Chao Chia-Ter, Han Der-Sheng, Huang Jenq-Wen
Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital BeiHu Branch, Taipei, Taiwan.
Graduate Institute of Toxicology, National Taiwan University College of Medicine, Taipei, Taiwan.
Front Cardiovasc Med. 2021 Feb 22;8:624313. doi: 10.3389/fcvm.2021.624313. eCollection 2021.
Vascular calcification (VC) is a subclinical manifestation of vascular disease burden among older adults, conferring an elevated mortality risk. Biomarkers capable of detecting and risk-stratifying VC associated with advanced age remains unavailable, impeding our effort to provide optimal care to geriatric patients. In this study, we aimed to investigate whether circulating miR-125b served as a potential indicator for VC in relatively healthy older adults. Community-dwelling older adults (age ≥65) were prospectively recruited during 2017, followed by clinical features documentation and VC rating based on aortic arch calcification (AAC) and abdominal aortic calcification (AbAC). Multiple logistic regression was done to evaluate the relationship between circulating miR-125b levels, VC presence and severity, followed by selecting the optimal cutoff point for VC diagnosis. A total of 343 relatively healthy older adults (median age, 73.8 years; 40% male; 59.8% having AAC) were enrolled, with a median circulating miR-125b level of 0.012 (interquartile range, 0.003-0.037). Those with more severe AAC had progressively decreasing miR-125b levels (<0.001). Multiple regression analyses showed that having higher miR-125b levels based on the median value were associated with a substantially lower risk of AAC [odds ratio (OR) 0.022, 95% confidence interval (CI) 0.011-0.044] compared to those having lower ones. An optimal cutoff of miR-125b for identifying AAC in older adults was 0.008, with a sensitivity and specificity of 0.86 and 0.80, respectively. Similar findings were obtained when using AbAC as the endpoint. We found that miR-125b serves as an independent indicator for VC in relatively healthy older adults, and may potentially be linked with VC pathophysiology.
血管钙化(VC)是老年人血管疾病负担的一种亚临床表型,会增加死亡风险。目前仍缺乏能够检测与高龄相关的VC并对其进行风险分层的生物标志物,这阻碍了我们为老年患者提供最佳护理的努力。在本研究中,我们旨在调查循环miR-125b是否可作为相对健康的老年人VC的潜在指标。2017年,我们前瞻性招募了社区居住的老年人(年龄≥65岁),随后记录临床特征,并根据主动脉弓钙化(AAC)和腹主动脉钙化(AbAC)进行VC分级。进行多因素logistic回归分析以评估循环miR-125b水平、VC的存在及严重程度之间的关系,然后选择VC诊断的最佳截断点。共纳入343名相对健康的老年人(中位年龄73.8岁;40%为男性;59.8%有AAC),循环miR-125b水平的中位数为0.012(四分位间距,0.003 - 0.037)。AAC越严重的患者,其miR-125b水平逐渐降低(<0.001)。多因素回归分析显示,与miR-125b水平低于中位数的患者相比,基于中位数具有较高miR-125b水平的患者发生AAC的风险显著更低[比值比(OR)0.022,95%置信区间(CI)0.011 - 0.044]。用于识别老年人AAC的miR-125b最佳截断值为0.008,敏感性和特异性分别为0.86和0.80。以AbAC作为终点时也获得了类似的结果。我们发现,miR-125b可作为相对健康的老年人VC的独立指标,并且可能与VC的病理生理学相关。