Correlation Between Plasma MiR-21 And Clinical Stage Of Diabetic Retinopathy And TCM Syndromes

Objective:Through comparing the plasma micro RNA-21,glycosylated hemoglobin and plasma creatinine in different syndrome of diabetic retinopathy patients to provide objective indicators for clinical syndrome differentiation.And comparing miR-21,GHb and Scr in proliferative with non-proliferative stages to provide potential biomarkers for proliferative DR.Methods:From January 2020 to December 2020,80 patients with type 2 diabetic retinopathy were observed in ophthalmology clinic and ward of the second people’s Hospital affiliated to Fujian University of traditional Chinese Medicine.According to the type of Traditional Chinese Medical syndrome of diabetic eye disease,it can be divided into four groups: Qi-yin deficiency group,spleen-kidney deficiency group,Yin-deficiency and blood stasis group and phlegm-stasis block group.After fundus fluorography,80 patients were divided into simple group and value-added group according to DR clinical stages.Basic data,such as miR-21、Scr、GHb and other data were collected,and inter-group comparison and correlation analysis were carried out.Results:(1)The difference of GHb between different syndromes in DR was statistically significant(F=8.348,P<0.001).Among them,the GHb in phlegm and blood stasis block group and Yin deficiency and blood stasis syndrome group was higher than that of Qi and Yin deficiency syndrome group,and the GHb of phlegm and blood stasis block group was higher than that of spleen and kidney deficiency syndrome group(all P<0.05).(2)There was no significant difference of Scr between different syndromes in DR(P>0.05).(3)There were significant differences of plasma miR-21 expression between different syndromes in DR(all P<0.001).Among them,the highest expression of plasma miR-21 was phlegm and blood stasis block syndrome group,followed by Qi-yin Jia-yu syndrome group,spleen and kidney deficiency syndrome group,Qi-yin deficiency syndrome group.(4)There was a positive correlation between plasma miR-21,GHb and DR syndromes.Through partial correlation analysis,there is still a positive correlation between plasma miR-21 and GHb(r=0.423,P<0.001)after considering the effect of plasma miR-21 factors.After considering the effect of GHb,there is still a positive correlation between plasma miR-21 and syndromes(r=0.788,P<0.001).(5)GHb in DR proliferative phase was higher than that in simple phase(P<0.001).(6)There was no significant difference of Scr between two phases in DR(P>0.05).(7)The expression of plasma miR-21 in DR proliferative phase was higher than that in simple phase(P<0.001).(8)There was a positive correlation between plasma miR-21,GHb and DR clinical period.The positive correlation between plasma miR-21 and GHb(r=0.396,P<0.001)was still found after partial correlation analysis.After considering the effect of plasma miR-21 factors,the positive correlation between GHb and DR syndromes was no longer present.After considering the effect of GHb,there is still a positive correlation between plasma miR-21 and syndromes(r=0.505,P<0.001).Conclusion:(1)There is a correlation between plasma miR-21 and DR TCM syndromes.The expression of plasma miR-21 in different DR of TCM syndrome is phlegm and blood stasis syndrome > Yin deficiency syndrome > spleen and kidney deficiency syndrome and qi-yin deficiency syndrome.The results suggest that plasma miR-21 may provide objective indexes for DR syndrome differentiation and classification.(2)There is a correlation between plasma miR-21 and DR clinical stage.The expression of plasma miR-21 in different DR clinical stages was proliferative > simple.suggesting that miR-21 may be an early biomarker for proliferative DR.(3)There was no correlation between Scr and DR syndrome type and clinical stage,GHb and DR syndrome type and clinical stage,but after considering the influence of plasma miR-21 factors,the relationship between GHb and clinical stage no longer existed,tips GHb not be an independent risk factor for DR.There is still a correlation between plasma miR-21 and GHb after considering the influence of syndromes,suggesting a correlation between plasma miR-21 and GHb.