摘要
目的分析糖耐量受损(IGT)、2型糖尿病患者血清超敏C反应蛋白(hs-CRP)与血糖、血胰岛素、血脂、胰岛素敏感性、胰岛素分泌功能、血清脂联素等的相关性.方法用减少样本数的Bergnan微小模型技术结合静脉葡萄糖耐量试验检测正常人、IGT、2型糖尿病患者的胰岛素敏感指数(SI)及急性胰岛素反应(AIR),同时测定受试者的体重指数(BMI)和腰臀比(WHR),检测空腹状态下血脂、血清hs-CRP、脂联素水平.结果正常组血清hs-CRP[0.40(0.21～1.67mg/L)]显著低于IGT[3.56(1.73～9.47 mg/L)]及2型糖尿病组[2.46(1.04～6.66 mg/L)](均P＜0.01),正常组的SI[(6.6±2.4)×10-4(min·mU/L)-1]和脂联素[7.77(6.35～10.70 mg/L)]显著高于IGT[分别为(1.5±1.1)×10-4(min·mU/L)-1,4.29(3.59～6.22 mg/L)]及2型糖尿病组[分别为(1.5±1.0)×10-4(min·mU/L)-1,3.46(2.37～4.72 mg/L)](均P＜0.01).后两组间这些值差异均无统计学意义.2型糖尿病组AIR[27.4(-2.5～76.5 mU/L)]显著低于正常组[(270.5±128.3)mU/L]及IGT组[(213.3±154.4)mU/L](均P＜0.01),正常组与IGT组之间差异无统计学意义.血清hs-CRP与高密度脂蛋白(HDL)、SI、脂联素呈负相关(P＜0.05或P＜0.01),与收缩压(SBP)、空腹血糖(FPG)、BMI、WHR、餐后2 h血糖(PPG)、空腹胰岛素(FINS)、餐后2 h胰岛素(PSI)呈正相关(P＜0.05或P＜0.01),在校正BMI、WHR后,hs-CRP与SI、脂联素仍存在负相关(P＜0.05或P＜0.01),与FPG、PPG正相关(均P＜0.01).多元逐步回归分析显示:以hs-CRP为应变量,脂联素进入方程(P＜0.01).结论IGT及2型糖尿病患者血清hs-CRP水平显著升高,hs-CRP与SBP,BMI、WHR、FPG、PPG、FINS、PSI正相关,与HDL、SI,尤其是与脂联素负相关,提示hs-CRP升高与代谢综合征、IGT、2型糖尿病及动脉粥样硬化的发生有关.
Objective To explore the possible correlation between serum highly sensitive C-reactive protein （hs-CRP） and blood glucose, insulin, lipids , insulin sensitivity index （ SI ） , acute insulin response （AIR） , and adiponectin in subjects with impaired glucose tolerance （IGT） or newly diagnosed type 2 diabetes mellitus （DM）. Methods SI and AIR were assessed by the reduced sample number of Bergman＇s minimal model method by intravenous glucose tolerance test in subjects. Meanwhile body mass index （BMI） , waist hip ratio （WHR） , the serum lipid profile, hs-CRP, adiponectin levels were measured. Results Compared with normal control （NC） group [SI（6.6±2.4）10^-4（min·mU/L）^-1, adiponectin 7.77（6.35-10.70 mg/L）, hs-CRP 0.40（0.21- 1.67mg/L） ], the SI and serum adiponectin in IGT group [ （ 1.5 ±1.1 ） 10^-4（min·mU/L）^-1 , 4.29（ 3.59-6.22 mg/L） respectively] and type 2 DM group [ （1.5 ± 1.0） ×10^-4（min·mU/L）^-1, 3.46 （2.37-4.72 mg/L） respectively] were significantly decreased （all P 〈 0.01 ） , and serum hs-CRP was significantly increased in IGT group [3.56（ 1.73-9.47 mg/L） ] and type 2 DM group [2.46（ 1.04-6.66 mg/L） ] （ both P 〈0.01 ）, However, there were no significant differences in above three variables between IGT and type 2 DM groups, The AIR in type 2 DM group [ 27.4 （ - 2.5-76.5 mU/L） ] was significantly lower than that in NC group （ 270.5 ± 128.3 ） mU/L and IGT [ （213.3 ±154.4 ）mU/L] group （both P 〈 0. 01 ）, while no significant difference between the latter two groups. As to serum hs-CRP level, it was negatively correlated with HDL and adiponectin （P 〈 0.05 or P 〈 0.01 ）, and positively correlated with systolic blood pressure （ SBP）, fasting plasma glucose （ FPG）, BMI, WHR, postprandial plasma glucose （PPG）, fasting serum insulin （FINS） and postprandial serum insulin （PSI） （P 〈 0.05 or P 〈 0. 01 ）. In general multivariate regression, only adiponectin was the significantly independent determinant for serum bs-CRP（ P 〈 0. 01 ）. Conclusion Serum bs-CRP level was increased in IGT and type 2 DM groups, and was positively correlated with SBP, FPG, BMI , WHR , PPG, FINS, PSI, while negatively correlated with HDL, SI, especially with adiponectin. It suggests that elevation of serum hs-CRP may play a role in the development of metabolic syndrome as well as IGT, type 2 DM and atherosclerosis.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2005年第6期507-510,共4页
Chinese Journal of Endocrinology and Metabolism
基金
国家自然科学基金(30270626)
上海市教委基金资助项目(05BZ28)
关键词
糖耐量受损
糖尿病
2型
C反应蛋白质
脂联素
胰岛素敏感指数
Impaired glucose tolerance
Diabetes mellitus, type 2
C-reactive protein
Adiponectin
Insulin sensitive index
