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微小RNA-93-5p在糖尿病合并冠心病患者中的表达及临床意义

Expression and clinical significance of microRNA-93-5p in patients with type 2 diabetes mellitus complicated with coronary heart disease

    摘要
  • 摘要:
    目的 探讨微小RNA-93-5p(miR-93-5p)在2型糖尿病(T2DM)合并冠心病(CHD)患者中的表达及临床意义。
    方法 选取2019年8月—2021年5月本院诊治的60例T2DM患者、57例T2DM合并CHD患者分别为T2DM组、T2DM合并CHD组，另纳入同期60例体检健康者为对照组。比较T2DM合并CHD组、对照组、T2DM组一般资料、血清miR-93-5p、白细胞介素-6(IL-6)水平; 分析T2DM合并CHD患者血清miR-93-5p、IL-6水平与低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、甘油三酯(TG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)的关系; 分析T2DM并发CHD的影响因素; 分析血清miR-93-5p、IL-6预测T2DM并发CHD的价值。
    结果 T2DM合并CHD组、T2DM组LDL-C、FINS、TG、FPG、TC、HbA1c及血清miR-93-5p、IL-6水平高于对照组, HDL-C水平低于对照组，差异有统计学意义(P < 0.01); T2DM合并CHD组LDL-C、FINS、TG、FPG、TC、HbA1c及血清miR-93-5p、IL-6水平高于T2DM组, HDL-C水平低于T2DM组，差异有统计学意义(P < 0.01)。T2DM合并CHD患者血清中miR-93-5p、IL-6水平与LDL-C、FINS、HbA1c、TC、FPG均呈正相关(P < 0.01), 与HDL-C呈负相关(P < 0.01); T2DM合并CHD患者血清中miR-93-5p表达水平与IL-6呈正相关(P < 0.05)。LDL-C、FINS、FPG、HbA1c、TC、miR-93-5p、IL-6是T2DM并发CHD的影响因素(P < 0.05); 血清miR-93-5p、IL-6预测T2DM并发CHD的曲线下面积(AUC)分别为0.888、0.898，截断值分别为2.59、77.98 ng/L, 敏感度均为75.4%, 特异度分别为89.2%、85.8%; miR-93-5p、IL-6联合预测T2DM并发CHD的AUC为0.939, 敏感度、特异度分别为91.2%、83.3%。
    结论 T2DM并发CHD患者血清miR-93-5p较高，其可能与IL-6共同参与T2DM并发CHD过程。IL-6联合miR-93-5p检测有望作为临床预测T2DM并发CHD的辅助方法。

     

    Abstract:
    Objective To investigate the expression and clinical significance of microRNA-93-5p (miR-93-5p) in patients with type 2 diabetes mellitus (T2DM) complicated with coronary heart disease (CHD).
    Methods A total of 60 patients with T2DM (T2DM group), 57 patients with T2DM complicated with CHD (T2DM with CHD group), and 60 healthy individuals (control group) were enrolled in this study from August 2019 to May 2021. The general information, serum miR-93-5p, and interleukin-6 (IL-6) levels were compared among the T2DM with CHD group, control group and T2DM group; the relationships of serum miR-93-5p and IL-6 levels with low-density lipoprotein cholesterol (LDL-C), fasting insulin (FINS), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), triglyceride (TG), glycated hemoglobin (HbA1c), and total cholesterol (TC) were analyzed in T2DM with CHD patients; the influencing factors of T2DM complicated with CHD were analyzed; the predictive value of serum miR-93-5p and IL-6 for T2DM complicated with CHD was evaluated.
    Results The levels of LDL-C, FINS, TG, FPG, TC, HbA1c, serum miR-93-5p, and IL-6 in the T2DM with CHD group and T2DM group were significantly higher than those in the control group, while the HDL-C level was significantly lower (P < 0.01); the levels of LDL-C, FINS, TG, FPG, TC, HbA1c, serum miR-93-5p, and IL-6 in the T2DM with CHD group were significantly higher than those in the T2DM group, while the HDL-C level was significantly lower (P < 0.01). The serum miR-93-5p and IL-6 levels in T2DM with CHD patients were positively correlated with LDL-C, FINS, HbA1c, TC and FPG (P < 0.01), and negatively correlated with HDL-C (P < 0.01); the expression level of miR-93-5p in serum was positively correlated with IL-6 (P < 0.05). LDL-C, FINS, FPG, HbA1c, TC, miR-93-5p, and IL-6 were the influencing factors of T2DM complicated with CHD (P < 0.05); the area under the curve (AUC) of serum miR-93-5p and IL-6 for predicting T2DM complicated with CHD was 0.888 and 0.898 respectively, with cut-off values of 2.59 and 77.98 ng/L respectively, sensitivity of 75.4% for both serum miR-93-5p and IL-6, and the specificity was 89.2% for miR-93-5p and 85.8% for IL-6; the AUC of the combined prediction of miR-93-5p and IL-6 for T2DM complicated with CHD was 0.939, with sensitivity and specificity of 91.2% and 83.3% respectively.
    Conclusion The serum miR-93-5p level is elevated in patients with T2DM complicated with CHD, and miR-93-5p together with IL-6 may participate in the process of T2DM complicated with CHD. The combined detection of IL-6 and miR-93-5p is expected to serve as an auxiliary method for prediction of T2DM complicated with CHD.

     

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