Department of Geriatric Cardiology, Hebei General Hospital, Shijiazhuang, Hebei, China.
Hebei Medical University, major in Cardiovascular Medicine, Shijiazhuang, Hebei, China.
Sci Rep. 2020 Mar 17;10(1):4894. doi: 10.1038/s41598-020-61836-z.
Circulating miRNAs have attracted attention as serum biomarkers for several diseases. In this study, we aimed to evaluate the diagnostic value of circulating miRNA-21 (miR-21) as a novel biomarker for elderly patients with type 2 cardiorenal syndrome (CRS-2). A total of 157 elderly patients with chronic heart failure (CHF) were recruited for the study. According to an estimated glomerular filtration rate (eGFR) cut-off of 60 ml/min/1.73 m, 84 patients (53.5%) and 73 patients (46.5%) were assigned to the CRS group and the CHF group, respectively. Expression levels of serum miR-21 and biomarkers for CRS, such as kidney injury factor-1 (KIM-1), neutrophil gelatinase-related apolipoprotein (NGAL), cystatin C (Cys C), amino-terminal pro-B-type natriuretic peptide (NT-proBNP), N-acetyl-κ-D-glucosaminidase (NAG), and heart-type fatty acid-binding protein (H-FABP), were detected. Serum miR-21, KIM-1, NGAL, Cys C, NT-proBNP and H-FABP levels were significantly higher in the CRS group than in the CHF group (P < 0.01), whereas NAG expression was not significantly different between the two groups (P > 0.05). Cys C, H-FABP and eGFR correlated significantly with miR-21 expression, but correlations with miR-21 were not significant for NT-proBNP, NGAL, NAG and KIM-1. Moreover, multivariate logistic regression found that serum miR-21, increased serum Cys C, serum KIM-1, hyperlipidaemia and ejection fraction (EF) were independent influencing factors for CRS (P < 0.05). The AUC of miR-21 based on the receiver operating characteristic (ROC) curve was 0.749, with a sensitivity of 55.95% and a specificity of 84.93%. Furthermore, combining miR-21 with Cys C enhanced the AUC to 0.902, with a sensitivity of 88.1% and a specificity of 83.6% (P < 0.001). Our findings suggest that circulating miR-21 has medium diagnostic value in CRS-2. The combined assessment of miR-21 and Cys C has good clinical value in elderly patients with CRS-2.
循环 miRNA 作为几种疾病的血清生物标志物引起了关注。在这项研究中，我们旨在评估循环 miRNA-21 (miR-21) 作为老年 2 型心肾综合征 (CRS-2) 患者新型生物标志物的诊断价值。总共招募了 157 名老年慢性心力衰竭 (CHF) 患者进行研究。根据估计肾小球滤过率 (eGFR) 截值 60 ml/min/1.73 m，84 名患者 (53.5%) 和 73 名患者 (46.5%) 分别被分配到 CRS 组和 CHF 组。检测血清 miR-21 和 CRS 标志物的表达水平，如肾脏损伤因子-1 (KIM-1)、中性粒细胞明胶酶相关载脂蛋白 (NGAL)、胱抑素 C (Cys C)、氨基末端 pro-B 型利钠肽 (NT-proBNP)、N-乙酰-β-D-氨基葡萄糖苷酶 (NAG) 和心脏型脂肪酸结合蛋白 (H-FABP)。CRS 组血清 miR-21、KIM-1、NGAL、Cys C、NT-proBNP 和 H-FABP 水平明显高于 CHF 组 (P < 0.01)，而两组间 NAG 表达无明显差异 (P > 0.05)。Cys C、H-FABP 和 eGFR 与 miR-21 表达显著相关，但 miR-21 与 NT-proBNP、NGAL、NAG 和 KIM-1 之间无显著相关性。此外，多元逻辑回归发现，血清 miR-21、血清 Cys C 升高、血清 KIM-1、高脂血症和射血分数 (EF) 是 CRS 的独立影响因素 (P < 0.05)。基于受试者工作特征 (ROC) 曲线的 miR-21 的 AUC 为 0.749，灵敏度为 55.95%，特异性为 84.93%。此外，将 miR-21 与 Cys C 结合可提高 AUC 至 0.902，灵敏度为 88.1%，特异性为 83.6% (P < 0.001)。我们的研究结果表明，循环 miR-21 在 CRS-2 中具有中等诊断价值。miR-21 和 Cys C 的联合评估对 CRS-2 老年患者具有良好的临床价值。
