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2型糖尿病合并血脂异常患者血浆微小RNA33b检测的临床意义

Clinical Significance of Determining Plasma MicroRNA33b in Type 2 Diabetic Patients with Dyslipidemia.

作者信息

Kimura Yuki, Tamasawa Naoki, Matsumura Koki, Murakami Hiroshi, Yamashita Maki, Matsuki Kota, Tanabe Jutaro, Murakami Hiroshi, Matsui Jun, Daimon Makoto

机构信息

Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine.

出版信息

J Atheroscler Thromb. 2016 Nov 1;23(11):1276-1285. doi: 10.5551/jat.33670. Epub 2016 Jun 15.

Abstract

AIM

Sterol regulatory element-binding protein (SREBP)-1c is the dominant liver insulin-stimulated isoform and strongly correlates with diabetic dyslipidemia characterized by hyperinsulinemia [i.e., high-density lipoprotein cholesterol (HDL-C) levels and hypertriglyceridemia]. MicroRNA (miRNA) 33b is harbored in the intron of SREBP-1c and represses ATP-binding cassette, sub-family A, and member 1 (ABCA1) expression, essential for HDL formation. We measured plasma miRNA33b levels as possible biomarkers for diabetic dyslipidemia in patients with type 2 diabetes mellitus (T2DM) showing insulin resistance.

METHODS

The participants included 50 patients with T2DM (M/F 31/19) enrolled in an educational program for controlling blood glucose levels at Hirosaki University Hospital. HbA1c, fasting plasma glucose, insulin, and lipid levels were determined. Plasma miRNA33b, miRNA33a and miRNA148a were quantified using a TaqMan MicroRNA Assay, and values were corrected with reference to miRNA16.

RESULTS

Mean BMI of participants were 28.2±6.6 (kg/m) and the Homeostasis Model Assessment of Insulin Resistance was 4.3±2.7. Patients' laboratory findings indicated diabetic dyslipidemia with insulin resistance. Plasma miRNA33b/16 levels revealed a positive correlation with plasma insulin level (r=0.326, P=0.021), serum C-peptide (r=0.280, P=0.049), and triglyceride (r=0.351, P=0.012), but no association with HDL-C (r=-0.210, P=0.143). The blood level of miRNA33a was approximately 1/150th of that of miRNA33b and was not correlated with the above parameters.

CONCLUSION

We postulated that plasma miRNA33b may be useful as a new metabolic biomarker of dyslipidemia in patients with T2DM as well as metabolic syndrome via an insulin/SREBP-1c/miRNA33b/ABCA1 pathway.

摘要

目的

固醇调节元件结合蛋白(SREBP)-1c是肝脏中受胰岛素刺激的主要亚型,与以高胰岛素血症为特征的糖尿病血脂异常密切相关[即高密度脂蛋白胆固醇(HDL-C)水平和高甘油三酯血症]。微小RNA(miRNA)33b位于SREBP-1c的内含子中,可抑制ATP结合盒A亚家族成员1(ABCA1)的表达,而ABCA1对HDL的形成至关重要。我们测量了2型糖尿病(T2DM)合并胰岛素抵抗患者血浆miRNA33b水平,将其作为糖尿病血脂异常的潜在生物标志物。

方法

研究对象包括50例在弘前大学医院参加血糖控制教育项目的T2DM患者(男/女=31/19)。测定糖化血红蛋白、空腹血糖、胰岛素和血脂水平。采用TaqMan微小RNA检测法对血浆miRNA33b、miRNA33a和miRNA148a进行定量,并以miRNA16作为参照进行校正。

结果

参与者的平均体重指数为28.2±6.6(kg/m²),胰岛素抵抗的稳态模型评估值为4.3±2.7。患者的实验室检查结果显示存在伴有胰岛素抵抗的糖尿病血脂异常。血浆miRNA33b/16水平与血浆胰岛素水平(r=0.326,P=0.021)、血清C肽(r=0.280,P=0.049)和甘油三酯(r=0.351,P=0.012)呈正相关,但与HDL-C无相关性(r=-0.210,P=0.143)。miRNA33a的血药浓度约为miRNA33b的1/150,且与上述参数无相关性。

结论

我们推测,血浆miRNA33b可能通过胰岛素/SREBP-1c/miRNA33b/ABCA1途径,作为T2DM患者以及代谢综合征患者血脂异常的一种新的代谢生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b770/5113745/2e9253ef1906/jat-23-1276-g002.jpg

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