The Expression And Significance Of Serum LncRNA-NEAT1 In Patients With Acute Pancreatitis

Research background and purpose:Acute pancreatitis is a frequently-seen serious digestive system disease.Mild pancreatitis,which may result from a number of causes,usually progress fast,with early symptoms like drastic belly pain and vomiting that pose a huge risk for the patient’s life or living quality.Of all patients with acute pancreatitis,10%-20% have developed transient or persistent distant organ failure,developed moderate to severe and severe acute pancreatitis,and even caused death.Therefore,it’s of great significance to diagnose acute pancreatitis(AP)at an early stage and make in-time judgment of its development.At present,as one of the imaging diagnostic methods,enhanced CT can help clinicians to judge the extent of pancreatic necrosis,evaluate the severity of the disease and prognosis.In addition,serum amylase and lipase levels have been used as serological markers for the diagnosis of acute pancreatitis for decades.However,so far,there is still no index that can be used as a gold standard to judge the severity of the disease.Therefore,it is very important to explore effective biomarkers for the early diagnosis,treatment and prognosis of acute pancreatitis.Long non-coding RNAs(Lnc RNAs)lack the ability to transcribe and encode proteins and are often defined by researchers based on their length and positional relationships.According to relevant studies,the abnormal expression of Lnc RNA is related to a variety of complex diseases(tumor,immune system disease,cardiovascular disease,infection,etc.).Among them,Lnc RNA nuclear rich transcript 1(NEAT1)has recently been identified as an important regulator of cell function.It interacts with other intracellular regulators and participates in a variety of inflammatory reactions including sepsis.However,the relationship between Lnc RNA-NEAT1 expression and acute pancreatitis has not been studied so far.Therefore,this paper discusses the expression and significance of Lnc RNA-NEAT1 in serum of patients with acute pancreatitis Its clinical significance.Methods:The present study was a case-control study.First,60 patients with acute pancreatitis,37 male patients and 23 female patients,were collected from January to December 2019 in the emergency department of the Affiliated Hospital of Qingdao University;the patients’ ages ranged from 22 to 78 years,with a mean age of(41.28 ± 14.69)years.The diagnosis of acute pancreatitis met the criteria of the Chinese Guidelines for the Diagnosis and Management of Acute Pancreatitis,namely,at least 2 of the following characteristics were met:(1)characteristic epigastric pain consistent with acute pancreatitis(2)serum amylase and/or lipase higher than 3 times the upper limit of normal values;(3)there was evidence of imaging consistent with acute pancreatitis.According to the relevant literature criteria,while referring to the Acute Physiology and Chronic Health II score(APACHEII),MCTSI score,and BISAP score as the scoring criteria,60 patients were divided into 27 patients in the severe acute pancreatitis group(SAP group,including moderate to severe pancreatitis with transient organ dysfunction and severe pancreatitis with persistent organ dysfunction)and 27 patients in the non-severe acute pancreatitis group(MAP group)in 33 cases.At the same time,20 cases were randomly selected from our hospital’s health checkups,and then fasting venous blood was collected from the subjects in the morning of the next day of admission to detect serum Lnc RNA-Neatl levels by fluorescence real-time quantitative PCR.The RNA concentration was determined using an enzyme marker.All statistical analyses were performed with IBM SPSS Statistics for Macintosh,version 21.0.In this experiment,measurement data were expressed as mean ± standard deviation(`x±s),and ANOVA was used to test whether there was a difference in serological Lnc RNA-NEAT1 expression among the groups,and the Bonferroni method was used to make a two-by-two comparison of whether there was a difference in Lnc RNA-NEAT1 expression among different clinical characteristics in patients with acute pancreatitis,and LSD-t test was used for measurement data,and LSD-t test was used for count data χ2 test;logistic regression model was used to screen independent risk factors for acute pancreatitis;the diagnostic value of Lnc RNA-NEAT1 on the condition of acute pancreatitis was adequately separated between the distribution of outcome values of critically ill and non-critically ill patients using the area under the ROC curve(AUC).The difference was statistically significant when P < 0.05.Results:(1)Serum Lnc RNA-NEAT1 expression was higher in all groups,and its expression was 1.63±0.82,2.97±1.04,3.88±0.93,respectively,and the difference was significant by comparing the expression rate of serum Lnc RNA-NEAT1 in each group,(F=31.833,P<0.05).(2)Two-by-two comparison of serum Lnc R-Neat1 expression in each group using Bonferroni method,it could be obtained that serum Lnc R-Neat1 expression in patients in MAP group and SAP group was higher than that in control group,and SAP group was higher than MAP group,and the difference was significant(P<0.05).(3)The mean values of Lnc RNA-NEAT1 expression in the acute phase of disease on admission and 24 hours before discharge were significantly higher in both the severe and non-severe disease groups than in the control group(p<0.05),while the expression level of NEAT1 decreased significantly in the 24 hours before discharge compared with that in the acute phase after clinical treatment and the decrease level in the severe disease group was higher than that in the non-severe disease group.(4)Logistic regression showed that Lnc RNA-NEAT1 was associated with a higher risk of acute pancreatitis and the association was statistically significant after adjusting for confounders(OR=4.75,95% CI: 2.30-9.83,P<0.01),while the association between sex and age and acute pancreatitis was not statistically significant.(5)The AUC of the area under the ROC curve was 0.82(95% CI=0.73-0.92,p<0.05),and the optimal cut-off value of Lnc RNA-NEAT1 was 3.30,and the sensitivity and specificity of diagnosing the degree of acute pancreatitis were 0.74 and 0.79,respectively,and the accuracy was 0.73Conclusion:In this study,it was preliminarily proved that the positive expression of lnc RNA-NEAT1 was positively correlated with the incidence of acute pancreatitis.The study of this indicator has important practical value in the clinical evaluation of the prognosis biomarkers of acute pancreatitis,and has important guiding significance in the clinical treatment and prognosis judgment of patients.