2型糖尿病家系成员血清高敏C反应蛋白水平变化及影响因素

目的 探讨2型糖尿病家系成员中血清高敏C反应蛋白(hs-CRP)水平的变化及影响因素. 方法 选择来自2型糖尿病家系的2型糖尿病患者427例,非糖尿病一级亲属377例及无糖尿病家族史的正常对照135例,用免疫比浊法测定血清hs-CRP的水平,同时测定血压、血脂等临床和生化指标,并进行各指标间的相关性分析.结果 和正常对照者相比较,2型糖尿病和非糖尿病一级亲属的hs-CRP水平明显升高(均P＜0.05),2型糖尿病患者的hs-CRP水平也明显高于非糖尿病一级亲属(P＜0.01).在2型糖尿病和非糖尿病一级亲属中,hs-CRP与体重指数、腰臀比、腹围、餐后2 h血糖、空腹及餐后2 h胰岛素水平、胰岛素抵抗指数(HOMA-IR)、甘油三酯、肌酐水平呈正相关,与高密度脂蛋白胆固醇呈负相关.非糖尿病一级亲属的hs-CRP还与收缩压、胰岛β细胞分泌功能(HOMA-β)呈正相关. 结论 非糖尿病一级亲属存在与2型糖尿病患者类似的炎症反应.随着糖代谢紊乱的加重,炎症反应也逐渐加重.炎症反应可能在2型糖尿病的发病中起重要作用.

Variation and influential factors of high sensitive C-reactive protein level in type 2 diabetic family members

Objective To explore the variation and influential factors of high sensitive C-reactive protein (hs-CRP) level in type 2 diabetic family members. Methods A total of 427 type 2 diabetic patients, 377 non-diabetic first-degree relatives of type 2 diabetics and 135 normal control subjects without diabetic family history were recruited. Serum hs-CRP, clinical and biochemical parameters were measured. The relations among indicators were analyzed. Results Compared with normal control subjects, serum hs-CRP levels in type 2 diabetics and first-degree relatives were significantly increased (both P＜0.05), and the increment was even marked in type 2 diabetics than that in first-degree relatives (P＜0.01). The serum hs-CRP levels in type 2 diabetics and first-degree relatives were positively associated with body mass index, waist-hip ratio, abdominal circumference, postgrandial 2 h plasma glucose, fasting and postgrandial 2 h serum insulin, HOMA-IR, triglyceride, creatinine and negatively correlated with high density lipoprotein-cholesterol. In first-degree relatives, serum hs-CRP level was positively associated with systolic blood pressure and HOMA-β. Conclusion As in type 2 diabetic patients, there exists inflammatory reaction in the non-diabetic first-degree relatives of type 2 diabetics, which may play an important role in the pathogenesis of type 2 diabetes mellitus.