多囊卵巢综合征患者血清miR-21及miR-93的表达及临床意义

Expressions of serum miR-21 and miR-93 in patients with polycystic ovary syndrome and their clinical significance

摘要:

目的：探讨血清miR-21及miR-93在多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者中的表达及其临床意义。方法：选取海南西部中心医院收治的186例PCOS患者（PCOS组）和60例健康女性（对照组）为研究对象，PCOS患者根据胰岛素抵抗指数（HOMA-IR）分为PCOS胰岛素抵抗组（n=121，HOMA-IR≥2.57）和PCOS非胰岛素抵抗组（n=65，HOMA-IR＜2.57），再根据体质指数（body mass index，BMI）分为肥胖组（n=58，BMI≥28 kg/m2）和非肥胖组（n=128，BMI＜28 kg/m2）。采用实时定量PCR（qRT-PCR）检测各组血清miR-21及miR-93水平变化。应用受试者工作特征（receiver operating characteristic curve, ROC）曲线分析血清miR-21及miR-93对PCOS的诊断价值。Pearson相关分析血清miR-21、miR-93与HOMA-IR的相关性。结果：PCOS组血清miR-21（1.71±0.36 vs. 0.48±0.06）及miR-93（1.93±0.58 vs. 0.75±0.12）表达水平均明显高于对照组（P<0.01）。肥胖组血清miR-21（2.54±0.83 vs. 0.68±0.10）及miR-93（2.85±1.04 vs. 0.96±0.17）表达水平均明显高于非肥胖组（P<0.01）。胰岛素抵抗组血清miR-21（2.61±0.78 vs. 0.53±0.08）及miR-93（2.91±1.13 vs. 0.82±0.15）表达水平均明显高于非胰岛素抵抗组（P<0.01）。ROC曲线显示，血清miR-21及miR-93诊断PCOS的最佳截值分别为1.25、1.54，两项联合诊断PCOS的AUC（95%CI）为0.815（0.759～0.874），明显高于单项miR-21[0.734（0.676～0.795）]和miR-93[0.683（0.627～0.741）]，其敏感度和特异度为83.6%和76.0%。相关分析显示，miR-21、miR-93与HOMA-IR均呈正相关（r=0.842，r=0.775，P<0.01）。结论：血清miR-21及miR-93在PCOS患者中高表达，且与胰岛素抵抗有关，两者联合检测对PCOS诊断具有一定价值。

Abstract:

Objective：To investigate the expressions of serum miR-21 and miR-93 in patients with polycystic ovary syndrome（PCOS） and their clinical significance. Methods：186 PCOS patients（PCOS group） and 60 healthy women （control group） were se－lected from Central Hospital of Western Hainan. PCOS patients were divided into insulin resistance group（n=121，HOMA-IR≥2.57） and non - insulin resistance group（n=65，HOMA-IR<2.57） according to insulin resistance index（HOMA-IR）. PCOS patients were divided into obese group（n=58，BMI≥28 kg/m2） and non-obese group（n=128，BMI＜28 kg/m2） according to body mass index（BMI）. Real time quantitative PCR （qRT-PCR） was used to detect the changes of serum miR-21 and miR-93 levels in each group. Receiv－er operating characteristic（ROC） curve was used to analyze the diagnostic value of serum miR-21 and miR-93 for PCOS. The correla－tions of serum miR-21 and miR-93 with HOMA-IR were determined using Pearson correlation. Results：The levels of serum miR-21（1.71±0.36 vs. 0.48±0.06） and miR-93（1.93±0.58 vs. 0.75±0.12） in PCOS group were significantly higher than those in control group（P<0.01）. The levels of serum miR-21（2.54±0.83 vs. 0.68±0.10） and miR-93（2.85±1.04 vs. 0.96±0.17） in obese group were significantly higher than those in non-obese group（P<0.01）. The levels of serum miR-21（2.61±0.78 vs. 0.53±0.08） and miR-93（2.91±1.13 vs. 0.82±0.15） in insulin resistance group were significantly higher than those in non-insulin resistance group（P<0.01）. ROC curves showed that the best cut-off values of serum miR-21 and miR-93 for PCOS diagnosis were 1.25 and 1.54，respectively. The AUC（95%CI） of the combined di－agnosis of PCOS was 0.815（0.759 to 0.874），which was significantly higher than that of diagnosis using only miR-21[0.734（0.676 to 0.795）] or miR-93[0.683（0.627 to 0.741）]. Its sensitivity was 83.6%，and its specificity was 76.0%. Pearson correlation showed that miR-21 and miR-93 were positively correlated with HOMA-IR（r=0.842，r=0.775，P<0.01）. Conclusion：Serum levels of miR-21 and miR-93 are high in PCOS patients，and they are associated with insulin resistance. The combined detection of miR-21 and miR-93 is valuable for the diagnosis of PCOS.