炎症因子与胰岛素抵抗和2型糖尿病大血管病变的相关性研究

尤巧英; 李成江; 李红; 朱麒钱; 斯徐伟

Abstract

尤巧英,李成江,李红,朱麒钱,斯徐伟.炎症因子与胰岛素抵抗和2型糖尿病大血管病变的相关性研究[J].Chinese journal of Epidemiology,2005,26(10):804-807

炎症因子与胰岛素抵抗和2型糖尿病大血管病变的相关性研究

Study on the association between inflammatory factor and insulin resistance as well as type 2 diabetes with macrovascular complications

Received:November 11, 2004

DOI：

KeyWord: 糖尿病,2型 C反应蛋白大血管病变胰岛素抵抗

English Key Word: Diabetes, type 2 Ultrasensitive C-reactive protein Mactrovascular complications Insulin resistance

FundProject:

Author Name	Affiliation
YOU Qiao-ying	Department of Endocrinology, Shaoxing People’s Hospital, Shaoxing 312000, China
LI Cheng-jiang	浙江大学医学院附属第一医院内分泌科
LI Hong	浙江大学医学院附属第一医院内分泌科
ZHU Qi-qian	Department of Endocrinology, Shaoxing People’s Hospital, Shaoxing 312000, China
SI Xu wei	Department of Endocrinology, Shaoxing People’s Hospital, Shaoxing 312000, China

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Abstract:

目的探讨炎症因子C－反应蛋白(CRP)与胰岛素抵抗(IR)和2型糖尿病(T2DM)大血管病变的关系。方法用颗粒增强免疫沉淀法测定T2DM合并大血管病变(70例)、T2DM无大血管病变(60例)及正常对照组(90名)的血清超敏CRP(usCRP)水平变化；用HOMA－IR模型作为估计IR 的指标；将CRP与HOMA－IR、空腹胰岛素(FINS)、同型半胱氨酸(Hcy)、空腹血糖(FBG)、体重指数(BMI)、腰臀比(WHR)、甘油三酯(TG)等作相关分析。结果T2DM合并大血管病变组血清usCRP 水平明显高于T2DM无大血管病变组及正常对照组(P＜0．01)，T2DM无大血管病变组高于正常对照组(P＜0．01)。当调整SBP、FBG、TG、WHR等因素的影响后，协方差结果显示usCRP在T2DM合并大血管病变组仍高于T2DM无大血管病变组及正常对照组(P＜0．05)，T2DM无大血管病变组高于正常对照组(P＜0．05)。在T2DM合并大血管病变组，Person相关分析显示，useCRP与FINS、HOMA－IR、TG呈正相关(P值分别＜0．05、＜0．01和＜0．05)，与Hcy等无关。逐步线性回归结果显示，TG、HOMA－IR是影响CRP的主要因素。结论 CRP可能是T2DM和T2DM大血管病变的危险因子，CRP可能通过胰岛素抵抗参与了T2DM大血管病变的发生和发展。

English Abstract:

Objective To study the possible associatin between C-reactive(CRP) and insulin resistance(IR) as well as the pathogenesis of type 2 diabetes macrovascular complication. Methods Serum CRP was measured by ultrasensitive immuoturbidimetiric, which was determined on type 2 diabetes(T2DM) with or without macrovascular complication(70 and 60 cases respectively) and on normal controls(90 cases). IR was estimated by homeostasis model assessment(HOMA-IR). Results Results showed that the concentration of CRP was higher in T2DM with or without macrovascular complications than that in the healthy subjects (P＜0.01), while it was higher in diabetic patients with macrovascular complications than that in diabetic patients without macrovascular complications (P＜0.01). In diabetic patients with macrovascular complications, person correlation analysis indicated that there existed positive correlations between CRP and FINS,HOMA-IR, triglyceride(TG) while stepwise linear regression showed that usCRP and HOMA-IR, TG having linear correlation. Conclusion CRP seemed to play a role in the initiation and progression of atherosclerosis in type 2 diabetes, possibly was by the way of IR.

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