819)alone and CRE(95%CI:0.587~0.701)detection alone(AUC=0.759,0.762,0.614,all P<0.05).Serum Hepcidin,LncRNA MIAT and CRE were positively correlated with depression severity in BPD patients(r=0.784,0.771,0.826,all P<0.05).Serum Hepcidin,LncRNA MIAT and CRE were positively correlated with mania severity in BPD patients(r=0.806,0.793,0.831,all P<0.05).Conclusion The levels of serum Hepcidin,LncRNA MIAT and CRE in BPD patients were higher than those in the normal population,and they were positively correlated with the severity of the disease.Combined detection may have a high diagnostic value.