摘要
目的探究miR-155及脑和肌肉组织芳香烃受体核转运蛋白的类似蛋白1基因(BMAL1m RNA)在男性慢性阻塞性肺疾病(COPD)合并失眠症患者中表达水平及与失眠的相关性。方法选取2021年6月—2023年4月新疆医科大学第二附属医院神经内科诊治急性发作伴失眠的男性COPD患者60例作为观察组,另外选取同期急性发作非失眠的男性COPD患者60例作为对照组。收集2组患者血清外泌体及肺泡灌洗液上清标本,检测并比较标本中miR-155及BMAL1 mRNA转录水平差异。通过Spearman相关性分析、二元Logistic回归分析筛选COPD患者发生失眠的危险因素。通过受试者工作特征曲线(ROC)及曲线下面积(AUC)评价各危险因素对发生失眠的预测价值。结果观察组患者血清外泌体、肺泡灌洗液上清中miR-155及BMAL1 mRNA表达水平均显著高于对照组(t/P=3.457/<0.001,4.147/<0.001,4.471/<0.001,4.336/<0.001)。相关性分析及二元Logistic回归分析表明血清外泌体、肺泡灌洗液上清中miR-155及BMAL1 mRNA表达水平升高均是COPD患者发生失眠的危险因素[OR(95%CI)=1.578(1.061~2.123)、1.955(1.208~3.164)、2.476(1.430~4.287)、2.574(1.357~4.885)],其中血清外泌体和肺泡灌洗液上清miR-155、BMAL1 mRNA及四者联合预测COPD患者失眠症发生的AUC分别为0.679、0.706、0.719、0.733和0.839,其中四项联合的预测价值最高(Z=2.932、2.771、2.693、2.553,P均<0.001)。结论COPD患者血清外泌体及肺泡灌洗液中miR-155及BMAL1水平升高与失眠症的发生显著相关,提示miR-155及BMAL1基因可能参与COPD相关性失眠的发生、发展过程。
Objective To explore the expression levels of miR-155 and similar protein 1(BMAL1)of aromatic hydrocarbon receptor nuclear transporters in brain and muscle tissue in male patients with chronic obstructive pulmonary disease(COPD)complicated with insomnia and its correlation with insomnia.Methods Sixty male COPD patients diagnosed and treated in the Neurology Department of the Second Affiliated Hospital of Xinjiang Medical University from June 2021 to April 2023 were selected as the observation group.In addition,60 male COPD patients with acute episodes of non-insomnia during the same period were selected as the control group.Collect serum extracellular vesicles and alveolar lavage fluid supernatant samples from two groups of patients,and detect and compare the differences in miR-155 and BMAL1 mRNA transcription levels in the samples.Screening the risk factors for insomnia in COPD patients through Spearman correlation analysis and binary logistic regression analysis.Evaluate the predictive value of various risk factors on the occurrence of insomnia through the receiver operating curve(ROC)and area under the curve(AUC).Results The expression levels of miR-155 and BMAL1 mRNA in serum extracellular vesicles and alveolar lavage fluid supernatant of the observation group were significantly higher than those in the control group(t/P=3.457/<0.001,4.147/<0.001,4.471/<0.001,4.336/<0.001).Correlation analysis and binary logistic regression analysis showed that elevated levels of miR-155 and BMAL1 mRNA expression in serum extracellular vesicles and alveolar lavage fluid supernatant were risk factors for insomnia in COPD patients[OR(95%CI)=1.578(1.061-2.123),1.955(1.208-3.164),2.476(1.430-4.287),2.574(1.357-4.885)],The AUC of miR-155 and BMAL1 mRNA in serum extracellular vesicles and alveolar lavage fluid supernatant for predicting the occurrence of insomnia in COPD patients was 0.679,0.706,0.719,0.733 and 0.839,the combination of the four factors has the highest value(Z=2.932,2.771,2.693,2.553,P<0.01).Conclusion The elevated levels of miR-155 and BMAL1 in the serum exosomes and alveolar lavage fluid of COPD patients are significantly correlated with the occurrence of insomnia,suggesting that miR-155 and BMAL1 may be involved in the occurrence and development of COPD related insomnia,providing potential targets for further exploration of the neuropathological mechanisms of insomnia in COPD patients in the future.
作者
穆清爽
刘顺
热依拉·牙合甫
杨新玲
Mu Qingshuang;Liu Shun;Ruila Yahefu;Yang Xinling(Department of the First Cadre,the Second Affiliated Hospital of Xinjiang Medical University,Key Laboratory of Nervous System Disease,Xinjiang Province,Urumqi 830063,China;不详)
出处
《疑难病杂志》
CAS
2023年第10期1067-1071,1077,共6页
Chinese Journal of Difficult and Complicated Cases
基金
新疆维吾尔自治区自然科学基金资助项目(2021D01C371)。
