Wu Tingting, Xie Dandan, Zhao Xiaotong, Xu Murong, Luo Li, Deng Datong, Chen Mingwei
Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230032, People's Republic of China.
Diabetes Metab Syndr Obes. 2021 Oct 15;14:4263-4273. doi: 10.2147/DMSO.S326066. eCollection 2021.
To explore the correlation between the expression of miR-34c in peripheral blood of patients with type 2 diabetes mellitus (T2DM) and the onset of diabetic foot ulcer (DFU) and diabetic foot osteomyelitis (DFO).
Sixty newly diagnosed patients with T2DM without DFU (T2DM group), 112 T2DM patients with DFU (DFU group) and 60 controls with normal glucose tolerance (NC group). The DFU group patients were subdivided into DFO (n=64) and NDFO (n=48) groups. Quantitative real-time PCR (qRT-PCR) method was used to determine miR-34c expression levels in the peripheral blood of subjects to analyze the clinical characteristics of DFU and DFO risk factors.
MiR-34c expression level in the T2DM group was marked higher than the NC group [2.99 (1.45-6.22) vs 1.01 (0.89-1.52)] (P < 0.05). However, the expression level of miR-34c in the DFU group was significantly higher than the T2DM group [9.65 (6.15-18.63) vs 2.99 (1.45-6.22)] (P < 0.01). Compared with the NDFO group, the expression level of miR-34c in the DFO group was also obviously increased [13.46 (8.89-19.11) vs 6.02 (5.93-14.72)] (P < 0.01). The expression level of miR-34c in DFU patients was positively correlated with the amputation rate of foot ulcers (P=0.030) and was negatively correlated with the healing rate of foot ulcers after eight weeks (P=0.025). Multifactorial logistic regression analysis showed that increased expression of miR-34c was an independent risk factor for DFU and DFO (OR=3.47, OR=4.25, P < 0.01). Meanwhile, the ROC curve analysis indicated that the AUC of miR-34c for the diagnosis of DFU and DFO was 0.803 and 0.904, the optimum sensitivity being was 100% and 98.7%, the optimum specificity was 98.4% and 98.4%, respectively.
The increased expression of miR-34c in peripheral blood of T2DM patients is closely related to the occurrence, development and prognosis of DFU and DFO.
探讨2型糖尿病（T2DM）患者外周血中miR-34c的表达与糖尿病足溃疡（DFU）及糖尿病足骨髓炎（DFO）发病的相关性。
选取60例新诊断的无DFU的T2DM患者（T2DM组）、112例T2DM合并DFU患者（DFU组）和60例糖耐量正常的对照者（NC组）。DFU组患者再分为DFO组（n=64）和非DFO组（n=48）。采用定量实时荧光定量聚合酶链反应（qRT-PCR）法检测受试者外周血中miR-34c表达水平，分析DFU的临床特征及DFO的危险因素。
T2DM组miR-34c表达水平显著高于NC组[2.99（1.45 - 6.22）对1.01（0.89 - 1.52）]（P<0.05）。然而，DFU组miR-34c表达水平显著高于T2DM组[9.65（6.15 - 18.63）对2.99（1.45 - 6.22）]（P<0.01）。与非DFO组相比，DFO组miR-34c表达水平也明显升高[13.46（8.89 - 19.11）对6.02（5.93 - 14.72）]（P<0.01）。DFU患者miR-34c表达水平与足部溃疡截肢率呈正相关（P=0.030），与8周后足部溃疡愈合率呈负相关（P=0.025）。多因素logistic回归分析显示，miR-34c表达增加是DFU和DFO的独立危险因素（OR=3.47，OR=4.25，P<0.01）。同时，ROC曲线分析表明，miR-34c诊断DFU和DFO的AUC分别为0.803和0.904，最佳灵敏度分别为100%和98.7%，最佳特异度分别为98.4%和98.4%。
T2DM患者外周血中miR-34c表达增加与DFU和DFO的发生、发展及预后密切相关。
