急性心肌梗死患者外周血NO-PGC1α线粒体生物合成通路相关基因的表达及其临床意义

Expression and clinical significance of molecules related to mitochondrial biogenesis in the peripheral blood of patients with acute myocardial infarction

摘要:

目的 探讨急性心肌梗死（AMI）患者外周血一氧化氮-过氧化物酶体增殖物激活受体γ共激活因子1α（NO-PGClα）线粒体生物合成通路相关基因的表达及其临床意义。方法 选取2019年5月—2021年6月常州市第二人民医院收治的AMI患者103例为AMI组，另取同期该院健康体检者69例为对照组。收集两组基本资料，采用实时荧光定量聚合酶链反应测定外周血NO-PGC1α线粒体生物合成通路的相关基因NO-PGClα、精氨酸酶2（Arg2）、一氧化氮合酶1（NOS1）mRNA的表达。分析AMI组不同病情患者NO-PGClα、Arg2、NOS1 mRNA相对表达量，分析影响AMI发生的因素，分析NO-PGClα、Arg2、NOS1 mRNA相对表达量预测AMI发生的价值。结果 重度狭窄组外周血NO-PGC1α、NOS1、Arg2 mRNA相对表达量高于中、轻度狭窄组（P <0.05），中度狭窄组NO-PGC1α、NOS1、Arg2 mRNA相对表达量高于轻度狭窄组（P <0.05）。多因素Logistic回归分析结果显示，NO-PGC1α mRNA［O^R=3.873（95% CI：1.594，9.412）］、NOS1 mRNA［O^R=4.267（95% CI：1.756，10.371）］、Arg2 mRNA［O^R=4.518（95% CI：1.859，10.979）］是影响AMI发生的独立因素（P <0.05）。ROC曲线结果表明，外周血NO-PGC1α、NOS1、Arg2 mRNA及3者联合预测AMI发生的敏感性分别为70.87%、71.84%、75.73%和70.87%，特异性分别为73.91%、72.46%、71.01%和91.30%，曲线下面积分别为0.764、0.742、0.759和0.908。结论 外周血NO-PGC1α线粒体生物合成通路的相关基因NO-PGClα、Arg2、NOS1 mRNA与AMI发生有关，3者联合预测AMI发生效能良好，且NO-PGClα、Arg2、NOS1 mRNA表达可能与AMI患者病情有关。

Abstract:

Objective To explore the expression and clinical significance of molecules related to mitochondrial biogenesis in the peripheral blood of patients with acute myocardial infarction (AMI).Methods A total of 103 AMI patients admitted to our hospital from May 2019 to June 2021 were selected and set as the AMI group, and 69 healthy individuals undergoing physical examinations in the hospital during the same period were included as the control group. The general data of the patients were collected, and the relative mRNA expressions of molecules related to mitochondrial biogenesis, including nitric oxide (NO)-peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1α), arginase 2 (Arg2) and nitric oxide synthase 1 (NOS1), in the peripheral blood were detected. The relative mRNA expressions of these molecules were also compared among AMI patients with different conditions, and the factors affecting the occurrence of AMI were analyzed. In addition, the values of the relative mRNA expressions of NO-PGC1α, Arg2 and NOS1 in predicting the occurrence of AMI were determined.Results The relative mRNA expressions of NO-PGC1α, NOS1 and Arg2 in the peripheral blood of the severe stenosis group were higher than those of the moderate stenosis group and mild stenosis group (P < 0.05), while those of the moderate stenosis group were even higher than those of the mild stenosis group (P < 0.05). Logistic multivariable regression analysis showed that the relative mRNA expressions of NO-PGC1α [O^R = 3.873 (95% CI: 1.594, 9.412) ], NOS1 [O^R = 4.267 (95% CI: 1.756, 10.371) ], and Arg2 [O^R = 4.518 (95% CI: 1.859, 10.979) ] were independent factors affecting the occurrence of AMI (P < 0.05). The receiver operating characteristic (ROC) curve analysis demonstrated that the sensitivities of the relative mRNA expressions of NO-PGC1α, NOS1 and Arg2 in the peripheral blood alone and their combination in predicting the occurrence of AMI were 70.87%, 71.84%, 75.73%, and 70.87%, with the specificities being 73.91%, 72.46%, 71.01%, and 91.30%, and the areas under the ROC curves being 0.764, 0.742, 0.759, and 0.908.Conclusions The relative mRNA expressions of molecules related to mitochondrial biogenesis including NO-PGC1α, Arg2 and NOS1 in peripheral blood are associated with the occurrence of AMI. The combination of the three well predicts the occurrence of AMI, and the relative mRNA expressions of the these molecules may be also related to the condition of AMI patients.