2024 年第 4 期 第 19 卷

老年2型糖尿病患者血清微小RNA-125a-3p和基质金属蛋白酶9水平与颈动脉粥样硬化的关系

Relationship of serum microRNA-125a-3p and matrix metalloproteinase 9 levels with carotid atherosclerosis in elderly patients with type 2 diabetes mellitus

作者：江巍白盟盟王海峰

英文作者：Jiang Wei Bai Mengmeng Wang Haifeng

单位：内蒙古自治区人民医院干部保健所，呼和浩特010010

英文单位：Cadre Health Care Institute Inner Mongolia Autonomous Region People′s Hospital Hohhot 010010 China

关键词：2型糖尿病；颈动脉粥样硬化；微小RNA-125a-3p；基质金属蛋白酶9

英文关键词：Type2diabetesmellitus;Carotidatherosclerosis;MicroRNA-125a-3p;Matrixmetalloproteinase9

• 摘要：

• 目的 探讨老年2型糖尿病（T2DM）患者血清微小RNA-125a-3p（miR-125a-3p）、基质金属蛋白酶9（MMP-9）水平与颈动脉粥样硬化（CAS）的关系。方法 选取2020年4月至2023年5月内蒙古自治区人民医院收治的200例老年T2DM患者（T2DM组），根据颈动脉内中膜厚度（CIMT）分为CAS亚组和非CAS亚组，另选取同期45例老年体检健康者为对照组。收集T2DM患者临床资料，检测研究对象血清miR-125a-3p、MMP-9水平。分析T2DM患者血清miR-125a-3p、MMP-9水平与CIMT、空腹血糖、糖化血红蛋白（HbA1c）、甘油三酯、低密度脂蛋白胆固醇（LDL-C）的相关性，多因素Logistic回归分析T2DM患者CAS的影响因素，受试者工作特征（ROC）曲线分析血清miR-125a-3p、MMP-9对T2DM患者CAS的预测价值。结果 T2DM组血清miR-125a-3p、MMP-9水平均高于对照组［（1.58±0.30）比（1.09±0.22）、（24±8）μg/L比（14±5）μg/L］（均P＜0.001）。200例T2DM患者中137例CIMT≥1.0 mm，CAS发生率为68.5%（137/200）。CAS亚组miR-125a-3p、MMP-9水平均高于非CAS亚组（均P＜0.05）。T2DM患者血清miR-125a-3p与MMP-9水平呈正相关（r=0.778，P＜0.001），二者与CIMT、空腹血糖、HbA1c、甘油三酯、LDL-C均呈正相关（均P＜0.001）。多因素Logistic回归分析结果显示，血脂异常、病程延长和HbA1c、LDL-C、miR-125a-3p、MMP-9升高为T2DM患者CAS的独立危险因素（均P＜0.05）。ROC曲线分析结果显示，血清miR-125a-3p、MMP-9联合预测老年T2DM患者CAS的曲线下面积大于二者单独预测(0.864比0.799、0.796)。结论 老年T2DM患者血清miR-125a-3p、MMP-9水平升高与CAS密切相关，可能成为T2DM患者CAS的辅助预测指标。

• Objective To investigate the relationship between serum microRNA-125a-3p (miR-125a-3p), matrix metalloproteinase 9 (MMP-9) levels and carotid atherosclerosis (CAS) in elderly patients with type 2 diabetes mellitus (T2DM). Methods Totally 200 elderly patients with T2DM admitted to Inner Mongolia Autonomous Region People′s Hospital from April 2020 to May 2023 (T2DM group) were selected. Patients were divided into CAS subgroup and non CAS subgroup according to carotid intima-media thickness (CIMT), and another 45 physically healthy elderly individuals were selected during the same period (control group). Clinical data of T2DM patients were collected and serum miR-125a-3p and MMP-9 levels of the subjects were measured. The correlation of serum miR-125a-3p and MMP-9 levels with CIMT, fasting blood glucose, glycosylated hemoglobin (HbA1c), triglycerides and low-density lipoprotein cholesterol (LDL-C) in T2DM patients was analyzed. Multivariate Logistic regression was used to analyze the factors influencing CAS in T2DM patients, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum miR-125a-3p and MMP-9 levels on CAS in T2DM patients. Results Compared with the control group, the serum levels of miR-125a-3p and MMP-9 in T2DM group were higher［(1.58±0.30) vs (1.09±0.22), (24±8)μg/L vs (14±5)μg/L］ (both P＜0.001). Among 200 T2DM patients, 137 patients had CIMT ≥1.0 mm, and the incidence of CAS was 68.5%(137/200). The levels of miR-125a-3p and MMP-9 in the CAS subgroup were higher than those in the non CAS subgroup (all P＜0.05). The serum miR-125a-3p level in T2DM patients were positively correlated with MMP-9 (r=0.778, P＜0.001), and both were positively correlated with CIMT, fasting blood glucose, HbA1c, triacylglycerol, and LDL-C (all P＜0.001). The results of multivariate Logistic regression analysis showed that dyslipidemia, prolonged course of disease, and elevated HbA1c, LDL-C, miR-125a-3p, and MMP-9 were independent risk factors for CAS in T2DM patients (all P＜0.05). The ROC curve analysis results showed that the combined prediction of serum miR-125a-3p and MMP-9 levels for CAS in elderly T2DM patients had a larger area under the curve compared to their individual predictions (0.864 vs 0.799, 0.796). Conclusion Elevated serum miR-125a-3p and MMP-9 levels in T2DM elderly patients are closely associated with CAS and may be secondary predictors of CAS in T2DM patients.