Serum MicroRNAs As Markers For Early Diagnosis Of Hyperlipidemic Acute Pancreatitis

ObjectiveThe incidence of hyperlipidemic acute pancreatitis(HTGAP)in China has been increasing in recent years.HTGAP is highly prone to recurrence,complications,and mortality,which seriously endangers the health of patients.At present,the diagnosis of HTGAP is mainly based on clinical signs,blood/urease amylase,lipase and serum triglyceride levels.However,these diagnostic criteria have certain limitations,which makes the clinical diagnosis and treatment work still face enormous difficulties and challenges.Therefore,there is an urgent need to develop specific biomarkers for the definitive diagnosis of HTGAP diseases.Recently,microRNA(miRNA)has received increasing attention as a new disease marker,which can be stably present in serum,plasma and other body fluids,and is convenient to sample.This allows miRNAs to serve as a novel,non-invasive biomarker for disease progression.However,there are few studies on miRNAs in HTGAP.This study was based on the early microarray analysis of the serum miRNA expression profile of THGAP in our team.Firstly,the expression of four miRNAs(miR-345-5p,miR-145-5p,miR-301a-3p,miR-18b-5p)in the primary cohort was verified.Then analyze its correlation with clinical scoring system and biochemical indicators.Finally,evaluate its predictive value in predicting the severity of HTGAP.Method1.We collected peripheral blood from patients with acute pancreatitis admitted to general surgery in the General Hospital of Western Theater Command PLA.The clinical data of the patients during hospitalization were collected and the APACHE II score and BISAP score were completed within 24 hours,and the Ranson score was completed within 48 hours.The diagnosis of HTGAP is made if the triglyceride concentration ≥11.3 mmol/L or between 5.65 and 11.3 mmol/L,and the serum is chyle.HTGAP is divided into two subgroups: severe(SAP)and mild(MAP).In addition,the serum of the hyperlipidemia and healthy subjects who participated in the physical examination of the General Hospital of the Western Theater PLA(no history of chronic basic diseases,and no abnormalities in physical examination)were collected as a control group.2.Real-time quantitative PCR was used to detect the expression levels of miR-345-5p,miR-145-5p,miR-301a-3p and miR-18b-5p in each group.3.The correlation between miRNA expression levels and scores of HTGAP was analyzed by scatter linear regression.4.ROC curves were used to analyze and assess the role of miRNAs in predicting the severity of HTGAP.Result1.The expression levels of miR-345-5p,miR-145-5p,miR-301a-3p and miR-18b-5p in serum of patients with HTGAP group(2.28±0.23,4.19±0.24,0.73±0.08,0.45±0.03) significantly higher than the non HTG-AP group(0.35±0.02,0.57±0.03,0.15±0.04,0.10±0.02),HTG-non AP group(0.29±0.04,0.54 ± 0.03,0.12 ± 0.01,0.06 ± 0.01)and healthy group(0.25±0.03,0.40 ± 0.05,0.09 ± 0.02,0.04 ± 0.01),the difference was statistically significant(P<0.05).There was no significant difference in the expression of miRNAs between non HTG-AP group,HTG-non AP and healthy group(P>0.05).2.The expression of miR-345-5p and miR-145-5p in HTGSAP was significantly higher than that of HTGMAP(0.69±0.23,1.25±0.11)(P<0.05).There was no significant difference in the expression of miR-301a-3p and miR-18b-5p in HTGSAP and HTGMAP(P>0.05).3.The expression levels of miR-345-5p and miR-145-5p were correlated with BISAP score,Ranson score and APACHE II score(P<0.05).4.miR-345-5p and miR-145-5p predict the severity of HTGAP with certain reliability.The predictive power of miR-345-5p is equivalent to Ranson score,APACHE II score and BISAP score.The predictive power of miR-145-5p is equivalent to the Ranson score and the BISAP score,but worse than the APACHE II score.Conclusion1.The expression of miR-345-5p,miR-145-5p,miR-301a-3p,and miR-18b-5p was significantly increased in HTGAP,and these four miRNAs may be serum markers of HTGAP patients.2.The expression of miR-345-5p and miR-145-5p in HTGSAP was significantly higher than that of HTGMAP.It is positively correlated with BISAP score,Ranson score and APACHE II score,and has a certain predictive effect on the severity of HTGAP.