血清3′端2′-O-甲基化修饰的miR-486-5p诊断冠心病的临床价值  

Clinical value of serum 3′-terminal 2′-O-methylated miR-486-5p assessment for the diagnosis of coronary heart disease

作　　者：张乐乐 吴嘉 王成 母迷迷 张钰[1] 汪俊军 Zhang Lele;Wu Jia;Wang Cheng;Mu Mimi;Zhang Yu;Wang Junjun(Department of Clinical Laboratory,Southeast University School of Medicine,General Hospital of the Eastern Theater of the Chinese People′s Liberation Army,Nanjing 210002,China)

机构地区：[1]东南大学医学院东部战区总医院检验科,南京210002

出　　处：《中华检验医学杂志》2024年第7期798-805,共8页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金(82172360,81871702)。

摘　　要：目的:检测冠心病患者血清中3′端2′-O-甲基化(2′-O-methylation,2′Ome)修饰的微小RNA-486-5p(miR-486-5p)水平的变化,评估其作为辅助诊断冠心病生物标志物的临床应用价值。方法:选取2021年1月至2022年12月于东部战区总医院确诊的冠心病患者70例及同期年龄、性别匹配的健康体检者60例进行回顾性病例对照研究。根据冠状动脉造影结果计算Gensini积分,将冠心病组分为轻中度狭窄(40例)和重度狭窄亚组(30例)。比较冠心病组及健康对照组的血清生化指标、miR-486-5p及2′Ome-miR-486-5p表达水平;采用Spearman相关性分析生化指标、Gensini积分与血清miR-486-5p及2′Ome-miR-486-5p水平的相关性;多因素Logistic回归分析血清miR-486-5p及2′Ome-miR-486-5p的水平对冠心病及冠状动脉狭窄程度的影响;采用受试者工作特征(ROC)曲线评价2′Ome-miR-486-5p水平对冠心病及冠状动脉狭窄程度的诊断价值。结果:冠心病组血清miR-486-5p和2′Ome-miR-486-5p水平高于健康对照组[0.31(0.17,0.84)比0.21(0.11,0.49),Z=2.055,P<0.05;2.30(1.32,5.40)比0.86(0.55,1.72),Z=5.840,P<0.05];轻中度和重度狭窄亚组血清2′Ome-miR-486-5p表达水平均高于健康对照组(P均<0.05),且重度狭窄亚组中血清2′Ome-miR-486-5p水平高于轻中度狭窄亚组[3.54(1.78,5.44)比1.63(1.25,4.07),Z=-2.053,P<0.05]。血清miR-486-5p和2′Ome-miR-486-5p水平均与Gensini评分呈正相关(r=0.277、0.479,P均<0.05);多因素Logistic回归分析显示,在校正了年龄、性别等混杂因素的影响后,血清2′Ome-miR-486-5p水平是冠状动脉狭窄程度的独立影响因素(OR=1.025,95%CI 1.002~1.049,P<0.05)。ROC曲线分析显示,血清2′Ome-miR-486-5p水平诊断冠心病、冠状动脉轻中度和重度狭窄的ROC曲线下面积分别为0.798、0.752和0.859,在最佳截断值为0.912、0.863和2.209时,敏感度分别为91.4%、92.5%和73.3%,特异度分别为56.7%、51.7%和81.7%。结论:冠心病患者血清2′Ome-miR-486Objective To detect the 3′-terminal 2′-O-methylation(2′Ome)modified microRNA-486-5p(miR-486-5p)levels in the serum of patients with coronary heart disease(CHD),and evaluate its clinical application value as a biomarker to assist the diagnosis of CHD.Methods Seventy patients with CHD diagnosed at the Eastern Theater General Hospital from January 2021 to December 2022 and 60 age-and sex-matched healthy people undergoing health examination during the same period were selected for this retrospective case-control study.The Gensini score was calculated based on coronary angiography results,and patients in the coronary artery disease group was categorized into mild-to-moderate stenosis(40 cases)and severe stenosis subgroups(30 cases);Serum biochemical indexes,miR-486-5p and 2′Ome-miR-486-5p expression levels were compared between the CHD group and the healthy control group;correlation of biochemical indices,Gensini score and serum miR-486-5p and 2′Ome-miR-486-5p levels was assessed by using Spearman correlation analysis;and multifactorial logistic regression was used to analyze the impact of serum miR-486-5p and 2′Ome-miR-486-5p levels on CHD and the degree of coronary artery stenosis;evaluation of the diagnostic value of 2′Ome-miR-486-5p levels on the degree of coronary artery disease and coronary artery stenosis was achieved by using ROC curve.Results Serum miR-486-5p and 2′Ome-miR-486-5p levels were significantly higher in CHD group than in the healthy control group[0.31(0.17,0.84)vs 0.21(0.11,0.49),Z=2.055,P<0.05;2.30(1.32,5.40)vs 0.86(0.55,1.72),Z=5.840,P<0.05];Serum 2′Ome-miR-486-5p expression levels were higher in both mild-moderate and severe stenosis subgroups than in healthy controls(P<0.05),and serum 2′Ome-miR-486-5p levels were higher in the severe stenosis subgroup than in the mild-moderate stenosis subgroup[3.54(1.78,5.44)vs 1.63(1.25,4.07),Z=-2.053,P<0.05].Both serum miR-486-5p and 2′Ome-miR-486-5p levels were positively correlated with the Gensini score(r=0.277 and 0.479,respectivel

关 键 词：动脉粥样硬化 心血管疾病 甲基化 微RNA 生物标志物 

分 类 号：R541.4[医药卫生—心血管疾病] R446.11[医药卫生—内科学]