Clinical valae of circulating microbonucleic acids mir-1 and mir-21 in evaluating the diagnosis of acute heart failure asymptomatic type 2 diabetic patients

Abstract

Objective: To investigate whether the circulating (microRNA-1 and 21) miR-1 and miR-21 expression might be used in the diagnosis of heart failure (HF) and silent coronary artery disease (SD) in asymptomatic type 2 diabetes mellitus (T2DM) patients and to explore the relationship of these miRs with N-terminal pro-brain natriuretic peptide (NT-proBNP) and galectin-3. Methods: One hundred thirty-five consecutive patients with T2DM and 45 matched control subjects were enrolled in the study. This study consisted of four groups: control group (mean age: 60.23±6.27 years, F/M:23/22), diabetic group (DM) (mean age: 61.50±5.08, F/M:23/22), DM+SCAD group (mean age: 61.61±6.02, F/M:20/25) and DM+ acute HF group (mean age: 62.07±5.26 years, F/M:20/25). Results: miR-1 was downregulated in the DM, CAD+DM and HF+DM groups by 0.54, 0.54 and 0.12 fold when compared with controls, respectively. miR-1 levels were significantly lower in HF+DM than DM with 0.22 fold changes (p<0.001); and in patients with CAD+DM group with 0.22 fold changes (p<0.001). Similarly, miR-21 was overexpressed in patients with DM, CAD+DM and HF+DM 1.30, 1.79 and 2.21 fold when compared with controls, respectively. An interesting finding is that miR-21 expression is significantly higher in HF+DM group compared to CAD+DM group. miR-1 was negatively correlated with NT-proBNP (r=-0.891; p<0.001) and galectin-3 (r=-0.886; p<0.001) in HF+DM group. miR-21 showed strongly positive correlation with (r=0.734; p<0,001) and galectin-3 (r=0.764; p<0.001) in HF+DM group. Conclusion: This results suggest that the circulating decreased miR-1 and increased miR-21 expression is associated with NT-proBNP and galectin-3 levels in acute HF+DM. Especially miR-21 expression might be useful in predicting the onset of acute HF in asymptomatic T2DM patients. miR-21 expression is more valuable than miR-1 in predicting cardiovascular events of acute HF and the combined analysis of miR-21 expression, galectin-3 and NT-proBNP can increase the predictive value of miR-21 expression.