Plasma miR-148b-3p is associated with CKD-related renal dysfunction and carotid plaque burden in patients with established coronary artery disease.

BACKGROUND

Chronic kidney disease (CKD) is associated with increased atherosclerotic burden and vascular risk, particularly in patients with established coronary artery disease (CAD). Circulating microRNAs may reflect renal dysfunction and systemic vascular injury. We investigated whether plasma miR-148b-3p is associated with renal function and carotid plaque burden in patients with established CAD.

METHODS

We conducted a single-center cross-sectional study of 190 hospitalized patients with coronary artery disease, including 90 with CKD and 100 without CKD. Plasma miR-148b-3p was measured by quantitative polymerase chain reaction. Carotid atherosclerosis was assessed by ultrasonography and quantified by Crouse score. Associations with renal function and plaque burden were evaluated using correlation analysis, multivariable regression, restricted cubic spline analysis, ROC analysis, bootstrap validation, and incremental predictive analyses. Bioinformatic and transcriptomic analyses were performed to identify hypothesis-generating candidate targets.

RESULTS

In patients with established CAD, plasma miR-148b-3p levels were higher in CKD than non-CKD patients [8.77 (7.35, 11.08) vs. 2.43 (1.41, 3.45), P = 7.497 × 10-5]. Higher miR-148b-3p was independently associated with lower eGFR (standardized β = -0.306, 95% CI -0.441 to -0.170, P = 1.455 × 10-5) and greater Crouse score (β = 0.160, 95% CI 0.028-0.292, P = 0.017). For carotid plaque detection, in exploratory ROC analyses, plasma miR-148b-3p showed limited discrimination in non-CKD patients and moderate discrimination in the CKD subgroup. Although bootstrap resampling suggested internal stability, these estimates require external validation. Integrative analyses identified enrichment of endothelial and atherogenic pathways and highlighted 4 shared candidate genes-MRPS25, ADAMTS5, MMP15, and RAB12.

CONCLUSIONS

In patients with established CAD, plasma miR-148b-3p was associated with CKD status, impaired renal function, and carotid plaque burden. Its potential adjunctive value for plaque assessment remains exploratory and requires confirmation in larger prospective cohorts with independent external validation.