2型糖尿病患者血清微小RNA-155和核苷酸结合寡聚结构域样受体蛋白3水平变化及对颈动脉粥样硬化的诊断价值

Changes of serum microRNA-155 and NOD-like receptor protein 3 levels in patients with type 2 diabetes mellitus and their diagnostic values for carotid atherosclerosis

目的探讨血清微小RNA(miR)-155、核苷酸结合寡聚结构域样受体蛋白3(NLRP3)水平变化及其对2型糖尿病(T_(2)DM)患者颈动脉粥样硬化(CAS)的诊断价值。方法选取2021年1月至2023年1月四川大学华西医院收治的T_(2)DM患者142例。根据是否存在CAS分为CAS组(72例)和非CAS组(70例)。收集和比较2组患者的一般资料,检测和比较2组患者血清miR-155和NLRP3水平。采用Pearson相关性分析方法分析T_(2)DM患者血清miR-155与NLRP3水平的相关性。采用多因素Logistic回归方法分析T_(2)DM患者CAS的影响因素。采用受试者工作特征曲线分析血清miR-155、NLRP3水平对T_(2)DM患者CAS的诊断价值。结果CAS组T_(2)DM病程长于非CAS组,吸烟史比例、糖化血红蛋白、稳态模型胰岛素抵抗指数、miR-155、NLRP3均高于非CAS组(均P<0.05)。Pearson相关性分析显示T_(2)DM患者血清miR-155与NLRP3水平呈正相关(r=0.765,P<0.001)。多因素Logistic回归模型结果显示T_(2)DM病程延长、吸烟史和糖化血红蛋白、稳态模型胰岛素抵抗指数、miR-155、NLRP3升高是影响T_(2)DM患者CAS的独立危险因素(均P<0.05)。受试者工作特征曲线分析显示血清miR-155、NLRP3水平二者联合诊断T_(2)DM患者CAS的曲线下面积大于血清miR-155、NLRP3水平单独诊断(0.900比0.791、0.799,Z=3.436、3.381,均P=0.001)。结论血清miR-155、NLRP3水平升高与T_(2)DM患者CAS发生密切相关,血清miR-155、NLRP3水平联合对T_(2)DM患者CAS的诊断价值较高。

Objective To investigate the changes of serum microRNA-155(miR-155)and NOD-like receptor protein 3(NLRP3)levels and their diagnostic values for carotid atherosclerosis(CAS)in patients with type 2 diabetes mellitus(T_(2)DM).Methods A total of 142 patients with T_(2)DM admitted to West China Hospital,Sichuan University from January 2021 to January 2023 were selected.According to the presence or absence of CAS,the patients were divided into CAS group(72 cases)and non-CAS group(70 cases).The general data of the two groups of patients were collected and compared,and the serum levels of miR-155 and NLRP3 were detected and compared between the two groups.Pearson correlation was used to analyze the correlation between serum miR-155 and NLRP3 levels in T_(2)DM patients.Multivariate Logistic regression was used to analyze the influencing factors of CAS in T_(2)DM patients.Receiver operating characteristic curve was used to analyze the diagnostic value of serum miR-155 and NLRP3 levels for CAS in T_(2)DM patients.Results The duration of T_(2)DM in the CAS group was longer than that in the non-CAS group,and the proportion of smoking history,glycosylated hemoglobin,homeostasis model assessment of insulin resistance index,miR-155 and NLRP3 were higher than those in the non-CAS group(all P<0.05).Pearson correlation analysis showed that serum miR-155 levels were positively correlated with NLRP3 levels in T_(2)DM patients(r=0.765,P<0.001).Multivariate Logistic regression model showed that the prolonged duration of T_(2)DM,smoking history,glycosylated hemoglobin,homeostasis model assessment of insulin resistance index,miR-155 and NLRP3 were independent risk factors for CAS in T_(2)DM patients(all P<0.05).Receiver operating characteristic curve analysis showed that the area under the curve of serum miR-155 and NLRP3 levels combined in the diagnosis of CAS in T_(2)DM patients was larger than those of serum miR-155 and NLRP3 levels alone(0.900 vs 0.791,0.799,Z=3.436,3.381;both P=0.001).Conclusions The increase of serum miR-155 and NLRP3 levels is closely related to the occurrence of CAS in T_(2)DM patients.The combination of serum miR-155 and NLRP3 levels has a high diagnostic value for CAS in T_(2)DM patients.