Expression Level And Significance Of LncRNA PVT1 In The Serum Of Patients With Lower Extremity Arteriosclerosis Obliterans

Objective:Lower Extremity Arteriosclerosis Obliterans(LEASO)is a common disease in vascular surgery.LEASO is mainly characterized by thickening and hardening of the intima of the lower extremity arteries,accompanied by the formation of atherosclerotic plaques and calcification,and may subsequently develop thrombosis.It is a type of atherosclerosis that occurs in the lower extremity arteries.Arteriosclerosis(AS)is a chronic inflammatory disease that mainly occurs in the coronary arteries,large and medium-sized arteries throughout the body,and the aorta.With the aging of the Chinese population and changes in dietary structure,the incidence of LEASO is showing a continuous upward trend.Most LEASO patients have no obvious clinical symptoms in the early stage,and due to the lack of specific and sensitive LEASO markers,it is difficult to screen and identify the disease in its early stage.Most patients have already developed more serious symptoms when they seek medical treatment,leading to severe lower extremity ischemia.In severe cases,amputation may be required or even life-threatening.This study explores the clinical significance of PVT1 in LEASO by detecting the expression level of long-chain non-coding RNA PVT1 in the serum of LEASO patients.Methods:This study included 133 patients diagnosed with LEASO(patients diagnosed with lower extremity arteriosclerosis obliterans by lower extremity arteriography or lower extremity arterial Doppler ultrasound examination)at Qingdao Municipal Hospital from July 2021 to April 2022.Among them,44 cases had coronary artery disease(CAD)(with a history of CAD,diagnosed by coronary artery multi-slice spiral CT imaging or coronary angiography,and other arterial diseases were excluded),defined as the LEASO combined with CAD group(LEASO+CAD group);patients who were excluded from CAD and other arterial diseases were defined as the LEASO group,with a total of 89 cases.In the LEASO group,patients were divided into unilateral and bilateral affected limb groups according to the affected limb;left and right affected limb groups.In the LEASO group,patients were graded according to the Rutherford classification.Fifty healthy individuals who came to our hospital for physical examination during the same period were randomly included and defined as the healthy control group.The expression of serum PVT1 in each group of patients was detected by qRT-PCR,and the difference in PVT1 expression level between groups was calculated;the ankle-brachial index(ABI)of patients in the LEASO group was measured using a sphygmomanometer,and the correlation between ABI and PVT1 was analyzed;clinical data and laboratory test results(including blood routine,liver function,kidney function,blood lipids)of all patients were collected at admission,and logistic regression analysis of the influencing factors of LEASO was performed with PVT1 and laboratory test results;PVT1 was used in combination with laboratory test indicators to diagnose and predict LEASO.Results:The expression of PVT1 was highest in the LEASO+CAD patient group(P<0.05);in addition,the expression of PVT1 in the LEASO group was higher than that in the healthy control group(P<0.05).In the LEASO group,there was no significant difference in serum PVT1 levels between the left lower limb group and the right lower limb group(P>0.05),and there was no significant difference in PVT1 expression between the single lower limb group and the double lower limb group(P>0.05).Moreover,in the LEASO group,as the Rutherford classification increased,the expression of PVT1 gradually increased,and it can be seen that the expression of PVT1 was negatively correlated with ABI.The results of logistic regression analysis of influencing factors showed that TG(OR=2.972,95%CI:1.159～7.618),LDL-C(OR=6.655,95%CI:1.490～29.723),CRP(OR=1.686,95%CI:1.218～2.335),and PVT1(OR=2.885,95%CI:1.350～6.167)were independent risk factors for the occurrence of LEASO.Finally,using the receiver operating characteristic curve to diagnose and predict LEASO with PVT1 combined with meaningful laboratory indicators,the ROC curve showed strong sensitivity.Conclusion:LncRNA PVT1 may be involved in the occurrence and development of LEASO and is related to the severity of AS lesions.The expression of PVT1 was negatively correlated with ABI,and logistic regression analysis of influencing factors suggested that the occurrence of LEASO may be related to the influence of blood lipids and inflammatory response.PVT1 combined with laboratory indicators to predict LEASO,the area under the receiver operating characteristic curve was large,and the prediction result had strong sensitivity.