2型糖尿病患者血清超敏C反应蛋白水平与颈动脉内膜—中层厚度的关系

目的探讨2型糖尿病(T2DM)患者血清C反应蛋白(CRP)水平与颈动脉内膜-中层厚度的关系.方法对120名T2DM患者和50名健康人用颗粒增强免疫沉淀法测定超敏CRP(usCRP)及用高敏感B型超声仪测定颈动脉内膜-中膜厚度(IMT),再根据所测usCRP水平将T2DM组分为低usCRP组(0～3mg/dl)80例,高usCRP组(3～10mg/dl)40例.结果高usCRP组较低usCRP组及正常对照组颈动脉平均IMT明显增厚(P＜0.01),颈动脉斑块率也增高(P＜0.01).在T2DM组,person相关分析显示,IMT与血清usCRP水平、糖尿病病程呈正相关(r=0.53、0.282,P＜0.01、0.05);以IMT为应变量的逐步线性回归分析显示,仅变量usCRP被选入模型,usCRP的偏回归系数b为0.036,P＜0.001.结论 CRP与颈动脉IMT密切相关,提示CRP可能是导致T2DM患者早期动脉粥样硬化的一项危险因素.

The relationship between C-reactive protein and carotid intimal medial thickness in patients with type 2 diabetes mellitus

Objective To investigate the relationship between C-reactive protein (CRP) and carotid intima media thickness in patients with type 2 diabetes mellitus. Methods Serum ultrasensitive CRP (usCRP) was measured with a ultrasensitive immunoturbidimetric assay and the carotid intima to media thickness (IMT) was assessed using sensitive ultrasound B-mode in 120 patients with type 2 diabetes and 50 normal subjects. The patients with type 2 diabetes were subdivided into high usCRP group (n=40) and low usCRP group (n=80) according to the serum usCRP levels. Results Patients with an elevated usCRP (n=40) showed a significantly larger IMT (P<0.01), also the rate of atheroma plaque (P<0.05) compared with the low usCRP group and the normal controls. In type 2 diabetic patients the IMT were significantly correlated with serum usCRP levels (r=0.53, P<0.001) and the duration of diabetes mellitus (r=0.282, P<0.05) Stepwise linear regression showed that IMT was an dependent variable, and usCRP, TG, TC, the duration of diabetes were independent variables. Serum usCRP had a linear correlation with IMT, and the unstandardized coefficients of usCRP was 3.604E-02, P<0.001. Conclusion CRP were significantly correlated with carotid IMT and it was showed that CRP may be an independently risk factor of subclinical atherosclerosis.