目的:探讨2型糖尿病(T2DM)患者血清let-7、微小RNA-26b(miR-26b)表达水平及与胰岛素抵抗(IR)的关系。方法:选取2018年3月至2019年3月本院内分泌科收治的60例初诊T2DM患者作为T2DM组，及同期本院70例健康体检者作为对照组。收集两组受试者临床资料，使用实时荧光定量PCR(qRT-PCR)法测定血清let-7、miR-26b表达水平；观察T2DM患者血清let-7、miR-26b表达水平及其与其他临床指标相关性，并采用ROC曲线分析血清let-7、miR-26b表达水平对T2DM患者发生IR的预测价值。结果:T2DM组患者总胆固醇(TC)、甘油三酯(TG)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、空腹胰岛素(FINS)及稳态模型评估的胰岛素抵抗指数(HOMA-IR)均显著高于对照组(n P<0.05)，胰岛素敏感性指数(ISI)、稳态模型评估的胰岛素β细胞功能指数(HOMA-β)均明显低于对照组(n P<0.05)。T2DM组患者血清let-7、miR-26b表达水平均明显低于对照组(n P<0.05)。T2DM组患者血清let-7、miR-26b表达水平与TC、TG、HbA1c、FPG、FINS及HOMA-IR均呈负相关(n P<0.05)，与ISI、HOMA-β均呈正相关(n P<0.05)。ISI、HOMA-IR及血清let-7、miR-26b表达水平均是影响T2DM患者发生IR的独立危险因子(n P<0.05)。血清let-7表达水平预测T2DM患者发生IR的曲线下面积(AUC)为0.858，最佳截断值为0.73，灵敏度和特异度分别为77.50%、80.00%；血清miR-26b表达水平预测T2DM患者发生IR的AUC为0.908，最佳截断值为0.60，灵敏度为80.00%，特异度高达92.50%。n 结论:T2DM患者血清let-7、miR-26b表达水平均显著下调，两者可能共同参与IR发生、发展，对T2DM患者发生IR均具有一定预测价值，且miR-26b预测效果更优。“,”Objective:To investigate the expressions of let-7 and microRNA-26b (miR-26b) in serum of patients with type 2 diabetes mellitus (T2DM) and their relationships with insulin resistance (IR).Methods:60 newly diagnosed patients with T2DM from March 2018 to March 2019 were selected as the T2DM group, and 70 healthy people in the same period were selected as the control group. The clinical data of the two groups were collected and the expression levels of let-7 and miR-26b in serum were measured by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR), the expression levels of let-7 and miR-26b in serum of patients with T2DM and their correlations with other clinical indicators were observed, and the receiver operating characteristic (ROC) curve was used to analyze the predictive values of let-7 and miR-26b levels in serum for IR in patients with T2DM.Results:Total cholesterol (TC), triglyceride (TG), glycosylated hemoglobin (HbA1c), fasting blood glucose (FPG), fasting insulin (FINS) and homeostasis model assessment of insulin resistance (HOMA-IR) in the T2DM group were significantly higher than those in the control group (n P<0.05), while insulin sensitivity index (ISI) and homeostasis model assessment of β cell function (HOMA-β) were significantly lower than those in the control group (n P<0.05). The serum levels of let-7 and miR-26b in patients in T2DM group were significantly lower than those in the control group (n P<0.05). The serum levels of let-7 and miR-26b in patients in T2DM group were negatively correlated with TC, TG, HbA1c, FPG, FINS and HOMA-IR (n P<0.05), and positively correlated with ISI and HOMA-β (n P<0.05). ISI, HOMA-IR and the serum levels of let-7 and miR-26b were independent risk factors for IR in patients with T2DM (n P<0.05). The area under curve (AUC) of serum let-7 expression predicting IR in patients with T2DM was 0.858, and the best cut-off value was 0.73, with sensitivity and specificity 77.50% and 80.00% respectively. The AUC of miR-26b in serum predicted the occurrence of IR in patients with T2DM was 0.908, and the best cut-off value was 0.60, with sensitivity and specificity 80.00% and 92.50%.n Conclusions:The expression levels of let-7 and miR-26b in serum of patients with T2DM are significantly decreased, both of them may participate in the occurrence and development of IR, and have certain predictive value for the occurrence of IR in patients with T2DM, while miR-26b is more effective.