Circulation Res.:可提前10年预测糖尿病的新血检

关键词:糖尿病,血检

据国外媒体9月19日报道,美国《循环研究》杂志刊登一项最新研究宣称,一种新型血检可以比目前诊断措施提前10年预测出糖尿病风险。

英国科学家在伯明翰英国科学节上宣称,这种血液测试预测10年后2型糖尿病风险的准确率可达50%以上。其原理是,识别血液中的遗传分子“微RNA”(MiR,又译“小分子RNA”)。该分子有助于确定患者心脏病和血管疾病的风险。

研究者表示,在英国,目前现有的约200万糖尿病患者中,这项测试还可以识别出哪些人已经或将会出现糖尿病并发症,比如,血管损伤导致的心脏病、中风及血液循环系统问题等。

新研究主持人伦敦国王学院曼纽尔·梅耶博士表示,希望这种新型MiR血检能与传统诊疗方法相结合,以提高糖尿病及其并发症的确诊准确率。新型MiR血检费用估计为2英镑(约合21元人民币)。这一血检的最大优势是,可以直接测试出糖尿病对血管造成的损伤情况。

梅耶博士表示,确诊高风险心血管病并发症,对于医生及糖尿病患者具有重要的临床意义。及早发现糖尿病患者心脏病等并发症风险,有助于医生尽早对症下药,实施降脂降压治疗,从而使并发症危险最小化。

梅耶博士研究了来自意大利北部的822名40—79岁的参试者。研究发现,一种叫做“MiR-126”的小分子RNA可保护血管免受损伤。健康血管细胞能够向血流中释放大量的MiR-126分子。然而,当血管遭到损伤的时候,血管MiR-126就只够血管本身使用,释放到血流中的MiR-126分子则更少。

研究发现,仅在英国,已确诊糖尿病患者占成年人的5%,另外,在35岁以上人群中,估计有3%的男性和2%的女性,2型糖尿病尚未诊断出来。糖尿病患者心脏病并发症的危险为2%—5%。在欧洲,大约15%的心脏病病例与糖尿病息息相关。

英国心脏基金会医学主管杰里米·皮尔森表示,这项研究非常重要,因为快捷简便的新型MiR血检可直接监控血管健康,赶在心脏病等并发症症状尚未出现之前,及早发现及时治疗,可挽救无数糖尿病患者的性命。(生物谷Bioon.com)

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生物谷推荐英文摘要:

Circulation Research. 2010;107:810-817  doi: 10.1161/CIRCRESAHA.110.226357

Plasma MicroRNA Profiling Reveals Loss of Endothelial MiR-126 and Other MicroRNAs in Type 2 Diabetes
Anna Zampetaki*, Stefan Kiechl*, Ignat Drozdov, Peter Willeit, Ursula Mayr, Marianna Prokopi, Agnes Mayr, Siegfried Weger, Friedrich Oberhollenzer, Enzo Bonora, Ajay Shah, Johann Willeit, Manuel Mayr

From the King's College London British Heart Foundation Centre (A.Z., I.D., U.M., M.P., A.S., M.M.) and Centre for Bioinformatics-School of Physical Sciences and Engineering (I.D.), King's College London, United Kingdom; Department of Neurology (S.K., P.W., J.W.), Medical University Innsbruck, Austria; Department of Public Health and Primary Care (P.W.), University of Cambridge, United Kingdom; Department of Laboratory Medicine and Department of Internal Medicine (A.M., S.W., F.O.), Bruneck Hospital, Italy; and Division of Endocrinology and Metabolic Diseases (E.B.), University Hospital of Verona, Italy.

Rationale:MicroRNAs (miRNAs) have been implicated in the epigenetic regulation of key metabolic, inflammatory, and antiangiogenic pathways in type 2 diabetes (DM) and may contribute to common disease complications.

Objective:In this study, we explore plasma miRNA profiles in patients with DM.

Methods and Results:Total RNA was extracted from plasma samples of the prospective population-based Bruneck study. A total of 13 candidate miRNAs identified by microarray screening and miRNA network inference were quantified by quantitative PCR in all diabetic patients of the Bruneck study and age- and sex-matched controls (1995 evaluation, n=80 each). Quantitative PCR assessment revealed lower plasma levels of miR-20b, miR-21, miR-24, miR-15a, miR-126, miR-191, miR-197, miR-223, miR-320, and miR-486 in prevalent DM, but a modest increase of miR-28-3p. Findings emerged as robust in multivariable analysis and were independent of the standardization procedure applied. For endothelial miR-126, results were confirmed in the entire Bruneck cohort (n=822) in univariate (odds ratio [95% confidence interval], 0.38 [0.26 to 0.55]; P=2.72x10–7) and multivariate analyses (0.57 [0.37 to 0.86]; P=0.0082). Importantly, reduced miR-15a, miR-29b, miR-126, miR-223, and elevated miR-28-3p levels antedated the manifestation of disease. Most differences in miRNA levels were replicated in plasma obtained from hyperglycemic Lepob mice. High glucose concentrations reduced the miR-126 content of endothelial apoptotic bodies. Similarly in patients with DM, the reduction of miR-126 was confined to circulating vesicles in plasma.

Conclusions:We reveal a plasma miRNA signature for DM that includes loss of endothelial miR-126. These findings might explain the impaired peripheral angiogenic signaling in patients with DM.

(责任编辑:jie.jiang)

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