血清微小RNA-21与2型糖尿病合并非酒精性脂肪性肝病的相关性研究  

Association between serum microRNA-21 and non-alcoholic fatty liver disease in type 2 diabetes mellitus

作　　者：张洋洋 吕亚亚 左玉琼[3] 陈倩 权金星[2] 刘静[2] 刘菊香[2] Zhang Yangyang;Lyu Yaya;Zuo Yuqiong;Chen Qian;Quan Jinxing;Liu Jing;Liu Juxiang(Clinical Medical College,Ningxia Medical University,Yinchuan 750000,China;Department of Endocrinology,Gansu Provincial Hospital,Key Laboratory of Endocrine and Metabolic Diseases of Gansu Province,Lanzhou 730000,China;Department of Medical Record Management,Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]宁夏医科大学临床医学院,银川750000 [2]甘肃省人民医院内分泌科、甘肃省内分泌代谢病重点实验室,兰州730000 [3]甘肃省人民医院病案管理科,兰州730000

出　　处：《中华糖尿病杂志》2024年第2期220-225,共6页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：国家自然科学基金(81960160);甘肃省自然科学基金(20JR5RA155)。

摘　　要：目的探讨血清微小RNA-21(miR-21)与2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)间的相关性。方法为横断面研究。选取2022年8月至2023年6月在甘肃省人民医院内分泌科住院的T2DM患者及同时期该院体检中心年龄、性别和体重指数(BMI)匹配的健康体检者作为研究对象。根据有无NAFLD将T2DM患者分为单纯T2DM组和T2DM合并NAFLD组,同期健康体检者纳入健康对照组。收集所有研究对象的年龄、性别、糖尿病病程、身高、体重,并计算BMI,检测其miR-21、哺乳动物雷帕霉素靶蛋白(mTOR)、高密度脂蛋白胆固醇(HDL-C)、白细胞介素-6(IL-6)、糖化血红蛋白(HbA_(1c))、空腹血糖(FPG)、空腹胰岛素(FINS),并计算稳态模型评估胰岛素抵抗指数(HOMA-IR)。采用单因素方差分析、Kruskal-WallisH检验或χ^(2)检验进行组间比较,采用Spearman相关性分析法分析miR-21水平与各指标间的相关性,采用逐步线性回归分析法分析血清miR-21水平的独立影响因素。结果共纳入研究对象136例,包括T2DM患者91例,健康体检者45例。其中单纯T2DM组45例,T2DM合并NAFLD组46例,健康对照组45例。与健康对照组相比,单纯T2DM与T2DM合并NAFLD组研究对象血清miR-21均降低(P<0.05)。Spearman相关性分析结果显示,调整年龄、性别、糖尿病病程和BMI后,血清miR-21水平与HDL-C、mTOR均呈正相关(r值分别为0.228和0.175,均P<0.05),与HbA_(1c)、FPG、FINS、HOMA-IR、IL-6均呈负相关(r值分别为-0.320、-0.230、-0.178、-0.283和-0.361,均P<0.05)。逐步线性回归结果显示,BMI、HbA_(1c)和IL-6均为血清miR-21水平的独立影响因素(t值分别为2.360、-2.354和-3.188,均P<0.05)。结论血清miR-21水平与T2DM合并NAFLD相关,miR-21水平下调可能与胰岛素抵抗、炎症反应和糖脂代谢途径相关。Objective To explore the relationship between serum microRNA-21(miR-21)and type 2 diabetes mellitus(T2DM)with non-alcoholic fatty liver disease(NAFLD).Methods This cross-sectional study screened patients with T2DM hospitalized in the Department of Endocrinology of Gansu Provincial Hospital and matched healthy individuals from August 2022 to June 2023.T2DM patients were divided into the T2DM alone group and the T2DM combined with NAFLD group based on the presence or absence of NAFLD.Healthy individuals undergoing physical examinations during the same period were included as the healthy control group.Data on age,sex,diabetic duration,height,weight,and body mass index(BMI)were collected.Levels of miR-21,mammalian target of rapamycin(mTOR),high-density lipoprotein-cholesterol(HDL-C),interleukin-6(IL-6),glycated hemoglobin A1c(HbA_(1c)),fasting plasma glucose(FPG),and fasting insulin(FINS)were measured,and the homeostasis model assessment of insulin resistance(HOMA-IR)was calculated.One-way analysis of variance,Kruskal-Wallis H test or χ^(2) test were used for comparisons between groups,Spearman correlation analysis was used to analyze the correlation between miR-21 level and various indicators,and stepwise linear regression analysis was used to analyze the independent influencing factors of serum miR-21 level.Results A total of 136 subjects were enrolled in the study,including 91 T2DM patients and 45 healthy physical examination subjects.Among them,there were 45 cases in the T2DM alone group,46 cases in the T2DM combined with NAFLD group,and 45 cases in the healthy control group.Serum miR-21 levels were reduced in both the T2DM alone and T2DM combined with NAFLD groups compared to the healthy control group(P<0.05).After adjusting for confounding factors,Spearman correlation analysis showed significant positive correlations between miR-21 levels and HDL-C and mTOR levels(r=0.228 and 0.175,respectively,both P<0.05),while negative correlations were observed with HbA_(1c),FPG,FINS,HOMA-IR,and IL-6 levels(r=-0.320,-0.230

关 键 词：糖尿病 2型 非酒精性脂肪性肝病 炎症反应 胰岛素抵抗 微小RNA-21 

分 类 号：R587.1[医药卫生—内分泌] R575.5[医药卫生—内科学]