目的：探讨血清和房水中miR-377-3p和miR-365-3p表达水平与糖尿病性黄斑水肿(DME)程度的相关性。方法：前瞻性研究。选取2021-02/ 2022-02三六三医院收治的初诊为DME患者60例60眼(如双眼发病取严重眼入组，若两眼程度一致取右眼)，其中轻度24眼，中度21眼，重度15眼； 另选同期本院收治的未发生DME的2型糖尿病患者60例60眼作为对照组。收集所有患者基本临床资料，包括BMI、吸烟史、饮酒史、高血压、高血脂、糖尿病病程、糖化血红蛋白、空腹血糖、Hcy； 实时荧光定量PCR(qRT-PCR)法检测血清和房水中miR-377-3p和miR-365-3p表达水平。结果：DME组患者糖尿病病程、糖化血红蛋白、空腹血糖、同型半胱氨酸(Hcy)均显著高于对照组(均P<0.05)； DME组患者血清中miR-377-3p和miR-365-3p表达水平均低于对照组(均P<0.05)； 重度组患者血清和房水中miR-377-3p和miR-365-3p表达水平显著低于中度组和轻度组，中度组显著低于轻度组(均P<0.05)； 血清中miR-377-3p和miR-365-3p表达水平与CMT呈负相关(r=-0.342、-0.374，均P<0.05)，房水中miR-377-3p和miR-365-3p表达水平与CMT呈负相关(r=-0.425、-0.503，均P<0.05)； 多因素Logistic回归分析结果显示，糖尿病病程、空腹血糖及Hcy是2型糖尿病患者发生DME的危险因素，血清中miR-377-3p和miR-365-3p是2型糖尿病患者发生DME的保护因素(P<0.05)。结论：DME患者血清和房水中miR-377-3p、miR-365-3p均低表达，并与DME患者严重程度呈负相关。

AIM: To explore the correlation between the expression levels of microRNA-377-3p(miR-377-3p)and microRNA-365-3p(miR-365-3p)in serum and aqueous humor and the degree of diabetes macular edema(DME).METHODS: A total of 60 DME patients(60 eyes)admitted to 363 Hospital from February 2021 to February 2022 were selected in this prospective study(the severe eye was selected if both eyes had DME, while the right eye was selected if the same degree of DME), including 24 mild eyes, 21 moderate eyes and 15 severe eyes. In addition, another 60 patients(60 eyes)with type 2 diabetes(without fundus disease)admitted to our hospital during the same period were selected as the control group. The basic clinical data of all subjects were collected, including body mass index(BMI), smoking history, drinking history, hypertension, hyperlipidemia, the course of diabetes, glycated hemoglobin levels, fasting blood glucose and homocysteine(Hcy); the expression levels of miR-377-3p and miR-365-3p were detected by real-time fluorescent quantitative PCR(qRT-PCR).RESULTS: The course of diabetes, glycosylated hemoglobin, fasting blood glucose and Hcy in DME group were obviously higher than those in control group(all P<0.05); the expression levels of miR-377-3p and miR-365-3p in serum of patients in DME group were lower than those in control group(all P<0.05); the expression levels of miR-377-3p and miR-365-3p in serum and aqueous humor in severe group were obviously lower than those in moderate group and mild group, and those in moderate group were obviously lower than those in mild group(all P<0.05); the expression levels of miR-377-3p and miR-365-3p in serum were negatively correlated with central macular thickness(CMT; r=-0.342, -0.374, all P<0.05), the expression levels of miR-377-3p and miR-365-3p in aqueous humor were negatively correlated with CMT(r=-0.425, -0.503, all P<0.05); the multivariate Logistic regression analysis showed that the course of diabetes, increased fasting blood glucose and Hcy were risk factors for DME in type 2 diabetes patients, and serum miR-377-3p and miR-365-3p were protective factors for DME in type 2 diabetes patients(P<0.05).CONCLUSION: The expression of miR-377-3p and miR-365-3p in serum and aqueous humor of patients with DME is low, which is negatively related to the severity of DME patients.

三六三医院医学科研课题孵化计划项目(No.2021FH021)