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目的探讨外周血单个核细胞(PBMCs)中miR-146a在T2DM合并周围神经病变(DPN)患者中的表达情况,及对DPN的诊断价值。方法根据是否合并DPN,将80例T2DM患者分为T2DM不伴DPN(T2DM)组36例和T2DM伴DPN(DPN)组44例。采用RT-PCR检测两组PBMCs miR-146a的表达水平,绘制受试者工作特征(ROC)曲线评价PBMCs中miR-146a对DPN的诊断价值,同时将miR-146a表达量与临床指标行相关性分析。结果 DPN组miR-146a表达水平低于T2DM组[(1.21±0.33)vs(2.51±0.32),P<0.05]。根据PBMCs中miR-146a表达水平绘制ROC曲线,得出ROC曲线下面积(AUC)为(0.704±0.069),敏感性83.8%,特异性61.9%(95%CI:0.568~0.840,P=0。009)。Pearson相关性分析显示,miR-146a的表达水平与病程、密歇根神经病变评分(MNSI)、多伦多临床评分系统(TCSS)、FPG呈负相关,与神经传导速度呈正相关(P<0.05)。结论外周血miR-146a可作为DPN的潜在分子标志物之一,有助于DPN的早期诊断。
Objective To investigate the expression of miR-146a in peripheral blood mononuclear cells (PBMCs) in patients with T2DM complicated with peripheral neuropathy (DPN) and the diagnostic value of DPN. Methods According to whether or not DPN was combined, 80 patients with T2DM were divided into two groups: 36 patients with T2DM without DPN (T2DM) and 44 patients with T2DM with DPN (DPN). The expression of miR-146a in two groups of PBMCs was detected by RT-PCR. The ROC curve was plotted to evaluate the diagnostic value of miR-146a in PBMCs for DPN. Meanwhile, the correlation between the expression level of miR-146a and clinical indexes analysis. Results The expression of miR-146a in DPN group was lower than that in T2DM group [(1.21 ± 0.33) vs (2.51 ± 0.32), P <0.05]. According to the ROC curve of miR-146a expression level in PBMCs, the area under the ROC curve (AUC) was (0.704 ± 0.069), the sensitivity was 83.8% and the specificity was 61.9% (95% CI: 0.568-0.840, P = 009). Pearson correlation analysis showed that the expression of miR-146a was negatively correlated with the course of disease, MNSI, TCSS and FPG, and positively correlated with nerve conduction velocity (P <0.05). Conclusion Peripheral blood miR-146a can be used as one of potential molecular markers of DPN, which is helpful for the early diagnosis of DPN.