miRNA-146a SNP及表达水平与急性STEMI患者诊断及预后的关系

刘巧志; 薛同能; 肖圣珏; 吴奇; 潘德锋; 朱红

doi:10.13201/j.issn.1001-1439.2021.11.007

miRNA-146a SNP及表达水平与急性STEMI患者诊断及预后的关系

- 1. 徐州医科大学附属医院心内科(江苏徐州, 221000);
- 2. 淮安市第一人民医院心内科
基金项目:
江苏省徐州市科技项目(No:KC20097)

详细信息

通讯作者: 朱红,E-mail:hongzhumao@sohu.com

中图分类号: R542.2

收稿日期: 2021-06-30

Correlation of miRNA-146a SNP and its expression with the diagnosis and prognosis of patients with acute STEMI

- 1. Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, China;
- 2. Department of Cardiology, Huai'an First People's Hospital

More Information

Corresponding author: ZHU Hong, E-mail: hongzhumao@sohu.com

Received Date: 30 June 2021

摘要

摘要: 目的:观察急性ST段抬高型心肌梗死(STEMI)患者血浆miRNA-146a rs2910164单核苷酸多态性(SNP)的分布特征及其与miRNA-146a表达水平的关系。方法:选取急性STEMI患者92例和正常对照组100例,在入院即刻检测两组miRNA-146a rs2910164基因的多态性及表达水平,观察两组人群中miRNA-146a基因多态性的分布特征,miRNA-146a表达水平在两组人群中的差异以及基因多态性与血浆中miRNA-146a表达水平的关系;用受试者工作特征(ROC)曲线评估患者入院即刻血浆miRNA-146a表达水平对急性STEMI患者的诊断价值;随访急性STEMI患者住院期间及出院后28个月内主要心血管不良事件(MACE)的发生情况;应用中位数分组法将92例急性STEMI患者的miRNA-146a表达水平分为高表达组和低表达组,采用Kaplan-Meier法分析miRNA-146a不同表达水平患者的MACE发生率,应用多因素Cox回归模型计算风险比(HR)及其95%置信区间(CI)。结果:与正常对照组相比,CC+GC基因型在急性STEMI患者中更常见,且CC+GC基因型携带者比非携带者罹患急性STEMI的风险高3.189倍(OR=3.189,95%CI1.450~7.015,P=0.004);急性STEMI组miRNA-146a表达水平明显高于正常对照组(P<0.001);入院即刻血浆miRNA-146a表达水平对于诊断急性STEMI的ROC曲线下面积为0.742;miRNA-146a高表达组患者MACE发生率明显高于低表达组(Log rank:P=0.001);miRNA-146a表达水平是急性STEMI患者MACE发生的独立危险因素(HR=2.712,95%CI1.450~5.072,P=0.002)。结论:血浆miRNA-146a基因型在两组人群中分布存在差异,与GG基因型相比,携带CC+GC基因型的人群罹患急性STEMI的可能性更大;急性STEMI患者血液中miRNA-146a表达水平明显高于正常人,且携带CC、GC基因型的患者miRNA-146a表达水平较携带GG基因型高;血浆miRNA-146a有可作为早期诊断急性STEMI的生物标志物,其表达水平的高低与急性STEMI患者预后相关。
- 急性ST段抬高型心肌梗死 /
- 血浆微小RNA-146a /
- 基因多态性 /
- 表达水平 /
- 预后
Abstract: Objective: To observe the distribution characteristics of plasma microRNA-146 a(miRNA-146 a) rs2910164 single nucleotide polymorphism(SNP) and the expression of miR-146 a in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods: Our research included in two groups: acute STEMI group(n=92) and normal control group(n=100). The polymorphism and expression of miRNA-146 a rs2910164 gene were detected immediately after admission, and the distribution characteristics of miRNA-146 a gene polymorphism were observed. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of plasma miRNA-146 a expression level immediately after admission for acute STEMI. The incidence of major cardiovascular adverse events(MACE) was followed up for 28 months after hospitalization and discharge. The miRNA-146 a expression level in 92 patients with acute STEMI was divided into high expression group and low expression group by median grouping method. The Incidence of MACE in patients with different expression levels of miRNA-146 a was analyzed by Kaplan-Meier method. The multivariate Cox regression model was used to calculate the risk ratio(HR) and its 95% confidence interval(CI).Results: CC+GC genotypes were increased in patients with acute STEMI than normal controls, and carriers of CC+GC genotypes had a 3.189-fold higher risk(OR=3.189, 95%CI: 1.450-7.015, P=0.004). The expression level of miRNA-146 a in acute STEMI group was significantly higher than that in normal control group(P=0.0001). The area under the ROC curve was 0.742 in plasma miRNA-146 a expression level for the diagnosis of acute STEMI immediately after admission. The incidence of MACE in patients with high miRNA-146 a expression was significantly higher than that in patients with low miRNA-146 a expression(Log rank: P=0.001). miRNA-146 a expression level was an independent risk factor for MACE in acute STEMI patients(HR=2.712, 95%CI: 1.450-5.072, P=0.002).Conclusion: The distribution of plasma miRNA-146 a genotype was different between the two groups. Compared with the GG genotype, the population carrying CC+GC genotype was more likely to suffer from acute STEMI. The expression level of miRNA-146 a in blood of patients with acute STEMI was significantly higher than that of normal controls, and the expression level of miRNA-146 a in patients with CC and GC genotypes was higher than that of patients with GG genotype. Plasma miRNA-146 a may be used as a biomarker for early diagnosis of acute STEMI, and the level of its expression is correlated with the prognosis of patients with acute STEMI.
- acute ST segment elevation myocardial infarction /
- miRNA-146a /
- SNP /
- expression /
- prognosis

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