糖尿病视网膜病变患者血清miR-20b-3p、miR-192表达与NLRP3炎症小体和预后不良的关系

Relationship Between Serum miR-20b-3p,miR-192 Expression and NLRP3 Inflammasome and Poor Prognosis in Diabetic Retinopathy Patients

目的探讨糖尿病视网膜病变(DR)患者血清微小核糖核酸(miRNA)-20b-3p、miR-192表达与NOD样受体热蛋白结构域相关蛋白3(NLRP3)炎症小体和预后不良的关系。方法选取2021年1月至2022年3月我院收治的DR患者165例。根据临床分级标准分为增生型DR(PDR)组89例和非增生型DR(NPDR)组76例,另选取同期我院收治的100例单纯2型糖尿病(T2DM)患者纳入T2DM组及100例体检健康志愿者纳入对照组。检测并对比4组血清miR-20b-3p、miR-192和外周血单核细胞NLRP3 mRNA、半胱氨酸蛋白酶-1(Caspase-1)mRNA表达、白细胞介素(IL)-1β、IL-18水平。采用Pearson相关性分析DR患者血清miR-20b-3p、miR-192表达与NLRP3炎症小体相关指标的相关性。DR患者出院后随访1年,根据是否发生视力残疾分为预后不良组47例和预后良好组118例,比较预后不良组和预后良好组血清miR-20b-3p、miR-192水平。收集DR患者的临床资料,单因素和多因素Logistic回归分析影响DR患者预后不良的因素。结果对照组、T2DM组、NPDR组、PDR组血清miR-20b-3p、miR-192表达依次降低,外周血单核细胞NLRP3 mRNA、Caspase-1 mRNA和血清IL-1β、IL-18水平依次升高(P<0.05)。Pearson相关性分析显示,DR患者血清miR-20b-3p、miR-192表达与NLRP3 mRNA、Caspase-1 mRNA、IL-1β、IL-18水平呈负相关(P<0.05)。随访1年,165例DR患者视力残疾发生率为28.48%(47/165)。多因素Logistic回归分析显示,T2DM病程偏长、PDR占比偏高和糖化血红白蛋白(HbA1c)、NLRP3 mRNA、Caspase-1 mRNA、IL-1β、IL-18水平升高为影响DR患者预后的独立危险因素,miR-20b-3p、miR-192升高为独立保护因素(P<0.05)。结论DR患者血清miR-20b-3p、miR-192低表达,与NLRP3炎症小体激活和预后不良密切相关,可能成为DR患者病情和预后评估的指标。

Objective To investigate the relationship between serum microribonucleic acid(miRNA)-20b-3p,miR-192 expression and NOD-like receptor thermal protein domain associated protein 3(NLRP3)inflammasome and poor prognosis in diabetic retinopathy(DR)patients.Methods From January 2021 to March 2022,165 DR patients who were admitted to our hospital were selected.Patients were divided into proliferative DR(PDR)group(n=89)and non-proliferative DR(NPDR)group(n=76)according to clinical grading standard,and 100 patients with simple type 2 diabetes mellitus(T2DM)who were admitted to our hospital during the same period were selected as T2DM group and 100 healthy volunteers were included in control group.Serum miR-20b-3p,miR-192,NLRP3 mRNA,cysteine proteinase-1(Caspase-1)mRNA expression,interleukin(IL)-1βand IL-18 in peripheral blood mononuclear cells were detected and compared in four groups.The correlation between serum miR-20b-3p,miR-192 expression and NLRP3 inflammasome-related indicators in DR patients were analyzed by Pearson correlation analysis.DR patients were followed up for 1 year after discharge,patients were divided into 47 cases in poor prognosis group and 118 cases in good prognosis group according to whether visual disability occurred,serum miR-20b-3p and miR-192 in poor prognosis group and good prognosis group were compared.Clinical data of DR patients were collected,and factors affecting poor prognosis of DR patients were analyzed by univariate and multivariate Logistic regression analysis.Results The expression of serum miR-20b-3p and miR-192 in control group,T2DM group,NPDR group and PDR group decreased in turn,and NLRP3 mRNA,Caspase-1 mRNA in peripheral blood mononuclear cells and serum IL-1βand IL-18 increased in turn(P<0.05).Pearson correlation analysis showed that serum miR-20b-3p and miR-192 in DR patients was negatively correlated with NLRP3 mRNA,Caspase-1 mRNA,IL-1βand IL-18(P<0.05).After 1 year of follow up,the incidence of visual disability in 165 DR patients was 28.48%(47/165).Multivariate Logistic regression analysis showed that longer course of T2DM,higher proportion of PDR and higher glycosylated hemoglobin albumin(HbA1c),NLRP3 mRNA,Caspase-1 mRNA,IL-1βand IL-18 were independent risk factors affecting the prognosis of DR patients,and higher miR-20b-3p and miR-192 were independent protective factors(P<0.05).Conclusion Low expression of serum miR-20b-3p and miR-192 in DR patients is closely relate to NLRP3 inflammasome and poor prognosis,which may be an index for evaluating the condition and prognosis of DR patients.