miR-29a-3p serves as a potential biomarker for diagnosing spinal tuberculosis: a comprehensive analysis integrating clinical data and molecular markers.

BACKGROUND: Spinal tuberculosis (STB), the most common bone and joint tuberculosis, often causes spinal deformity and impairs quality of life. While microRNAs (miRNAs) regulate various disease pathogenesis, their expression and function in STB remain poorly understood. METHODS: 100 STB patients (observation group) from Ningxia Medical University Affiliated Hospital (Jan 2021-Dec 2024) and 100 healthy controls were enrolled. miRNA high-throughput sequencing of 3 samples per group identified differentially expressed miRNAs, validated via known STB signaling pathways. Real-time fluorescence quantitative reverse transcription PCR(RT-qPCR) quantified peripheral blood miR-29a-3p in all participants. Clinical data were collected. Independent samples t-tests, linear regression, Spearman correlation, and receiver operating characteristic(ROC) curves analyzed miR-29a-3p's expression differences, associations with clinical parameters, and diagnostic performance (alone or combined with conventional indicators). RESULTS: Peripheral blood miR-29a-3p was significantly lower in STB patients (AUC = 0.864). It negatively correlated with erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) but not with white blood cell count, disease duration, or neutrophil percentage. Combining miR-29a-3p with bacteriological testing, T-cell spot test(T-SPOT), and imaging significantly improved diagnostic performance. CONCLUSION: miR-29a-3p shows distinct low expression in STB patients' peripheral blood, associated with inflammation activity and conventional diagnostic indicators, making it a promising auxiliary biomarker. Critically, integrating miR-29a-3p into combined detection strategies enhances and optimizes current STB diagnostic frameworks, addressing unmet clinical needs for more accurate and efficient diagnosis, thus holding substantial value for improving STB management.