血清miR-210、TSG-6、CTRP3水平与扩张型心肌病患者心肌纤维化及预后的关系

doi:10.3969/j.issn.1006-5725.2025.23.009

Abstract

Abstract:

Objective To investigate the correlation between serum microRNA-210 （miR-210）， tumor necrosis factor-stimulated gene 6 （TSG-6）， and complement C1q tumor necrosis factor-related protein 3 （CTRP3） and their association with myocardial fibrosis and prognosis in patients with dilated cardiomyopathy （DCM）. Methods A total of 117 patients with DCM admitted to Taizhou People's Hospital between March and August 2024 were enrolled in the DCM group. Based on cardiac magnetic resonance imaging findings， these patients were further classified into a myocardial fibrosis group （n = 96） and a non-fibrosis group （n = 21）. Additionally， according to the occurrence of acute heart failure during one-year follow-up， they were categorized into a heart failure group （n = 47） and a non-heart failure group （n = 70）. Concurrently， 58 age- and sex-matched healthy volunteers were recruited as the control group. Serum levels of miR-210， TSG-6， CTRP3， N-terminal propeptide of type Ⅲ procollagen （PⅢNP）， left ventricular ejection fraction （LVEF）， and N-terminal pro-B-type natriuretic peptide （NT-proBNP） were measured and compared across all groups. Results The DCM group exhibited significantly higher serum levels of miR-210， TSG-6， PⅢNP， and NT-proBNP， lower CTRP3 levels， and reduced LVEF compared to the healthy controls （P < 0.05）. Similarly， the fibrosis group showed elevated serum levels of miR-210， TSG-6， PⅢNP， and NT-proBNP， decreased CTRP3 levels， and impaired LVEF relative to the non-fibrosis group （P < 0.05）. The heart failure group also demonstrated higher serum concentrations of these biomarkers， along with lower CTRP3 and reduced LVEF， compared to the non-heart failure group （P < 0.05）. Serum miR-210 and TSG-6 levels were positively correlated with PⅢNP and NT-proBNP （P < 0.05） and negatively correlated with LVEF （P < 0.05）. Multivariate analysis revealed that elevated serum miR-210 （OR = 2.065， 95%CI： 1.116 ~ 3.821） and TSG-6 （OR = 1.047， 95%CI： 1.013 ~ 1.083） were independent risk factors for heart failure in DCM patients （P < 0.05）， whereas higher CTRP3 levels （OR = 0.911， 95%CI： 0.849 ~ 0.978） were associated with a protective effect （P < 0.05）. The sensitivity of serum miR-210， TSG-6， and CTRP3 in predicting heart failure in DCM patients was 72.34%， 74.47%， and 74.47%， respectively， with specificities of 62.86%， 62.86%， and 68.57%， yielding AUC values of 0.669， 0.712， and 0.759， respectively. Conclusions Serum levels of miR-210 and TSG-6 are elevated， whereas CTRP3 levels are reduced in patients with DCM. These biomarkers are closely associated with myocardial fibrosis and cardiac function impairment. Moreover， miR-210， TSG-6， and CTRP3 exhibit significant predictive value for the prognosis of DCM.

Key words: dilated cardiomyopathy, myocardial fibrosis, prognosis, microRNA-210, tumor necrosis factor-stimulated gene 6, complement C1q tumor necrosis factor-related protein 3

CLC Number:

R542.2

Yebao WANG,Yongping LIN,Ling LIU,Jianmin. LI. Correlation of serum miR‑210， TSG‑6 and CTRP3 with myocardial fibrosis and prognosis in patients with dilated cardiomyopathy[J]. The Journal of Practical Medicine, 2025, 41(23): 3690-3696.

