多囊卵巢综合征患者血清microRNA-27a、microRNA-320的表达及其临床意义

Expression and clinical significance of miR-27a and miR-320 in patients with polycystic ovarian syndrome

摘要:

目的 探讨血清microRNA-27a（miR-27a）、microRNA-320（miR-320）在多囊卵巢综合征（PCOS）患者中的表达及临床意义。方法 选取2017年1月—2020年8月海南西部中心医院收治的180例PCOS患者，根据胰岛素抵抗指数（HOMA-IR）分为IR组113例（HOMA-IR≥ 2.58）和NIR组67例（HOMA-IR< 2.58）；另选取该院体检的健康女性80例作为对照组。于月经第3～5天采集静脉血，检测血清miR-27a、miR-320的表达，以及性激素、糖脂代谢、胰岛素抵抗指标。经阴道超声测量卵巢体积并计数卵泡数。分析miR-27a、miR-320表达与BMI、性激素、糖脂代谢、胰岛素抵抗、卵巢体积、卵泡数的相关性及PCOS发病的影响因素。结果 IR组BMI、血清睾酮（T）、总胆固醇（TC）、胰岛素抵抗（HOMA-IR）、miR-27a mRNA的相对表达量高于NIR组和对照组（P <0.05），miR-320 mRNA的相对表达量低于NIR组和对照组（P <0.05）。NIR组BMI、血清T、TC、HOMA-IR、miR-27a mRNA的相对表达量高于对照组（P <0.05），miR-320 mRNA的相对表达量低于对照组（P <0.05）。血清miR-27a的表达与BMI、卵泡数、卵巢体积、T、TC、HOMA-IR呈正相关（r =0.749、0.835、0.764、0.867、0.907和0.882，均P <0.05），血清miR-320表达与卵泡数、卵巢体积、T、HOMA-IR呈负相关（r =-0.791、-0.808、-0.768和-0.752，均P <0.05）。卵泡数增加［R=1.865（95%CI：1.252，2.776）］、T水平升高［R=1.536（95% CI：1.179，2.001）］、HOMA-IR增加［R=1.702（95% CI：1.185，2.446）］、miR-27a高表达［R=1.933（95% CI：1.278，2.923）］、miR-320低表达［R=0.610（95% CI：0.467，0.796）］是PCOS易感因素（P <0.05）。联合miR-27a、miR-320诊断PCOS的AUC为0.917（95% CI：0.869，0.964），高于单独诊断的0.708（95% CI：0.637，0.779）和0.676（95% CI：0.602，0.750）。结论 PCOS患者血清miR-27a表达上调，miR-320表达下调，miR-27a高表达、miR-320低表达与PCOS易感和胰岛素抵抗有关，可作为PCOS诊断指标。

关键词:多囊卵巢综合征;miR-27a;miR-320;肥胖;糖脂代谢;胰岛素抵抗

Abstract:

Objective To investigate the expression and clinical significance of miR-27a and miR-320 in patients with polycystic ovarian syndrome (PCOS).Method A total of 180 cases of PCOS patients admitted to Hainan West Central Hospital from January 2017 to August 2020 were selected and divided into IR group (HOMA-IR≥ 2.58, 113 cases) and NIR group (HOMA-IR < 2.58, 67 cases) according to insulin resistance index (HOMA-IR). Another 80 healthy women were selected as the control group. Venous blood was collected on the 3rd to 5th day of menstruation (no date for amenorrhea) to detect the expression of serum miR-27a and miR-320, sex hormone, glucose and lipid metabolism, and insulin resistance indexes. Ovarian volume and number of follicles were measured by transvaginal ultrasound. The correlation of miR-27a and miR-320 expression with BMI, sex hormone, glucose and lipid metabolism, insulin resistance, ovarian volume, follicle number, and pathogenesis factors of PCOS were analyzed.Results The levels of BMI, serum testosterone (T), total cholesterol (TC), insulin resistance (HOMA-IR), and miR-27a in IR groups were higher than those in NIR group and control group (P < 0.05), and the expression of miR-320 was lower than that in NIR group and control group (P < 0.05). The levels of BMI, serum T, TC, HOMA-IR, and miR-27a in NIR group were higher than those in control group (P < 0.05), and the expression of miR-320 was lower than that in control group (P < 0.05). Serum miR-27a expression was positively correlated with BMI (r = 0.749), follicle number (r = 0.835), ovarian volume (r = 0.764), T (r = 0.867), TC (r = 0.907) and HOMA-IR (r = 0.882) (all P < 0.05), and miR-320 was negatively correlated with follicle number (r = -0.791), ovarian volume (r = -0.808) , T (r = -0.768) and HOMA-IR (r = -0.752) (all P < 0.05). Higher follicle number [R= 1.865, (95% CI: 1.252, 2.776)], increased T level [O^R=1.536, (95% CI: 1.179, 2.001)], increased HOMA-IR [R= 1.702 (95% CI: 1.185, 2.446)], high expression of miR-27a [R= 1.933, (95% CI: 1.278, 2.923)], and low expression of miR-320 [R = 0.610, (95% CI: 0.467, 0.796)] were the susceptibility factors of PCOS (P < 0.05). The AUC of combined method was 0.917, which was higher than that of alone method (P < 0.05).Conclusion The expression of miR-27a was up-regulated and miR-320 was down-regulated in PCOS patients. The high expression of miR-27a and low expression of miR-320 were related to PCOS susceptibility and insulin resistance. MiR-27a and miR-320 can be used as a diagnostic index of PCOS.

Key words:polycystic ovary syndrome;microRNA-27a;microRNA-320;obesity;glycolipid metabolism;insulin resistance