| Objectives:1.By comparing the constituent differences of risk factors among different groups,the common risk factors were analyzed,and the mechanism of interaction between rheumatoid arthritis(RA)and coronary atherosclerotic heart disease(CHD)was discussed;2.On the basis of exploring the difference of risk factor composition among different groups,we further combined with the gene expression regulator micro RNA(miRNA)to analyze the correlation between gene level and traditional risk factors,and to explore the possible mechanism of miRNA participating in CHD lesions in RA patients.Methods:Chapter 1: Study on risk factors of RA combined with CHDFrom October 2020 to October 2022,59 RA patients with CHD who were hospitalized in the Rheumatology and Immunology Department of the Sixth Affiliated Hospital of Kunming Medical University were selected as the observation group(including 23 males and 36 females);203 CHD patients(including 78 males and 125females)and 197 RA patients(including 46 males and 151 females)hospitalized in the Rheumatology and Immunology Department were the case control group;115 people(45males and 70 females)from the health examination center in the same period were randomly selected as the health control group.The data of sex,age,liver function index and blood lipid index were collected for statistical analysis.In addition to the general inter-group comparison and correlation analysis,binary logistic regression analysis was performed to screen the pathogenic risk factors of each subgroup,analyze the composition differences of the risk factors of each subgroup and screen the common risk factors,and explore the possible mechanism of the interaction between RA and CHD.Chapter 2: Study on the correlation between miRNA and RA combined with CHDFrom October 2021 to October 2022,39 RA patients with CHD hospitalized i-n the Rheumatology and Immunology Department of the Sixth Affiliated Hospital of Kunming Medical University were selected as the observation group(including14 males and 25 females),55 CHD patients hospitalized in the heart(including 17 males and 38 females)and 32 RA patients hospitalized in the Rheumatology and Immunology Department(including 9 males and 23 females)as the case control gr-oup,A total of 81 people(including 29 males and 52 females)from the health examination center in the same period were randomly selected as the health control group.Extract the miRNA from the whole blood of EDTA-K2 anticoagulant for q-uantitative PCR detection,observe the difference of miRNA in different population-s and the relationship between miRNA and risk factors in different groups,and ex-plore the possible mechanism of miRNA involvement in CHD lesions in RA patie-nts.Results:Chapter 1:Study on risk factors of RA combined with CHD1.Univariate analysis of variance showed that total bilirubin(TBIL)、direct bilirubin(DBIL)、Indirect bilirubin(IBIL)、albumin(ALB)、globulin(GLO)、albumin to glob-ulin ratio(AGR)、alanine aminotransferase(ALT)、aspartate aminotransferase(AST)、al-kaline phosphatase(ALP)、total cholesterol(TC)、triglyceride(TG)、high-density lipopr-otein cholesterol(HDL-C)、low-density lipoprotein cholesterol(LDL-C)、apolipoprotein A1(Apo A1)、creatine kinase(CK)、creatine kinase-MB(CK-MB)、high sensitive troponin T(hs-c Tn T)、Immunoglobulin A(Ig A)、procalcitonin(PCT)、Interleukin 6(IL-6)、C-reactionprotein(CRP)、high sensitive troponin T(hs CRP)、whit-e blood cell(WBC)、neutrophil(NEUT)、platelet(PLT)had statistical differences betwe-en RA combined wi th CHD,simple RA,simple CHD and healthy people(P<0.05),while very low-den sity lipoprotein cholesterol(VLDL-C)、apolipoprotein B100(Apo B100)、lipoprotein(a)[L p(a)]、N terminal B type natriuretic peptide(NT-pro BNP)、Imm-unoglobulin G(Ig G)、Immunoglobulin M(Ig M)、complement 3(C3)、complement 4(C4)、complement 1q(C1q)、rheumatoid factor(RF)、leukomonocyte(LYMPH)had no statistical differences be tween different groups(P>0.05);2.Through binary logistic regression,it was found that TBIL,IBIL,ALB,AGR,TC,HDL-C,Apo A1,Ig A,CRP,hs CRP,WBC,PLT were statistically significant between RA combined with CHD group and healthy control group(P<0.05),among which TBIL,IBIL,ALB,AGR,TC,HDL-C,Apo A1 were negatively correlated with disease occurrence(OR<1),Ig A,CRP,hs CRP,WBC,PLT were positively correlated with disease occurrence(OR>1);There was significant difference in DBIL,IBIL,ALT,TC,HDL-C,LDL-C between CHD group and healthy control group(P<0.05),among which IBIL,TC,HDL-C,LDL-C were negatively correlated with the incidence of CHD(OR<1),and DBIL,ALT were positively correlated with the incidence of CHD(OR>1);There were statistically significant differences in TBIL,IBIL,ALB,AGR,AST,TC,HDL-C,Ig A,IL-6,CRP,hs CRP,WBC,PLT between RA group and healthy control group(P<0.05),among which TBIL,IBIL,ALB,AGR,TC,HDL-C were negatively correlated with RA incidence(OR<1),AST,Ig A,IL-6,CRP,hs CRP,WBC,PLT were positively correlated with RA incidence(OR>1).Chapter 2: Study on the correlation between miRNA and RA combined with CHD1.The results of real-time fluorescence quantitative PCR showed that there were significant differences between different disease groups in miR-146 a and miR-155(P<0.001).Among them,the expression of miR-146 a was the highest in the whole blood of RA patients and the lowest in CHD patients.There was a significant difference between the two groups and the healthy control group(P<0.05).The expression of miR-146 a in the RA combined with CHD group was lower than that in the healthy control group(P=0.184);The level of miR-155 in RA group and CHD group was significantly higher than that in the healthy control group(P<0.001).Although the level of miR-155 in RA combined with CHD group was also significantly higher than that in the healthy control group(P=0.001),its increase was lower than that in RA group(P=0.435)and CHD group(P=0.737).2.Spearman correlation analysis showed that the expression of miR-146 a in RA combined with CHD group was positively correlated with Ig A(r=-0.177),hs CRP(r=0.203),WBC(r=0.377),and negatively correlated with Ig A;Mi R-155 was only positively correlated with WBC(r=0.259).In CHD group,miR-146 a was only negatively correlated with HDL-C(r=-0.254);Mi R-155 was only negatively correlated with HDL-C(r=-0.283).In RA group,miR-146 a was negatively correlated with Ig A(r=-0.402),IL-6(r=-0.291)and WBC(r=-0.294);Mi R-155 was negatively correlated with Ig A(r=-0.300)and IL-6(r=-0.218).Conclusions:1.There were differences in the composition of risk factors among RA combined with CHD,RA and CHD.Among them,IBIL and HDL-C are common risk factors;TBIL,ALB,AGR,Ig A,CRP,hs CRP,WBC and PLT are common risk factors of RA combined with CHD and RA;CK and CK-MB are unique risk factors for CHD.2.There are differences in the expression of miR-146 a in different populations,which may be related to the occurrence of diseases.Among them,miR-146 a may affect the levels of Ig A,WBC and hs CRP through mediating immune and inflammatory pathways,thus playing a certain role in RA and RA combined with CHD.3.The expression of miR-155 is complex in different populations,and its role in RA and RA combined with CHD is unclear. |