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References 26

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组别	例数	性别（男/女）/例	年龄/岁	收缩压/mmHg	舒张压/mmHg
DCM组	117	83/34	58.76 ± 10.24	127.16 ± 10.18	78.54 ± 8.27
健康对照组	58	41/17	57.92 ± 9.73	125.43 ± 11.64	76.35 ± 9.10
t/χ²值		0.001	0.519	1.008	1.595
P值		0.973	0.604	0.315	0.113
组别	例数	体质量指数/（kg/m²）	基础心率/（次/min）	吸烟/［例（%）］	饮酒/［例（%）］
DCM组	117	22.43 ± 2.16	72.65 ± 10.04	35（29.91）	29（24.79）
健康对照组	58	22.75 ± 2.09	74.33 ± 9.82	12（20.69）	10（17.24）
t/χ²值		0.932	1.050	1.680	1.275
P值		0.352	0.295	0.195	0.259

组别	例数	miR-210	TSG-6 /（ng/mL）	CTRP3 /（pg/mL）
DCM组	117	1.21 ± 0.30	196.50 ± 48.36	149.34 ± 37.18
健康对照组	58	0.92 ± 0.24	150.37 ± 39.12	180.27 ± 45.32
t值		6.412	6.310	4.810
P值		< 0.001	< 0.001	< 0.001

组别	例数	PⅢNP /（ng/mL）	LVEF/%	NT-proBNP /（pg/mL）
DCM组	117	16.26 ± 4.10	36.14 ± 9.08	583.40 ± 147.63
健康对照组	58	12.33 ± 3.12	60.27 ± 10.43	195.26 ± 50.75
t值		6.432	15.741	19.437
P值		< 0.001	< 0.001	< 0.001

组别	例数	miR-210	TSG-6/ （ng/mL）	CTRP3/ （pg/mL）
纤维化组	96	1.24 ± 0.31	202.53 ± 50.18	145.73 ± 36.29
非纤维化组	21	1.08 ± 0.27	168.92 ± 43.67	165.84 ± 40.72
t值		2.189	2.841	2.250
P值		0.031	0.005	0.026

组别	例数	PⅢNP/ （ng/mL）	LVEF/%	NT-proBNP/ （pg/mL）
纤维化组	96	16.79 ± 4.19	35.12 ± 8.72	633.24 ± 160.15
非纤维化组	21	13.86 ± 3.47	40.78 ± 9.63	355.56 ± 88.92
t值		2.985	2.644	7.674
P值		0.003	0.009	< 0.001

Correlation of serum miR‑210， TSG‑6 and CTRP3 with myocardial fibrosis and prognosis in patients with dilated cardiomyopathy

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组别	例数	miR-210	TSG-6/ （ng/mL）	CTRP3/ （pg/mL）
心衰组	47	1.33 ± 0.35	218.57 ± 54.39	130.62 ± 33.15
非心衰组	70	1.13 ± 0.28	181.68 ± 44.32	161.91 ± 40.57
t值		3.422	4.025	4.392
P值		0.001	< 0.001	< 0.001

组别	例数	PⅢNP/ （ng/mL）	LVEF/%	NT-proBNP/ （pg/mL）
心衰组	47	17.84 ± 4.52	30.09 ± 7.56	1 085.24 ± 273.48
非心衰组	70	15.20 ± 3.85	40.20 ± 10.15	246.45 ± 61.33
t值		3.389	5.826	24.798
P值		0.001	< 0.001	< 0.001

指标	PⅢNP		LVEF		NT-proBNP
指标	r值	P值	r值	P值	r值	P值
miR-210	0.446	< 0.001	-0.412	< 0.001	0.538	< 0.001
TSG-6	0.503	< 0.001	-0.468	< 0.001	0.602	< 0.001
CTRP3	-0.419	< 0.001	0.553	< 0.001	-0.571	< 0.001

因素	β	SE	Waldχ²	OR	95%CI	P值
miR-210高水平	0.725	0.314	5.331	2.065	1.116 ~ 3.821	0.021
TSG-6高水平	0.046	0.017	7.322	1.047	1.013 ~ 1.083	0.007
CTRP3高水平	-0.093	0.036	6.674	0.911	0.849 ~ 0.978	0.010

指标	截断值	AUC	95%CI	灵敏度/%	特异度/%	约登指数
miR-210	1.200	0.669	0.565 ~ 0.772	72.34	62.86	0.352
TSG-6	191.69	0.712	0.615 ~ 0.808	74.47	62.86	0.373
CTRP3	143.42	0.759	0.668 ~ 0.851	74.47	68.57	0.430

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