Circulating miRNA-21 as a diagnostic biomarker in elderly patients with type 2 cardiorenal syndrome
Circulating miRNA-21 as a diagnostic biomarker in elderly patients with type 2 cardiorenal syndrome
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循环 miRNA-21 作为老年 2 型心肾综合征患者的诊断生物标志物
DOI：
10.1038/s41598-020-61836-z
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发表时间：
2020-03-17
影响因子：
4.6
通讯作者：
Guo, YiFang
中科院分区：
文献类型：
--
作者：
Wang, Yan;Liang, Yi;Guo, YiFang
循环mirna作为几种疾病的血清生物标志物引起了人们的关注。在这项研究中，我们旨在评估循环miRNA-21 （miR-21）作为一种新的生物标志物对老年2型心肾综合征（CRS-2）患者的诊断价值。研究共招募了157名老年慢性心力衰竭（CHF）患者。根据估计肾小球滤过率（eGFR）截止值为60 ml/min/1.73 m2，分别有84例（53.5%）和73例（46.5%）患者被分配到CRS组和CHF组。检测血清miR-21的表达水平以及CRS的生物标志物，如肾损伤因子-1 （KIM-1）、中性粒细胞明胶酶相关载脂蛋白（NGAL）、胱抑素C （Cys C）、氨基末端前b型利钠肽（NT-proBNP）、n -乙酰基-κ- d -葡萄糖氨基苷酶（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、H-FABP水平显著高于CHF组（P< 0.01），而NAG表达在两组间无显著差异（P< 0.05）。Cys C、H-FABP和eGFR与miR-21表达显著相关，而NT-proBNP、NGAL、NAG和KIM-1与miR-21的相关性不显著。多因素logistic回归分析发现，血清miR-21、血清Cys C、血清KIM-1升高、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 AUC为0.749，灵敏度为55.95%，特异性为84.93%。此外，将miR-21与Cys C结合可将AUC提高至0.902，敏感性为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。联合评估miR-21与Cys - C在老年CRS-2患者中具有较好的临床价值。
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 m2, 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.