循环外泌体miR-485-3p和miR-32-5p表达与早发冠心病发病的相关性研究

Correlation of circulating exosomal miR-485-3p and miR-32-5p expression with the incidence of early-onset coronary heart disease

目的分析循环外泌体miR-485-3p、miR-32-5p表达和早发冠心病发病的相关性。方法回顾性纳入2023年10月至2024年5月确诊为早发冠心病的50例患者作为观察组,另外纳入同期检查排除冠心病诊断的50例健康体检者作为对照组,收集两组基本资料和临床资料,对存在差异的指标采取多元logistic回归模型分析早发冠心病的影响因素,采取Spearman相关分析法分析血浆外泌体miR-485-3p、miR-32-5p水平和早发冠心病发生及Gensini积分的相关性,并绘制受试者工作特征(ROC)曲线,评价血浆外泌体miR-485-3p、miR-32-5p单独或联合对早发冠心病的预测价值。结果观察组的冠心病家族史比例、吸烟史比例、低密度脂蛋白(LDL)、miR-485-3p、miR-32-5p及Gensini积分均高于对照组(P<0.05)。存在差异的指标采取多元logistic回归模型分析,发现吸烟史、冠心病家族史、LDL、miR-485-3p、miR-32-5p均为影响早发冠心病发生的主要因素,OR值分别为6.997(95%CI:1.578~31.027)、16.671(95%CI:1.666~166.799)、2.632(95%CI:1.060~6.537)、12.717(95%CI:2.629~61.505)、6.000(95%CI:1.839~19.571)。早发冠心病和循环外泌体miR-485-3p、miR-32-5p表达呈正相关关系(r=0.525、0.548,P<0.05);早发冠心病Gensini积分和循环外泌体miR-485-3p、miR-32-5p表达也呈正相关关系(r=0.485、0.506,P<0.05)。ROC曲线发现,循环外泌体miR-485-3p、miR-32-5p预测早发冠心病的ROC曲线下面积(AUC)值分别为0.927、0.936,联合预测的AUC值达到0.957。结论循环外泌体miR-485-3p、miR-32-5p在早发冠心病中表达均上调,二者与早发冠心病发病及冠脉病变程度呈正相关,均为疾病发生的影响因素,能当作预测疾病发生的潜在生物标志物,且联合两项指标的预测价值更高。

Objective To investigate the correlation between circulating exosomal miR-485-3p,miR-32-5p expression,and the incidence of early-onset coronary heart disease(CHD).Methods This study retrospectively included 50 patients with a confirmed diagnosis of early-onset CHD from October 2023 to May 2024 as the observation group and 50 matched,healthy individuals without CHD as the control group.Demographic and clinical data were collected and compared.Multivariate logistic regression analysis was applied to evaluate the significant predictors of early-onset CHD.Additionally,Spearman correlation analysis was used to assess the relationship between plasma exosomal miR-485-3p,miR-32-5p levels,and CHD occurrence and severity,indicated by the Gensini score.The diagnostic utility of exosomal miR-485-3p and miR-32-5p,individually and combined,was assessed using receiver operating characteristics(ROC)curve analysis.Results The observation group exhibited significantly higher proportions of family history of CHD,smoking history,low density lipoprotein(LDL)levels,miR-485-3p,miR-32-5p,and Gensini scores than the control group(P<0.05).Logistic regression analysis indicated that smoking history,family history of CHD,LDL,miR-485-3p,and miR-32-5p were key risk factors for early-onset CHD,the OR values were 6.997(95%CI:1.578-31.027),16.671(95%CI:1.666-166.799),2.632(95%CI:1.060-6.537),12.717(95%CI:2.629-61.505),6.000(95%CI:1.839-19.571).respectively.Positive correlations were found between early-onset CHD and elevated levels of circulating exosomal miR-485-3p and miR-32-5p(r=0.525 and 0.548,respectively;P<0.05),as well as between the Gensini score and these two exosomal miRNAs(r=0.485 and 0.506,respectively;P<0.05).The ROC curve analysis yielded the area under ROC curve(AUC)values of 0.927 and 0.936 for miR-485-3p and miR-32-5p,respectively,with a combined predictive AUC of 0.957.Conclusion Circulating exosomal miR-485-3p and miR-32-5p are upregulated in early-onset CHD,demonstrating positive correlations with both disease incidence and coronary lesion severity.These miRNAs may serve as predictive biomarkers for early-onset CHD,with higher diagnostic accuracy when combined.