Construction and Validation of a Predictive Model of Serum miR-30d-5p，miR-146a-5p，and Treg/Th17 Ratio for Predicting 90-day Prognosis in Elderly Patients with Sepsis

Guangyun HU; Lingling WANG

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Guangyun HU, Lingling WANG. Construction and Validation of a Predictive Model of Serum miR-30d-5p，miR-146a-5p，and Treg/Th17 Ratio for Predicting 90-day Prognosis in Elderly Patients with Sepsis[J]. Journal of Kunming Medical University.

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Construction and Validation of a Predictive Model of Serum miR-30d-5p，miR-146a-5p，and Treg/Th17 Ratio for Predicting 90-day Prognosis in Elderly Patients with Sepsis

Guangyun HU,
Lingling WANG^,

Department of Geriatrics，The Second People’s Hospital of Lianyungang ，Lianyungang Jiangsu 222000，China

Received Date: 2026-01-15
Available Online: 2026-06-09

Abstract

Abstract

Objective To investigate the relationship between serum microRNA-30d-5p （miR-30d-5p）, microRNA-146a-5p （miR-146a-5p）, regulatory T cell/helper T cell 17 （Treg/Th17） ratio and the prognosis of elderly patients with sepsis, and to construct and verify a nomogram prediction model. Methods A prospective observational study was conducted, enrolling 382 elderly sepsis patients treated at the Second People's Hospital of Lianyungang from January 2019 to December 2023. Patients were randomly divided in a 7∶3 ratio into a modeling group （n = 268） and a validation group （n = 114）. The modeling group was stratified into a survival group （n = 182） and a mortality group （n = 86） based on 90-day survival status. Serum and peripheral blood samples were collected within 24 hours of admission. Serum miRNA levels were detected using qRT-PCR, and the Treg/Th17 ratio was determined by flow cytometry. Multivariate Logistic regression analysis was used to identify independent risk factors and construct a nomogram model. The model performance was validated using ROC curves, calibration curves, and decision curve analysis （DCA）. Results Serum miR-30d-5p and miR-146a-5p levels were significantly lower in the mortality group compared to the survival group, while the Treg/Th17 ratio and APACHE II score were significantly higher （P < 0.05）. Multivariate Logistic regression analysis showed that low miR-30d-5p levels, low miR-146a-5p levels, high Treg/Th17 ratio, and high APACHE II score were independent risk factors for 90-day mortality in elderly sepsis patients. The nomogram model constructed based on these indicators showed an AUC of 0.886 （95%CI: 0.842 ～ 0.930） in the modeling group and 0.862 （95%CI: 0.795～ 0.929） in the validation group. The Hosmer-Lemeshow test yielded P = 0.652 in the modeling group and P = 0.584 in the validation group. The calibration curve showed good consistency between predicted probability and actual incidence rate. Conclusion Decreased serum miR-30d-5p and miR-146a-5p levels, and increased Treg/Th17 ratio are closely associated with adverse prognosis in elderly sepsis patients. The prediction model constructed based on these parameters demonstrates good discriminative ability and accuracy, providing a valuable reference for clinical assessment.
- Elderly sepsis,
- miR-30d-5p,
- miR-146a-5p,
- Treg/Th17 ratio,
- Prognosis,
- Predictive model

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References(28)

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