miRNA-122在冠心病合并非酒精性脂肪性肝病患者血清中的表达以及临床意义  

Expression and clinical significance of miRNA-122 in serum of coronary heart disease patients with nonalcoholic fatty liver disease

作　　者：努尔麦麦提·叶尔逊[1] 地力夏提·阿不都热合曼 梁灿灿[1] Nuermaimaiti Yeersun;Dilixiati Abudureheman;Liang Cancan(Digestive department,The Second Affiliated Hospital of Xinjiang Medical University,State Key Laboratory of Pathogenesis,Prevention and Treatment of High Incidence Diseases in Central Asia(Urumqi,830000),China)

机构地区：[1]省部共建中亚高发病成因与防治国家重点实验室,新疆医科大学第二附属医院消化内科,新疆乌鲁木齐8300002 [2]省部共建中亚高发病成因与防治国家重点实验室,新疆医科大学第一附属医院血管甲状腺外科

出　　处：《中西医结合肝病杂志》2024年第3期225-229,共5页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题(No.SKL-HIDCA-2021-EF2)。

摘　　要：目的:探讨miRNA-122在冠心病合并非酒精性脂肪性肝病(NAFLD)患者血清中的表达以及临床意义。方法:选取2021年1月至2022年12月在我院就诊的200例冠心病患者作为研究对象,按是否合并NAFLD分为单纯冠心病组100例和冠心病合并NAFLD组100例,比较两组患者一般临床资料以及血清miRNA-122表达水平,多因素Logistic回归分析获得影响冠心病患者合并NAFLD的独立预测因素,重点分析miRNA-122与冠心病合并NAFLD的相关性,并构建相关列线图模型,按冠心病合并NAFLD患者miRNA-122的中位数将100例冠心病合并NAFLD患者划分为高miRNA-122组62例(62.0%)和低miRNA-122组38例(38.0%),分析冠心病合并NAFLD患者miRNA-122与临床指标的相关性。结果:多因素Logistic回归分析结果显示,SYNTAX评分、胰岛素抵抗指数(HOMA-IR)以及miRNA-122为影响冠心病患者合并NAFLD的独立预测因素(P<0.05),基于多因素分析获得的3个独立预测因素:SYNTAX评分、HOMA-IR以及miRNA-122,构建冠心病患者合并NAFLD的列线图模型;列线图模型的校准曲线显示,冠心病患者合并NAFLD概率的预测值与实际观测值符合度良好(P>0.05),ROC分析结果显示,SYNTAX评分、HOMA-IR以及miRNA-122预测冠心病患者合并NAFLD的曲线下面积(AUC)分别为0.775(95%CI:0.721~0.856)、0.752(95%CI:0.711~0.813)以及0.822(95%CI:0.784~0.873),3者联合预测的AUC最大为0.918(95%CI:0.878~0.959);低miRNA-122组患者甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、肝脏硬度、SYNTAX评分、C反应蛋白(CRP)以及HOMA-IR明显高于高miRNA-122组(P<0.05)。结论:基于SYNTAX评分、HOMA-IR以及miRNA-122构建的列线图模型对于冠心病患者合并NAFLD具有较高的预测价值,冠心病合并NAFLD患者中血清miRNA-122表达水平较低者,其肝纤维化和冠状动脉粥样硬化病变程度较重。Objective:To investigate the expression and clinical significance of miRNA-122 in the serum of coronary heart disease patients with nonalcoholic fatty liver disease(NAFLD).Methods:200 coronary heart disease patients who were treated in our hospital from January 2021 to December 2022 were selected as the study subjects.They were divided into 100 coronary heart disease patients(50.0%)and 100 coronary heart disease patients combined with NAFLD(50.0%)according to whether they were combined with NAFLD.The general clinical data and the expression level of miRNA-122 of patients between the two groups were compared.The independent predictive factors affecting the combination of NAFLD in coronary heart disease patients were obtained by multivariate logistic regression analysis.Focusing on the analysis of the correlation between miRNA-122 and NAFLD in coronary heart disease patients,the relevant nomogram model was established.About 100 coronary heart disease patients with NAFLD were divided into high miRNA-122 group(62%)and low miRNA-122 group(38%)according to the median of miRNA-122 in coronary heart disease patients with NAFLD.The correlation between miRNA-122 and clinical indicators in coronary heart disease patients with NAFLD was analyzed.Results:Multivariate logistic regression analysis showed that SYNTAX score,HOMA-IR and miRNA-122 were independent predictors in coronary heart disease patients with NAFLD(P<0.05).A nomograph model of coronary heart disease patients with NAFLD was constructed based on three independent predictors obtained from multivariate analysis:SYNTAX score,HOMA-IR and miRNA-122.The calibration curve of the nomograph model showed that the predicted value of the probability in coronary heart disease patients with NAFLD was in good agreement with the actual observation value(P>0.05).The ROC analysis results showed that the area under the curve(AUC)of SYNTAX score,HOMA-IR and miRNA-122 predicting coronary heart disease patients with NAFLD were 0.775(95%CI:0.721~0.856),0.752(95%CI:0.711~0.813)and 0.82

关 键 词：冠心病 非酒精性脂肪性肝病 miRNA-122 

分 类 号：R575[医药卫生—消化系统]