糖调节受损患者血清超敏C反应蛋白和细胞间黏附分子-1水平的变化

目的检测空腹血糖调节受损(IFG)及糖耐量减低(IGT)人群空腹血清超敏C反应蛋白(hs-CRP)、细胞间黏附分子-1(ICAM-1)水平,探讨血清hs-CRP、ICAM-1与胰岛素抵抗(IR)之间的关系。方法选取健康对照组30例,IFG组30例,IGT组30例,IFG并IGT组30例,新发2型糖尿病组(T2DM)30例。对所有受试者空腹测血清hs-CRP、ICAM-1、血糖、甘油三酯、胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹胰岛素等(FINS)项目,应用稳态模型评估法评价胰岛素抵抗指数(HOMA-IR)。结果各试验组的FINS、空腹血糖(FBG)、HOMA-IR均高于正常对照组,差异有显著性(P<0.05);IGT组、IFG并IGT组、T2DM组的CRP、ICAM-1高于正常对照组,差异有显著性(P<0.05);CRP、ICAM-1在IFG组与正常组之间无显著性差异(P>0.05)。T2DM组的FINS、FBG、HOMA-IR、CRP、ICAM-1高于IGT组,差异有显著性(P<0.05),IFG并IGT组与IGT组比较,上述指标均无显著性差异(P>0.05)。逐步多元回归分析显示,BMI、hs-CRP、ICAM-1是影响HOMA-IR的重要危险因素。结论 (1)T2DM组、糖调节受损人群(包括IFG、IGT、IFG并IGT)存在明显的胰岛素抵抗,CRP、ICAM-1、BMI是胰岛素抵抗的危险因素;(2)随着糖耐量受损的加重,血清hs-CRP、ICAM-1水平逐渐升高;(3)糖调节受损时期即可能存在内皮功能损伤,并出现大血管病变的一些病理生理改变(如急性时相蛋白CRP,ICAM-1)。

The changes of C-reactive protein and intercellular adhesion molecule in people with impaired glucose regulation

Objective To investigate the difference levels of C-reactive protein(CRP)and intercellular adhesion molecule-1(ICAM-1)and compare the relationships between CRP or ICAM-1 and insulin resistance(IR)in subjects with impaired glucose regulation.Methods 150 subjects participated in the study,among them,30 subjects as healthy control group,30 cases with IFG,30 cases with IGT,30 cases with IFG add IGT,and 30 cases with T2DM.Overnight fasting blood samples were drawn for lipid,glucose,insulin,CRP,ICAM-1,and other biochemical measurements,IR index estimated used HOMA.The statistic analysis was performed by SPSS for 14.0.Results The levels of fasting insulin(FINS),fasting blood glucose(FBG)and HOMA-IR were higher in every experimental group than in healthy control group(P<0.05).The levels of CRP and ICAM-1 in IGT,IFG with IGT and T2DM group increased with statistical significance compared with control group(P<0.05),but there was no difference between IFG group and control group(P>0.05).The levels of FINS,FBG,HOMA-IR,CRP,ICAM-1 were higher in T2DM group than in IGT group(P<0.05),but there was no difference between IFG with IGT group and IGT group(P>0.05).Stepwise multiple linear regression analysis suggested BMI,CRP and ICAM-1 were independent risk factors of HOMA-IR.Conclusions (1)There are significant IR in IFG,IGT,IFG add IGT and T2DM groups.CRP,BMI and ICAM-1 are risk factors of HOMA-IR;(2)Significant difference of CRP,ICAM-1 in different glucose tolerant states,with the worsening of glucose tolerence,CRP,ICAM-1 concentrations are gradually increased;(3)There is not only endothelial dysfunction in impaired glucose regulation group,but also some main blood vessel pathophysical changes(acute phase response protein,CRP,ICAM-1).