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血清微小RNA-1-3p、转录激活因子4在老年慢性心力衰竭患者中的表达水平及其与认知功能损伤的关系

Expression levels of serum microRNA-1-3p and activating transcription factor 4 in elderly patients with chronic heart failure and their relationships with cognitive impairment

    摘要
  • 摘要:
    目的 探讨老年慢性心力衰竭(CHF)患者血清微小RNA-1-3p(miR-1-3p)、转录激活因子4(ATF4)的表达水平及其与认知功能损伤的关系。
    方法 选取老年CHF患者150例为研究对象。根据蒙特利尔认知评估量表(MoCA)评分将患者分为认知功能损伤组(n=75)和认知功能正常组(n=75)。采用实时荧光定量聚合酶链反应(RT-qPCR)法检测2组血清miR-1-3p水平。采用酶联免疫吸附试验(ELISA)检测2组血清ATF4水平。采用Pearson相关性分析法分析老年CHF伴认知功能损伤患者血清miR-1-3p与ATF4水平的相关性。采用Logistic回归分析法分析老年CHF患者发生认知功能损伤的影响因素。采用受试者工作特征(ROC)曲线评估血清miR-1-3p、ATF4水平对CHF患者发生认知功能损伤的预测价值。
    结果 认知功能损伤组的左心室射血分数(LVEF)、MoCA评分、血清miR-1-3p水平低于认知功能正常组, N末端脑钠肽前体(NT-proBNP)水平、血清ATF4水平高于认知功能正常组，差异有统计学意义(P < 0.05)。老年CHF伴认知功能损伤患者血清miR-1-3p水平与血清ATF4水平呈负相关(r=-0.523, P < 0.001)。miR-1-3p、ATF4是老年CHF患者发生认知功能损伤的影响因素(P < 0.05)。血清miR-1-3p、ATF4联合预测老年CHF患者发生认知功能损伤的曲线下面积(AUC)大于血清miR-1-3p、ATF4单独预测的AUC, 差异有统计学意义(P < 0.05或P < 0.001)。
    结论 血清miR-1-3p表达水平与老年CHF患者认知功能呈正相关，血清ATF4表达与老年CHF患者认知功能呈负相关。血清miR-1-3p、ATF4可能是评估老年CHF患者认知功能损伤的潜在标志物。

     

    Abstract:
    Objective To explore the expression levels of serum microRNA-1-3p (miR-1-3p) and activating transcription factor 4 (ATF4) in elderly patients with chronic heart failure (CHF) and their relationships with cognitive impairment.
    Methods A total of 150 elderly patients with CHF were selected as the study subjects. Based on the Montreal Cognitive Assessment (MoCA) score, the patients were divided into cognitive impairment group (n=75) and normal cognitive function group (n=75). Real-time fluorescent quantitative polymerase chain reaction (RT-qPCR) was used to detect the serum miR-1-3p levels in both groups. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the serum ATF4 levels in the two groups. Pearson correlation analysis was applied to analyze the correlation between serum miR-1-3p and ATF4 level in elderly CHF patients with cognitive impairment. Logistic regression analysis was conducted to identify the influencing factors of cognitive impairment in elderly CHF patients. The predictive value of serum miR-1-3p and ATF4 levels for cognitive impairment in CHF patients was evaluated using receiver operating characteristic (ROC) curves.
    Results The left ventricular ejection fraction (LVEF), MoCA score and serum miR-1-3p level were significantly lower in the cognitive impairment group, while the N-terminal pro-brain natriuretic peptide (NT-proBNP) level and serum ATF4 level were significantly higher than those in the normal cognitive function group (P < 0.05). There was a negative correlation between serum miR-1-3p level and serum ATF4 level in elderly CHF patients with cognitive impairment (r=-0.523, P < 0.001). Both miR-1-3p and ATF4 were identified as influencing factors for cognitive impairment in elderly CHF patients (P < 0.05). The area under the curve (AUC) for predicting cognitive impairment in elderly CHF patients using a combination of serum miR-1-3p and ATF4 was significantly greater than the AUCs for prediction of serum miR-1-3p or ATF4 alone (P < 0.05 or P < 0.001).
    Conclusion The expression level of serum miR-1-3p is positively correlated while the expression of serum ATF4 is negatively correlated with cognitive function in elderly CHF patients. The serum miR-1-3p and ATF4 may serve as potential markers for evaluating cognitive impairment in elderly CHF patients.

     

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