C反应蛋白与胰岛素抵抗、代谢综合征的相关性研究

目的探讨血清高敏c反应蛋白（hs—CRP）水平与代谢综合征（metabolic syndrome，MS）、胰岛素抵抗的关系。方法选择408例（男207例，女201例）可疑糖尿病的门诊患者，911定其血清hs—CRP水平，同时测量体质量指数、腰围、血压、血脂、血糖及空腹胰岛素水平，计算稳态模型胰岛素抵抗指数（HOMA—IR）；根据国际糖尿病联盟的MS定义将患者分为MS组和非MS组；分析hsCRP水平与胰岛素抵抗、MS的相关性。结果MS组hs—CRP中住数18．7mg／L，明显高于非Ms组9．1mg／L（P〈0．001）；随着代谢异常个数的增加以及HOMA—IR值的增高，hs-CRP水平逐渐升高；按hs—cRP三分位分组后，随着hs—cRP的升高，血糖调节异常、高血压、血脂异常、肥胖及代谢综合征的患病率均逐渐增高（P〈0．001）；多元线性回归分析显示腰围、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、性别及年龄与血hs—CRP水平的相关系数具有统计学意义（r依次为0．32、0．17、-0．12、-0．14、0．11，P〈0．05）。结论代谢综合征、胰岛素抵抗与体内炎症反应有关，hs—CRP水平增高可以作为代谢综合征的重要标志。

Relationship of C-reactive protein to insulin resistance and metabolic syndrome

Objective To assess the association between the level of serum high sensitive C-reactive protein(hs-CRP),metabolic syndrome(MS) and insulin resistance.Methods Four hundred and eight outpatients of suspected diabetes mellitus(male 207,female 201) after medical check-up were enrolled.Their serum hs-CRP level and anthropometrical parameters,plasma glucose,lipid,fast insulin were measured,and Homeostasis model assessment of insulin resistance(HOMA-IR) was calculated.All the patients were divided into two groups: MS group(195 subjects) and non-MS group(213 subjects).The correlation of hs-CRP,insulin resistance and MS were analysed.Results The median hs-CRP in MS( 18.7 mg/L) was significantly higher than that without MS ( 9.1 mg/L)(P< 0.001 ).Hs-CRP level increased with the number of abnormal components of MS.The morbidities of abnormal glucose tolerance,dyslipidemia,hypertension,obesity and metabolic syndrome increased with hs-CRP level.The correlation coefficients between hs-CRP and waist circumstance,TG and HDL,gender and age were of statistical significance in linear regression analyses (r= 0.32 , 0.17 , -0.12 , -0.14 , 0.11 ,P< 0.05 ).Conclusion MS and insulin resistance are associated with inflammatory response,hs-CRP level can be used as an important marker of MS.