2型糖尿病家系成员中糖调节受损一级亲属的血清高敏C反应蛋白与胰岛素抵抗的相关性

目的探讨2型糖尿病(T2DM)家系成员中糖调节受损(IGR)一级亲属的血清高敏C反应蛋白(hs-CRP)与胰岛素抵抗(IR)的相关性。方法选择T2DM家系成员中空腹血糖受损(IFG)一级亲属(B组)34例;糖耐量减低(IGT)一级亲属(C组)89例;IGT与IFG并存的一级亲属(D组)34例;在家系成员的配偶中,选择无糖尿病家族史的正常对照130名(A组)。采用免疫比浊法测定血清hs-CRP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C组和D组的hs-CRP均显著高于A组(P值分别<0.05、0.01),D组较B组、C组显著升高(P值分别<0.05、0.01)。在一级亲属中,hs-CRP与年龄、体质指数、血压、腰臀比、腹围、餐后2h血糖、空腹胰岛素、餐后2h胰岛素、稳态模型评估IR指数、三酰甘油、低密度脂蛋白及稳态模型评估B细胞功能指数呈正相关(P值均<0.05),与高密度脂蛋白呈负相关(P<0.01)。结论T2DM患者IGR一级亲属存在与T2DM患者类似的炎性反应和IR。随着糖代谢紊乱的加重,炎性反应也逐渐加重,并且与IR密切相关。炎性反应可能在T2DM的发病中起重要作用。

Association between high-sensitive C-reactive protein and insulin resistance in the first-degree relatives with impaired glucose regulation of patients with type 2 diabetes

Objective To explore the association between high-sensitive C-reactive protein and insulin resistance in first-degree relatives with impaired glucose regulation(IGR)of patients with type 2 diabetes (T2DM).Methods Thirty-four IFG first degree relatives,89 first-degree relatives with impaired glucose tolerance(IGT),34 first-degree relatives with impaired fasting glucose(IFG) IGT and 130 normal control subjects(without diabetic family history),were included in this study.Serum hs-CRP,clinical and biochemical parameters such as blood pressure and serum lipid levels were measured,and the association between different parameters were analyzed.Results Compared to normal control subjects,serum hs-CRP levels in IGT and IFG IGT groups were significantly increased(P<0.05 and P<0.01);and the level in IFG IGT group were higher than those in the IFG and IGT group(P<0.05 and P<0.01).The serum hs-CRP level in IGR first-degree relatives was positively associated with the age,BMI,blood pressure,WHR,AC,GLU2h,INS0,INS2h,HOMA-IR, TG,LDL,and HOMA-B;and was negatively correlated with HDL.Conclusion The IGR first-degree relatives of T2DM patients also have the inflammatory reaction and insulin resistance like T2DM patients.The inflammatory reaction aggravates with the severity of glucose metabolism and is correlated with insulin resistance. Inflammatory reaction may play an important role in the pathogenesis of T2DM.