2023 年第 11 期 第 18 卷

2型糖尿病合并冠心病老年患者外周血微小RNA-4465和微小RNA-6089水平变化及临床意义

Changes and clinical significance of microRNA-4465 and microRNA-6089 levels in peripheral blood of elderly patients with type 2 diabetes mellitus and coronary atherosclerotic heart disease

作者：李会1孟宪杰1马宁1郑军1郭智慧2

英文作者：Li Hui1 Meng Xianjie1 Ma Ning1 Zheng Jun1 Guo Zhihui2

单位：1河北省唐山市人民医院内分泌科，唐山063000；2开滦总医院内分泌科，唐山063000

英文单位：1Department of Endocrinology Tangshan People′s Hospital Hebei Province Tangshan 063000 China; 2Department of Endocrinology KaiLuan General Hospital Tangshan 063000 China

关键词：2型糖尿病；外周血微小RNA；冠状动脉疾病

英文关键词：Type2diabetesmellitus;PeripheralbloodmicroRNA;Coronaryarterydisease

• 摘要：

• 目的  探讨2型糖尿病合并冠心病（冠状动脉粥样硬化性心脏病）老年患者外周血微小RNA（miR）-4465和miR-6089水平变化及临床意义。方法  选取河北省唐山市人民医院2020年11月至2021年1月收集的90例受试者，包括30例T2DM不合并冠心病（非冠心病组）、30例T2DM合并冠心病（冠心病组）以及30例健康受试者（对照组）。分析3组临床资料、外周血miR-4465和miR-6089水平。采用多因素Logistic回归模型分析T2DM合并冠心病的危险因素。采用Pearson相关性分析法分析外周血miR-4465和miR-6089水平与Gensini评分的相关性。绘制受试者工作特征(ROC)曲线分析外周血miR-4465和miR-6089对T2DM合并冠心病的诊断价值。结果  冠心病组空腹血糖、糖化血红蛋白、收缩压、低密度脂蛋白胆固醇（LDL-C）、总胆固醇水平及血糖控制不佳比例均高于非冠心病组和对照组，高密度脂蛋白胆固醇、三酰甘油水平均低于非冠心病组和对照组，差异均有统计学意义（均P＜0.05）。冠心病组外周血miR-4465、miR-6089水平均高于非冠心病组和对照组［（17.6±3.4）比（8.4±2.6）、（3.1±0.8），（33.1±4.5）比（19.5±2.8）、（4.2±1.3）］（均P＜0.05）；非冠心病组miR-4465、miR-6089水平均高于对照组（均P＜0.05）。多因素Logistic回归分析结果显示，miR-4465、miR-6089、LDL-C水平升高、高血压病、血糖控制不佳均是T2DM合并冠心病的独立危险因素（均P＜0.05）。Pearson相关性分析结果显示，T2DM合并冠心病患者外周血miR-4465和miR-6089水平均与Gensini评分呈正相关（均P＜0.001）。受试者工作特征曲线分析结果显示，外周血miR-4465和miR-6089诊断T2DM合并冠心病的曲线下面积为0.912（0.806～0.956）、0.920（0.823～0.987）。结论  T2DM合并冠心病的老年患者外周血miR-4465和miR-6089水平均明显增高，二者可作为评估T2DM患者冠心病风险的参考指标。

• Objective  To investigate the changes and clinical significance of microRNA(miR)-4465 and miR-6089 levels in peripheral blood of elderly patients with type 2 diabetes mellitus (T2DM) and coronary atherosclerotic heart disease (CHD). Methods  From November 2020 to January 2021, 90 subjects were enrolled in this study in Tangshan People′s Hospital, Hebei Province, including 30 cases of T2DM without CHD (non-CHD group), 30 cases of T2DM with CHD (CHD group), and 30 cases of healthy subjects (control group). Clinical data, peripheral miR-4465 and miR-6089 levels of three groups were analyzed. Multivariate Logistic regression model was used to analyze the risk factors of T2DM with CHD. Pearson correlation analysis was used to analyze the correlation of the levels of miR-4465 and miR-6089 in peripheral blood with Gensini scores. Receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of peripheral blood miR-4465 and miR-6089 in T2DM patients with CHD. Results  Levels of fasting glucose, glycosylated hemoglobin, systolic blood pressure, low-density lipoprotein cholesterol (LDL-C), total cholesterol and the proportion of poor glucose control in CHD group were higher than those in non-CHD group and control group, while high-density lipoprotein cholesterol and triacylglycerol levels were lower than those in non-CHD group and control group (all P<0.05). Levels of miR-4465 and miR-6089 in CHD group were higher than those in non-CHD group and control group ［（17.6±3.4） vs （8.4±2.6）,（3.1±0.8）;（33.1±4.5） vs （19.5±2.8）,（4.2±1.3）］(all P<0.05); levels of miR-4465 and miR-6089 in non-CHD group were higher than those in control group (both P<0.05). Multivariate Logistic regression analysis showed that elevated miR-4465, miR-6089, LDL-C, hypertension, and poor glycemic control were independent risk factors for T2DM combined with CHD (all P<0.05). Pearson correlation analysis showed that peripheral miR-4465 and miR-6089 levels were positively correlated with Gensini scores (both P<0.001). ROC curve analysis showed that the area under the curve of peripheral miR-4465 and miR-6089 in the diagnosis of T2DM combined with CHD were 0.912(0.806-0.956) and 0.920(0.823-0.987), respectively. Conclusion  Levels of miR-4465 and miR-6089 in peripheral blood of elderly patients with T2DM and CHD are significantly higher. Both of them can be used as reference indicators to evaluate the risk of CHD in T2DM patients.