Expression Of MiR-122 In Serum Of Patients With HBV-ACLF And Its Clinical Significance

Objective:To analyze the relationship between the expression of miR-122 in HBV-related acute-on-chronic liver failure(HBV-ACLF)and clinical indicators,and to further explore the potential value of miR-122 in serum in the assessment of HBV-ACLF.Methods:1.Serum samples from 49 patients with HBV-ACLF,30 patients with chronic hepatitis B(CHB)were collected from the first Affiated Hospital of Shanxi medical University,and through the physical examination center collected healthy subjects(HC)serum samples in 30 cases.The patients were divided into HBV-ACLF group,CHB group,HC group(normal control group)respectively.HBV-ACLF patients were further divided into early,middle and late stages according to the the severity of clinical manifestations.2.Total RNA was extracted from each serum sample using RNAiso PLUS Total RNA extraction reagent.The reverse transcription of the target gene and the internal reference gene was carried out by miRNA RT-PCR kit,and the relative expression level of miR-122 was detected by real-time real-time quantitative PCR.In this study,with the snRNAu6 as endogenous control,the relative expression of miR-122 was expressed as2-?CT.SPSS 22.0 was used for statistical analysis.3.The differences of miR-122 expression levels between different groups were compared and analyzed the correlation between the expression of miR-122 and the biochemical indexes in serum of HBV-ACLF patients.Furthermore,the role of miR-122 in the progression of HBV-ACLF was analyzed by Unconditional logistic regression model,thus indirectly reflecting the association between the levels of miR-122 and the severity ofthe disease.Receiver operating characteristic curve(ROC)was used to evaluate the potential values of miR-122 in the diagnosis of HBV-ACLF.Results:1.The relative expression levels of miR-122 in serum of HBV-ACLF group were51.27(29.35-82.73),15.35(11.49-22.43)in CHB group,8.03(5.87-8.88)in HC group.Compared with the level of miR-122 in serum of healthy subjects and CHB patients,the expression level of miR-122 in serum of patients with HBV-ACLF was up-regulated(P<0.001)?The relative expression levels of miR-122 in serum of different clinical stages of HBV-ACLF were 32.45(17.54-45.73)in the early stage,66.17(47.24-99.46)in middle stage and 85.63(81.01-146.02)in late stage.And the expression of miR-122 in serum of patients with advanced HBV-ACLF was significantly higher than that in early and mid-term(P <0.001,P = 0.048).2.The serum level of miR-122 in patients with HBV-ACLF was positively correlated with the level of serum total bilirubin(TBIL)(r = 0.508,P <0.001)and negatively with PTA(r=-0.797,P <0.001).Unconditional logistic regression model showed that an increase of one unit of relative expression of miR-122(2-?CT)was associated with an 5.8%increase in the risk of progression from early stage to middle stages and an 13.0% increase in the risk from early stage to late stage.The ROC analysis showed that the area under the curve(AUC)of disease diagnosis was 0.942(95% CI,0.903-0.982),sensitivity: 83.7%,specificity: 86.7%.Conclusions:The expression level of miR-122 in serum can be used as a potential biomarker to evaluate the severity of HBV-ACLF and has a certain reference value in the diagnosis of HBV-ACLF.