2024 年第 9 期 第 0 卷

2型糖尿病患者血清微小RNA-155和核苷酸结合寡聚结构域样受体蛋白3水平变化及对颈动脉粥样硬化的诊断价值

Changes of serum microRNA-155 and NOD-like receptor protein 3 levels in patients with type 2 diabetes mellitus and their diagnostic values for carotid atherosclerosis

作者：曾义迦1宋敏2喻虹2

英文作者：Zeng Yijia1 Song Min2 Yu Hong2

单位：1四川大学华西医院健康管理中心，成都610041；2西部战区总医院心内科，成都610000

英文单位：1Health Management Center West China Hospital Sichuan University Chengdu 610041 China; 2Department of Cardiology General Hospital of Western Theater Command Chengdu 610000 China

关键词：2型糖尿病；微小RNA-155；核苷酸结合寡聚结构域样受体蛋白3；颈动脉粥样硬化；诊断价值

英文关键词：Type2diabetesmellitus;MicroRNA-155;NOD-likereceptorprotein3;Carotidatherosclerosis;Diagnostievalue

• 摘要：

• 目的 探讨血清微小RNA（miR）-155、核苷酸结合寡聚结构域样受体蛋白3（NLRP3）水平变化及其对2型糖尿病（T2DM）患者颈动脉粥样硬化（CAS）的诊断价值。方法 选取2021年1月至2023年1月四川大学华西医院收治的T2DM患者142例。根据是否存在CAS分为CAS组（72例）和非CAS组（70例）。收集和比较2组患者的一般资料，检测和比较2组患者血清miR-155和NLRP3水平。采用Pearson相关性分析方法分析T2DM患者血清miR-155与NLRP3水平的相关性。采用多因素Logistic回归方法分析T2DM患者CAS的影响因素。采用受试者工作特征曲线分析血清miR-155、NLRP3水平对T2DM患者CAS的诊断价值。结果 CAS组T2DM病程长于非CAS组，吸烟史比例、糖化血红蛋白、稳态模型胰岛素抵抗指数、miR-155、NLRP3均高于非CAS组（均P＜0.05）。Pearson相关性分析显示T2DM患者血清miR-155与NLRP3水平呈正相关（r＝0.765，P＜0.001）。多因素Logistic回归模型结果显示T2DM病程延长、吸烟史和糖化血红蛋白、稳态模型胰岛素抵抗指数、miR-155、NLRP3升高是影响T2DM患者CAS的独立危险因素（均P＜0.05）。受试者工作特征曲线分析显示血清miR-155、NLRP3水平二者联合诊断T2DM患者CAS的曲线下面积大于血清miR-155、NLRP3水平单独诊断（0.900比0.791、0.799，Z=3.436、3.381，均P=0.001）。结论 血清miR-155、NLRP3水平升高与T2DM患者CAS发生密切相关，血清miR-155、NLRP3水平联合对T2DM患者CAS的诊断价值较高。

• Objective To investigate the changes of serum microRNA-155 (miR-155) and NOD-like receptor protein 3 (NLRP3) levels and their diagnostic values for carotid atherosclerosis (CAS) in patients with type 2 diabetes mellitus (T2DM). Methods A total of 142 patients with T2DM admitted to West China Hospital, Sichuan University from January 2021 to January 2023 were selected. According to the presence or absence of CAS, the patients were divided into CAS group (72 cases) and non-CAS group (70 cases). The general data of the two groups of patients were collected and compared, and the serum levels of miR-155 and NLRP3 were detected and compared between the two groups. Pearson correlation was used to analyze the correlation between serum miR-155 and NLRP3 levels in T2DM patients. Multivariate Logistic regression was used to analyze the influencing factors of CAS in T2DM patients. Receiver operating characteristic curve was used to analyze the diagnostic value of serum miR-155 and NLRP3 levels for CAS in T2DM patients. Results The duration of T2DM in the CAS group was longer than that in the non-CAS group, and the proportion of smoking history, glycosylated hemoglobin, homeostasis model assessment of insulin resistance index, miR-155 and NLRP3 were higher than those in the non-CAS group (all P<0.05). Pearson correlation analysis showed that serum miR-155 levels were positively correlated with NLRP3 levels in T2DM patients (r=0.765, P<0.001). Multivariate Logistic regression model showed that the prolonged duration of T2DM, smoking history, glycosylated hemoglobin, homeostasis model assessment of insulin resistance index, miR-155 and NLRP3 were independent risk factors for CAS in T2DM patients (all P<0.05). Receiver operating characteristic curve analysis showed that the area under the curve of serum miR-155 and NLRP3 levels combined in the diagnosis of CAS in T2DM patients was larger than those of serum miR-155 and NLRP3 levels alone (0.900 vs 0.791, 0.799, Z=3.436, 3.381; both P=0.001). Conclusions The increase of serum miR-155 and NLRP3 levels is closely related to the occurrence of CAS in T2DM patients. The combination of serum miR-155 and NLRP3 levels has a high diagnostic value for CAS in T2DM patients.