糖尿病与临床实践杂志

抽象的

Global Diabetes 2019: Circulating MicroRNAs in overweight and obese patients - Angelo Michele Carella - T. Masselli-Mascia Hospital

Angelo Michele Carella

MicroRNAs, short noncoding RNA sequences, regulate several biological processes and seem also regulate insulin signaling, immune-mediated inflammation, adipokine expression, adipogenesis, lipid metabolism, and food intake. MiRNAs may have a role in molecular mechanisms linked to cellular pathways of some diseases, as viral infections, cancer, diabetes, obesity and cardiovascular disease. The recent discovery of circulating miRNAs (c-miRNAs) easily detectable and measurable in plasma and other body fluids, led to the hypothesis of their potential role as disease indicators. It has been shown that altered levels of several c-miRNAs are linked to overweight, obesity and their complications. Different levels of some c-miRNAs were found significantly associated with weight gain, but most of the data concern comorbidities and complications of obesity as insulin resistance, pre-diabetes, diabetes, dyslipidaemia, adipogenesisdys regulation and inflammatory processes. Moreover, several evidences were obtained in obese children, in newborns and in maternal pre-gestational and gestational obesity. In particular the expression of some c-miRNAs differs in infants born to obese women compared with those born to lean women and these biomarkers might be useful in predicting future risk of obesity in children. At last, down-regulation of different c-miRNAs was observed in overweight/obese subjects after low or high glycemic index diet and after low-fat diet; c-miRNAs might also be potential novel biomarkers for the benefits of bariatric surgery and the effects of mild exercise. A potential role of c-miRNAs detection as diagnostic, prognostic and therapeutic biomarkers in overweight and obese patients is supported by scientific evidence but there are several limits: number, duration and sample size of clinical studies are small; source of cmiRNAs, extraction procedures, quantities of blood samples and methods of analysis were promiscuous and not well standardized; high costs required for c-miRNAs detection. Reproducible and well standardized methods as well as low cost and wide availability assays to detect c-miRNAs with high sensitivity/specificity and large, long-term and randomized controlled clinical studies are need to determine whether c-miRNAs can play a role as biomarkers for management of overweight and obesity in daily clinical practice.