A panel of serum-derived exosomal miRNAs as markers of cardiovascular risk assessed by carotid intima-media thickness in patients with type 2 diabetes

OBJECTIVES: Patients with type 2 diabetes mellitus (T2DM) exhibit accelerated atherosclerosis progression and an increased risk of cardiovascular disease (CVD). Early CVD diagnosis and timely intervention are critical to mitigate complications and mortality in this population. METHODS: Serum exosomes were isolated from 12 T2DM patients with or without carotid atherosclerosis (CAS). miRNA profiling was performed using microarray analysis. A total of 187 T2DM patients were divided into the test and validation cohorts. Plasma-derived exosomal miRNAs were quantified using quantitative PCR (qPCR), and their diagnostic potential was assessed using receiver operating characteristic curve analysis and area under the curve (AUC) calculations. RESULTS: Microarray analysis identified 23 differentially expressed miRNAs (DEMIs), including 19 upregulated and 4 downregulated miRNAs. Four of these (hsa-miR-433-3p, hsa-let-7b, hsa-miR-30-5p, and hsa-miR-122-5p) were significantly elevated in patients with CAS and showed positive correlation with carotid intima-media thickness. The results also showed that these miRNAs demonstrated diagnostic efficacy for CAS detection in patients with T2DM, and were stratified by disease severity. CONCLUSIONS: The identified miRNA panel represents a promising diagnostic biomarker for CAS in patients with T2DM, providing a foundation for the development of targeted therapies to address diabetic cardiovascular complications.