糖尿病大血管病变

　　【摘要】 目的探讨糖尿病心血管并发症与血浆中miR-21、胱抑素C(Cys-c)表达的关系。方法选取T2DM患者148例，根据诊断结果，分为T2DM+心血管疾病组(T2DM+CVD)和单纯T2DM组(T2DM)，另选取健康体检者作为NC组。检测各组血清中Cys-C等相关因子，RT-PCR测定血浆中miR-21含量。结果 两组Cys-C水平差异有统计学意义(P<0.05)。RT-PCR检测结果显示，NC组miR-21表达量均高于其他两组。Cys-C、miR-21联合检测结果显示，其敏感性为89.6%(60/67)，阳性预测值为81.1%(61/74)，特异性为82.7%(67/81)，阴性预测值为90.5%(67/74)。相关分析结果显示，T2DM心血管并发症与Cys-C呈正相关，与miR-21呈负相关。结论 T2DM心血管并发症与Cys-C、miR-21有相关性，Cys-C与miR-21联合检测能提高临床对于T2DM心血管并发症的敏感性和特异性。

　　【关键词】 糖尿病心血管并发症;miR-21;胱抑素C;相关性

　　【Abstract】 Objective To investigate the correlation of the levels of cystatin C (Cys-C)and the expression of miR-21 with cardiovascular complications in patients with type 2 diabetes (T2DM). Methods 148 cases of diabetes were divided into diabetes with cardiovascular complications (T2DM+CVD group) and without complications (T2DM group).76 healthy volunteers served as normal controls (NC group). Serum Cys-C and other relevant factors were measured. The levels of plasma miR- 21 were determined by reverse transcription polymerase chain reaction (RT-PCR). Results There was significant difference in the level of serum Cys-C between T2DM+CVD group and T2DM group (P<0.05). RT-PCR showed the expressions of miR-21were higher in NC group than those in T2DM group and T2DM+CVD group. The diagnostic sensitivity and specificity of the combination assay of Cys-C and miR-21 were 89.6% (60/67) and 82.7% (67/81), respectively; with the positive predictive value of 81.1% (61/74) and negative predictive value of 90.5% (67/74), respectively. Diabetic cardiovascular complications were positively associated with serum Cys-C, and negatively associated with miR-21. Conclusion The association of diabetic cardiovascular complications and Cys-C and miR-21 suggested that the combination assay of Cys-C and miR-21 can improve the clinical diagnostic values.

　　【Key words】 Cardiovascular complications; Diabetes, type 2; miR-21; Cystatin C(Cyc-s)