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

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,usCRP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。

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

Objective To study the possible association 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 immuoturbidimetric, 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.