Wang Lin, Zheng Aitian, Zeng Na, Li Zheng, Tang Lizhu, Long Caidan, Wu Biaoliang
Department of Endocrinology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China.
Department of Endocrinology, Pingshan District People's Hospital, Pingshan General Hospital of Southern Medical University, Shenzhen, Guangdong, China.
Evid Based Complement Alternat Med. 2023 Jan 30;2023:2523245. doi: 10.1155/2023/2523245. eCollection 2023.
Intensive glycemic control and exosomal miRNAs have both been reported to improve wound repair in diabetic ulcers. In this study, we aimed to investigate the effects of intensive glycemic control on serum exosome microRNA-126-3p (miR-126-3p), microRNA-125b-1-3p (miR-125b-1-3p), and wound healing in patients with diabetic ulcers.
Herein, 45 diabetic patients with an ulcer, aged 35-75 years old, were randomly assigned to the intensive glycemic control group ( = 21) and the conventional glycemic control group ( = 24). Serum exosomes were extracted in the laboratory and assessed by Western blotting, transmission electron microscopy, and nanoparticle tracking analysis. The expression of miR-126-3p and miR-125b-1-3p was validated using quantitative real-time polymerase chain reaction. The wound healing of each diabetic ulcer patient was measured and imaged; additionally, clinical and follow-up data were collected. Finally, the clinical and laboratory data were combined for statistical analysis.
Intensive glycemic control was significantly more conducive to wound healing and infection control than conventional glycemic control ( < 0.05). Serum exosomal miR-126-3p was negatively correlated with fasting plasma glucose levels ( = 0.34, < 0.05) and positively associated with the wound healing rate ( = 0.45, < 0.01). The level of miR-126-3p in the intensive glycemic control group was significantly higher than that in the conventional glycemic control group ( < 0.01). Serum exosomal miR-125b-1-3p was not correlated with blood glucose levels ( = 0.03, > 0.05) and was positively associated with the wound healing rate ( = 0.33, < 0.05). No significant difference was observed in the level of miR-125b-1-3p between the intensive and conventional glycemic control groups. Regarding the prognosis of diabetic ulcers, the intensive glycemic control group was better than the conventional group ( = -2.02, < 0.05).
Serum exosome (miR-125b-1-3p and miR-126-3p) levels are correlated with wound healing in diabetic ulcers. Intensive glycemic control increases the serum exosomal miR-126-3p level, which might be one of the mechanisms that promotes wound healing in diabetic ulcers.
强化血糖控制和外泌体微小RNA（miRNA）均已被报道可改善糖尿病溃疡的伤口愈合。在本研究中，我们旨在探讨强化血糖控制对糖尿病溃疡患者血清外泌体微小RNA-126-3p（miR-126-3p）、微小RNA-125b-1-3p（miR-125b-1-3p）及伤口愈合的影响。
在此，45例年龄在35至75岁之间患有溃疡的糖尿病患者被随机分为强化血糖控制组（n = 21）和传统血糖控制组（n = 24）。在实验室中提取血清外泌体，并通过蛋白质免疫印迹法、透射电子显微镜和纳米颗粒跟踪分析进行评估。使用定量实时聚合酶链反应验证miR-126-3p和miR-125b-1-3p的表达。测量并拍摄每位糖尿病溃疡患者的伤口愈合情况；此外，收集临床和随访数据。最后，将临床和实验室数据合并进行统计分析。
与传统血糖控制相比，强化血糖控制在促进伤口愈合和控制感染方面明显更具优势（P < 0.05）。血清外泌体miR-126-3p与空腹血糖水平呈负相关（r = 0.34，P < 0.05），与伤口愈合率呈正相关（r = 0.45，P < 0.01）。强化血糖控制组中miR-126-3p的水平显著高于传统血糖控制组（P < 0.01）。血清外泌体miR-125b-1-3p与血糖水平无相关性（r = 0.03，P > 0.05），与伤口愈合率呈正相关（r = 0.33，P < 0.05）。强化血糖控制组和传统血糖控制组之间miR-125b-1-3p的水平未观察到显著差异。关于糖尿病溃疡的预后，强化血糖控制组优于传统组（P = -2.02，P < 0.05）。
血清外泌体（miR-125b-1-3p和miR-126-3p）水平与糖尿病溃疡的伤口愈合相关。强化血糖控制可提高血清外泌体miR-126-3p水平，这可能是促进糖尿病溃疡伤口愈合的机制之一。
