外周血microRNA-146a的表达与糖尿病周围神经病变的关系  

Relationship between the expression of microRNA-146a in peripheral blood and diabetic peripheral neuropathy

作　　者：洪盈盈 赵晓宏[1] 周庆元[1] 柳围堤[1] 薛开禄 

机构地区：[1]西安交通大学医学院附属3201医院内分泌科,723000

出　　处：《国际内分泌代谢杂志》2018年第1期6-9,14,共5页International Journal of Endocrinology and Metabolism

摘　　要：目的 分析外周血microRNA-146a（miR-146a）表达水平与糖尿病周围神经病变（DPN）的关系.方法 回顾性分析2015年5月-2016年7月西安交通大学医学院附属3201医院内分泌科收治的90例2型糖尿病（T2DM）患者的临床资料,分为T2DM合并DPN组（42例）与T2DM组（48例）.所有患者入院后均采集外周血标本,测定外周血单核细胞（PBMCs）中miR-146a的表达水平,并收集其基线资料情况.测定患者右侧腓神经运动神经传导速度（MCV）、感觉神经传导速度（SCV）,计算密歇根糖尿病神经病变评分（MNSI）.采用Pearson相关性分析法探讨各指标与miR-146a表达的相关性,采用logistic回归分析研究miR-146a表达的影响因素,应用受试者工作特征（ROC）曲线下面积（AUC）探讨miR-146a对T2DM发生DPN的预测价值.结果 与T2DM组相比,T2DM合并DPN组病程长,HbA1c、尿白蛋白/肌酐比值（UAlb/Cr）升高,而腓神经MCV、SCV、MNSI以及miR-146a表达水平降低（t=3.586～15.143,P均＜0.05）.miR-146a水平与病程、空腹血糖、HbA1c、MNSI呈负相关（r=-0.531、-0.621、-0.551、-0.662,P均＜0.05）,与MCV、SCV呈正相关（r=0.791、0.622,P均＜0.05）. MCV（OR=1.198,95％CI：1.021 ～1.398,P ＜0.05）、SCV（OR=2.851,95％ CI：1.551 ～5.261,P＜0.05）是影响miR-146a表达的独立危险因素,病程（OR =0.162,95％ CI：0.081 ～0.264,P＜0.05）、MNSI（OR=0.416,95％ CI：0.071～0.456,P＜0.05）为其保护因素.miR-146a预测DPN的敏感性为83.91％,特异性为62.12％ （95％ CI：0.567 ～0.841,P =0.008）.结论 T2DM合并DPN患者外周血miR-146a表达水平较低,且SCV、MCV为影响miR-146a表达的独立危险因素,同时miR-146a对T2DM患者DPN的发生有较高的预测价值.Objective To analyze the relationship between the expression of microRNA-146a （miR-146a） in peripheral blood and diabetic peripheral neuropathy （DPN）.Methods The clinical data of 90 patients with type 2 diabetes mellitus （T2DM） treated in the Department of Endocrinology of the 3201 Hospital affiliated to Medical College of Xi＇an Jiaotong University from May 2015 to July 2016 were retrospectively analyzed.The patients were divided into T2DM with DPN group （n =42） and T2DM group （n =48）.Peripheral blood of all patients were collected to test the expression of miR-146a in peripheral blood mononuclear cells （PBMCs）.The baseline data were collected.The motor nerve conduction velocity （MCV） and sensory nerve conduction velocity （SCV） of right peroneal nerve were tested,and the Michigan diabetic neuropathy score （MNSI） were calculated.The relationship between each index and miR-146a expression were explored by Pearson correlation analysis.Logistic regression analysis was used to study the influencing factors of miR-146a expression.The area under the receiver operating curve （ROC） was used to investigate the predictive value of miR-146a in the development of DPN in T2DM.Results Compared with T2DM group,the course of disease was longer,the level of HbA1c and urinary albumin/creatinine ratio were high-er,the MCV and SCV of peroneal nerve and MNSI as well as the expression of miR-146 were lower in T2DM with DPN group （t =3.586-15.143,all P ＜ 0.05）.The expression of miR-146a was negatively correlated with course of disease,fasting blood glucose,HbA1 c,MNSI （r =-0.531,-0.621,-0.551,-0.662,all P ＜ 0.05）,and was positively correlated with MCV and SCV （r =0.791,0.622,all P ＜ 0.05）.The MCV （OR =1.198,95％CI：1.021-1.398,P ＜0.05）and SCV（OR =2.851,95％ CI：1.551-5.261,P ＜0.05） were independent risk factors of the expression of miR-146a,while the course of disease （OR =0.162,95％ CI：0.081-0.264,P ＜0.05） and MNSI （OR =0.416,95％ CI：0.071-0.456,P

关 键 词：2型糖尿病 糖尿病周围神经病变 microRNA-146a 

分 类 号：R587.2[医药卫生—内分泌]